DPC and Medicare

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Do you want to hear something crazy?

No matter whether I take Medicare insurance at my new practice, or if I decide NOT to take Medicare insurance at my new practice, I cannot see anyone with Medicare until probably July!  Let me explain.

I have been a Family Practice doctor in the Williamsport PA area for more than 25 years. I have been credentialed to take insurances this whole time. But since I have changed jobs, that “credentialing” approval process has to start over. It can take 3 to 6 months (and many man hours of red tape) until I am fully credentialed to take all the insurances I want. 

So I have decided to have a DPC (Direct Primary Care) practice in which I do not bill insurance.   Medicare rules say that I must “opt out” of being a Medicare provider.  This status of being “opted out” doesn’t take effect until July 1st!    So I will not be able to provide medical care for people with Medicare insurance (even though I’m not billing their insurance) until after that date.

This is your government and the insurance companies at work.  It’s one major reason I look forward to the freedom of a DPC practice.  DPC is a membership-based model that focuses on patient care by eliminating the middleman of the insurance companies and administrators. 

If you have Medicare insurance, you can reserve a spot in my practice. We can schedule you for your first visit on July 1st or after.