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 Pay-Per-Visit option is best suited for:

1.  "In Network" commercially insured patients with moderate to high deductibles
2.  "Out of Network" commercially insured patients with moderate to high deductibles
3.  Patients who are members of a Healthcare Sharing Ministry, aka Ministerial Plan
4.  Uninsured

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 but can become patients of Priority Medical Partners, SC.  Please visit Direct Pay FAQ section for more information.

Priority Medical Partners Direct 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.

Priority Medical Partners Direct Child and Adolescent Services

Adolescent Patient Services (Ages 12-17) - PMPdirect will provide services to 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 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.

Elementary School Age PatientServices (Ages 6-11) - PMPdirect will provide “walk-in-clinic” type services to elementary school age members.  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, pink eye, ear infections, 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.

Pay-Per-Visit Office Visit, Procedure, and Lab Fee Schedule

Level 1 Office Visit:  $80/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)
Level 3 visit (31-45 min)  $180
Level 4 visit (46-60 min)  $240

 

pay-per-visit discounted procedure fees

*procedure fees are in addition to office visit fees
**will require lab/pathology review if tissue sent for analysis

$130    **Incise and drain abscess
$110      Remove foreign body from skin
$80      Paring a callus
$120    **Skin "punch" biopsy
$80      Removing skin tag (+$10/ea additional tag)
$150     Removal ingrown toenail
$120   **Shave removal skin lesion (no sutures)
$180   **Excise skin lesion (with sutures)
$80      Evacuation of blood beneath nail surface
$100     Laceration repair, per suture
$50       Cryo destruction lesion, per lesion
$150   **Aspirate fluid from joint space or bursa
$170     Injection joint/bursa with steroid
$170     Injection of Tendon Sheath
$100    Electrocardiogram + interpretion
$20     Pulse Oximetry (blood oxygen level)  
$200  Casting
$150   Splinting
$40    Ear wax removal, lavage (+$60 w instrument)
$40     Nebulizer (Albuterol) treatment

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

Note: All pricing and fees are subject to change based on market availability.

Practice Brochure - contains a concise summary of our healthcare services.  Please feel free to print, email, and/or send to family and friends who may be interested in our services.

 

Level 2 Office Visit:  $120/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 lab fees

$35      BMP
$36      CMP
$34      CBC
$39      Hemoglobin A1C (HgA1C)
$42      Lipid Panel
$57      Lyme Disease Screen
$37      PT with INR
$42     Prostate Specific Antigen (PSA)
$35     Renal (Kidney) Function Panel
$36     Sedimentation Rate (ESR)
$38     Thyroid Stimulating Hormone (TSH)
$34  Uric Acid
$36     Urinalysis with Reflex to Culture
$39     Vitamin B12
$62     Vitamin D 25 Hydroxy (Vitamin D Level)
$44     Free T3
$38     Free T4
$66     Testosterone (Free and Total)
$46     Urine Microalbumin with Creatinine
$35     Rapid Strep
$43     Throat Cuture

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

Note: 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.

Note: All pricing and fees are subject to change based on market availability.

 

Intrusive Administrative Third-Party Paperwork (IATPP):  This includes, but is not limited to, prior authorizations for medication approval and for procedures.  IATPP utilizes Practice staff, consumes valuable Practice resources and diverts staff from Patient care. 

$40    0-15 min spent processing IATPP
$80    16-30 min spent processing IATPP
$120    31-45 min spent processing IATPP
$160    46-60 min spent processing IATPP
+ $40/each additional 15 min of IATPP