Pay-Per-Visit (PPV) Option

 

Choosing this option means that you will pay our direct pay practice,  Priority Medical Partners Direct, SC ("PMPdirect"),  in full at the end of each visit for the services that were provided to you by your physician.  Paying us directly bypasses the insurance billing process and effectively reduces our operating costs allowing us to pass this cost savings on to you by charging you lower prices which are much less than the charges that would typically accrue in an insurance based system for similar services.

The PPV option operates in similar fashion to the insurance option where you pay for services only when you receive services. The PPV option differs from the insurance option because the patient pays the doctor directly at the time of service to receive care at prices approximately 50% less than what would have been paid using the insurance option instead of the practice billing your insurance for the services you receive.

PPV option differs from the DPC option because there is a charge for every service (such as office visits, telephone or virtual visits/consultations, procedures, and paperwork generated by pharmacies and your insurance company that your doctor fills out on your behalf) whereas these services are included in your DPC membership.

The Pay-Per-Visit option is best suited for:

1.  Insured patients with moderate to high deductibles
2.  Patients who are members of a Healthcare Sharing Ministry, aka Ministerial Plan
3.  Patients with no insurance

 

HOW PATIENTS BENEFIT FROM OUR pay-per-visit MODEL

1.  Primary care is "routine" care.  Routine care can be affordable when patients pay their doctors directly and when administrative overhead is minimized.  Patients who pay us directly reduce our overhead and we pass that cost savings back to our patients by charging them MUCH less.
2.  Your doctor will spend less time on paperwork and more time taking care of you.
3.  Since the vast majority of patients will never reach their deductible (even when paying higher insurance based rates in traditional insurance based practices) it makes sense for patients to pay their doctor directly (at a much lower "uninflated" rate) greatly minimizing patient out of pocket costs. 
4.  NO Co-pays! -  We are not contracted with insurance and you are not paying using insurance!

 

Who can participate?

  • Adult Patients ages 18-64

  • Adolescent Services (Ages 12-17) - see below

  • Elementary School Age Services (Ages 6-11) - see below

*Patients under 18 years of age require a permission slip or the presence of at least one parent or legal guardian.  If a parent wants to be appraised of or involved in the medical decision making, they must be present at the visit.

Note: Patients enrolled in Medicare or who are eligible for Medicare cannot belong to Priority Medical Partners Direct, SC (PMPdirect) due to federal regulations.

 

Adult Internal Medicine Services

Preventative Exams (male and female complete screening exams including Pap and pelvics)

Treatment of Chronic Conditions (e.g., diabetes, heart disease, kidney disease, hypertension, thyroid disease, gastrointestinal disease, lung disease, common muscle and joint disorders, etc.)

Treatment of Acute Conditions (e.g., cough, colds, flu, sore throats, muscle strains and sprains, headaches, rashes, tick bites, pneumonia, bronchitis, sinusitis, urinary tract infections, etc.)

Minor Procedures (e.g., repair of most lacerations, removal of skin tags, removal of skin lesions, removal of
ingrown nails/toenails, removal of fish hooks and slivers, soft tissue injections, joint "cortisone" injections and aspirations, diabetic nail trimming, drainage soft tissue abscesses, skin cryotherapy treatments for warts and other skin conditions, etc.)

Office Labs and Diagnostics
In House Labs and Diagnostics include digital ECG, urine dipstick, blood pulse oxygen testing, rapid strep testing)
We draw blood for all other laboratory studies which will processed by an outside facility.

*Patients in need of additional services (Xrays, MRI, Ultrasound, CT, Stress Tests, or Specialty Physician services etc.) will be referred for such services.

 

Child and Adolescent Services

Child and Adolescent Patient Services (Ages 6-17) - PMPdirect will provide services to children and adolescent age members for “walk-in-clinic” type services and physical wellness exams.  Typical walk-in services include, but are not limited to: coughs, colds, sinus infections, sore throats, abrasions, strains, sprains, simple fracture management, injuries, school athletic physicals, urinary tract infections, lacerations, skin lesions and rashes, asthma attacks, burns, heartburn, pink eye, ear infections, etc.)  PMPdirect physicians will, on a case by case basis, manage certain common chronic child and adolescent conditions (such as asthma, acid reflux disease, seasonal allergies, etc.) but will defer the management of complex medical conditions (such as seizures, developmental and behavioral disorders, significant congenital defects, etc.) to a pediatric specialist.

Office Labs and Diagnostics
In House Labs and Diagnostics include digital ECG, urine dipstick, blood pulse oxygen testing, rapid strep testing)
We draw blood for all other laboratory studies which will processed by an outside facility.

*Patients in need of additional services (Xrays, MRI, Ultrasound, CT, Stress Tests, or Specialty Physician services etc.) will be referred for such services.

 

Pay-Per-Visit Office Visit FEES

Level 1 Office Visit:  $105/visit (NO Copay!)
Typically 15 minute visit
Single, Low Complex Medical Conditions
Typical examples:

  • Cold/Sinus

  • Bronchitis

  • Bladder/Urinary Tract Infections

  • Sore Throat

  • Ear Infection

  • Tick and Insect Bites

  • Minor Headache

  • Skin Rashes

  • Sport/Camp Physicals

  • Sprain/Strain Evaluation (splint & casts extra)

  • Laceration Evaluation (repair extra)

  • Skin Lesion Evaluation (treatment extra)

  • Joint/Bursa Evaluation (aspirate/inject extra)

  • Single Problem f/u from Level 2 Visit


 

Extended Visits (if needed) (NO Copay!)
Level 3 visit (31-45 min)  $225
Level 4 visit (46-60 min)  $300

 

 

Level 2 Office Visit:  $170/visit (NO Copay!)
Typically 30 minute visit
Multiple Low Complex Medical Conditions
Single More Serious Complex Medical Condition
Multiple Stable Chronic Conditions with med refills
Adult Preventative Examination
Consultations from Outside Providers
*Multiple = reasonable # of conditions that can safely and effectively be managed within a 30 minute visit
Typical examples:

  • Diabetes Management

  • Thyroid Managment

  • Heart Disease Management

  • Lung Disease Management

  • Kidney Disease Management

  • Hypertension Management

  • Gastrointestinal Disease Management

  • Rheumatological Disease Management

  • Abdominal Pain

  • Pelvic Pain

  • Severe Headache

  • Pneumonia

  • Chest Pain

  • Multiple "Aches and Pains" or "Just don't feel well"

 

Pay-Per-Visit Discounted Procedure Fees

$285        Incise and drain abscess
$225       Remove foreign body from skin, simple
$120       Paring a callus
$275       Skin "punch" biopsy
$25         Removing skin tag, each
$260       Removal ingrown nail
$235       Shave removal skin lesion (<0.6cm)
$300       Excision of skin lesion with closure (<0.6cm)
$125       Evacuation of blood beneath nail surface
$200       Laceration repair (+ $100/ea additional suture)
$50         Destruct skin lesion, per lesion
$235       Aspiration of fluid from joint space or bursa
$270       Injection joint/bursa/tendon sheath w steroid
$105       Electrocardiogram (with interpretation)
$10         Pulse Oximetry
$300       Casting
$260       Splinting
$50         Ear wax removal, lavage

This list is not comprehensive.  Pay-Per-Visit patients receive discounted pricing on ALL procedures performed in our office.

Note: All pricing and fees are subject to change.

 

Pay-Per-Visit Lab Fees

$45    CMP
$49    Hemoglobin A1C (HgA1C)
$52    Lipid Panel
$73  Lyme Disease Screen
$52    Hepatitis C Antibody Screen
$52    Prostate Specific Antigen (PSA)
$47    Thyroid Stimulating Hormone (TSH)
$49    Vitamin B12
$75    Vitamin D
$69    Testosterone, Total
$45    Rapid Strep
$89    Chlamydia trachomatis/Neisseria gonorrhoeae
$62    Estradiol
$67    FSH and LH
$120  Hepatitis Panel
$79    Pap (cytology)
$175  Pap and HPV

  This list is not comprehensive.  Pay-Per-Visit patients will receive PPV pricing on ALL labs drawn in our office.

Some tests may require additional "reflex or confirmatory testing" which will lead to additional charges.  Practice will invoice Patient for the fee associated with “reflex” testing as soon the Practice becomes aware that a “reflex test” was performed.

All pricing and fees are subject to change.

Pay-Per-Visit FEES FOR “ON-SITE” RADIOLOGY SERVICES

$180 X-ray
$450       Ultrasound
$650 Echocardiogram (Transthoracic)

On-site radiology fees reflect bundled pricing and include the cost to perform the test and the cost for the radiologist to review and report the results of the test.

All pricing and fees are subject to change.