Frequently asked questions

Direct Primary Care (DPC) Basics

What is Direct Primary Care?

Direct Primary Care, or DPC, is a model of healthcare that puts patients first by getting rid of the red tape that constrains traditional practices. How? It's simple: we don't accept insurance, and – believe it or not – this actually saves you money in the long run.



How will this save me money?

You won't have to pay a co-pay for office visits or routine physicals. Also you'll be able to avoid many visits altogether by sending your questions directly to us via email and text – something you won't get from a traditional practice. We've negotiated amazing deals for prescription medications, blood tests, X-rays, and MRI/CT scans on your behalf. If we had contracts with insurance companies, we would be legally obligated to charge higher prices. More importantly, since you are getting all this amazing care from us, you can cut way back on your insurance premiums. Most DPC patients find a high-deductible, low-premium insurance plan so they're covered in the case of a major health issue. But leave the rest of your healthcare to us.



Will I benefit from Direct Primary Care if I don't require frequent medical attention?

Of course. Everyone benefits from a service tailored directly to them. That’s why we offer truly custom healthcare. We’re here for you if you're sick or hurt, but we also help you proactively maintain good overall health. Every visit with us will be thorough, relaxed, and as long as you need to address your health concerns. The longer you're our patient, the more we learn about your health and lifestyle, and the better we can help you maintain that health.



Is this the same as "concierge medicine"?

Not quite...The terms are often mistakenly used interchangeably, but they are not the same. Both DPC and concierge practices charge a periodic fee, however, under the concierge model, this fee only gets you access; that is, it doesn't actually cover any of your care. Instead a concierge practice still bills insurance for your visits. Under DPC, your visits and other care are included in your fee, plus you're provided with other incredible benefits like wholesale pricing for labs and radiology studies, deeply discounted prescription prices, direct digital communication with your doctor, and all the rest.



Want to know more about direct primary care?

Here’s a few articles that profile the Direct Primary Care approach to medicine: FORBES: Direct Primary Care: Restoring The Doctor-Patient Relationship TIME: Medicine is About to Get Personal US News: Physicians Abandon Insurance for Blue Collar Model AARP: The Doctor Will See You But Not Your Insurance American Academy of Family Physicians: Direct Primary Care WRAL: Patients Pay Monthly Fee, Not Insurance Co-Pay to See Raleigh Physician



What if I need labs or imaging done?

We have negotiated wholesale prices with local labs. Price lists available in the clinic – no hidden fees or big bills a few weeks later!! You can also use your insurance to pay for labs and imaging. Think about your health insurance similar to car insurance. You wouldn’t submit a tiny fender bender to your insurance if your deductible wasn’t met, why submit small lab expenses?



I have a lot of health problems. Do you charge extra?

Our monthly membership fees are the same price for every patient, regardless of pre-existing conditions. Some labs, tests, and procedures may cost extra but we will negotiate wholesale pricing on these! We will manage your health problems to the extent of our practice limitations and will refer to a specialist when necessary. And if a referral is needed, we will still be your quarterback and make sure everyone will be in the loop.



What if I need to go to the hospital?

If you feel you have a life-threatening emergency, call 911 immediately. Synergize DPC does not have admitting privileges at any hospital. If you need to be hospitalized, we will work to help coordinate care during and after your hospitalization. While no one can predict when your appendix will rupture, the goal of our clinic is to minimize hospitalizations by focusing on preventative care and increasing accessibility to your doctor. Remember, you will still need insurance to cover any hospitalization.



What if the doctor goes out of town?

Dr. Sumner is always available via telemedicine and patients will be notified of any such events ahead of time. This is one of the big differences with Synergize DPC compared to a traditional practice – you will ALWAYS have access to your doctor. NOT just a nurse answering service. In the event you need to physically be seen while Dr. Sumner is unavailable, she will partner with trusted area physicians to ensure her patients receive quality care.



Membership and Benefits

So how much does membership cost?

See our prices on our pricing page. We charge a flat monthly fee, and in exchange you get unlimited office visits, wholesale prices on prescription medication, your doctor's cell phone number, and a whole lot more.



What does the membership cover?

The fee covers excellent primary care through office visits with no copay. This includes the following: annual wellness exams, sports physicals, school physicals, chronic care office visits, follow-up visits, basic office procedures and treatment of acute illness or minor injuries, all with minimal wait times in the office. The fee also covers direct communications with your doctor via phone, text, video chat or email. Our patients will also have access to discounted labs, prescriptions and special procedures not included in the membership fees.



What medical conditions do you care for?

We treat all kinds of common everyday problems like colds, flu, strep, rashes and injuries. We also treat more complicated long term medical problems like adult diabetes, high blood pressure, high cholesterol and thyroid disorder.



What happens if I need to go to the hospital or see a specialist?

For starters, having such unprecedented direct access to your doctor will prevent hospitalizations and specialty referrals in many cases. However when those types of care are required, we will certainly continue to work with your hospitalist during your hospital stay as well as work closely with any specialist. Depending on the level of care and the sorts of expertise required, we may rely on those specialized caregivers to manage your treatment.



Can children become members too?

Yes. We are happy to accept the children of our enrolled clients. See our pricing page for details.



What if I need medical attention when I'm away from home?

Of course – this sort of care is "baked in" to the DPC model. Because you'll have your doctor's email and phone number, you can reach out to us whenever you need, wherever you are. Many illnesses can be diagnosed and treated with a simple conversation. We’ll also locate the nearest pharmacy and order the medications most appropriate for your circumstances.



Are my medical records ever shared with government agencies, insurance carriers, or pharmaceutical companies?

We maintain high standards of patient privacy. We will never provide your health information to any third party unless you specifically ask that we do so.



When do I pay my fees for non-covered labs and procedures?

Charges will be added and applied to your preferred method of payment.



What if I decide to cancel?

We expect to have an open, honest, respectful relationship with you. If you have voiced a complaint that we cannot satisfy together, we will gladly allow you to terminate your membership.



Is my membership fee tax-deductible?

Unfortunately, this is somewhat unclear. You can use your HSA/FSA to pay for these services now, so please confer with your tax consultant to clarify tax consequences in your particular circumstances.



Why a monthly membership fee?

In the current healthcare system, doctors are incentivized to see as many patients as possible during the day. After all, it is a business. Your doctor is reimbursed by your insurance company (at an undisclosed negotiated rate) when they see you – and only when they see you. Often times, the doctor does not even know these negotiated rates off the top of their head. Adding a strep test, depression screen or review of lab work increases the cost of your visit – and because of deductibles and out-of-pocket costs, patients often get bills later. Having a low monthly membership fee, allows us to operate the practice on a day-to-day basis and build-in costs so you don’t receive unplanned bills. Our goal is to be transparent with our pricing and services, all while offering our patients the luxurious healthcare previously only dreamed of: extended appointments, full access to your physician (not a nurse help line), relaxing clinic atmosphere and a partner in your healthcare decisions. But if your prefer to structure your budget with one-time purchases, we also offer a yearly membership plan – and at a discount!



What if I need to go to the Emergency Room?

If you feel you have a life-threatening emergency, call 911 immediately. While we will focus on preventative care, some things may require evaluation at an emergency room as they would at any clinic.



How do I pay?

We accept all major credit cards and direct bank transfers (ACH). Membership fees are paid by the calendar month on an ongoing basis until cancellation. Payment of membership fees is required to remain an active member and receive service. ALL members must enroll for Auto-Pay of invoices with a Credit or pin-less Debit Card. Due to our low staff and low overhead business model we cannot invoice or bill membership or other fees. Memberships require NO LONG-TERM CONTRACTS or commitments. However, cancellation and re-enrollment will require a fee as noted below. Cancellation
You may cancel your membership at any time for any reason by phone, message or mail. All charges, including membership fees, will continue to accrue until notice of cancellation is given.
Please call with any other questions.



What do you NOT do?

We do not treat chronic pain or carry narcotics in our office. We also do not provide prenatal care (obstetrics). At this time, we don’t provide vaccinations but please call with any questions or it will be discussed at visits as needed.



Insurance and Payments

Do you accept insurance?

No, fortunately for both you and us. Perhaps the most critical distinction in our model of care centers on a direct, personal relationship between you and your doctor. That directness carries over to our business model as well. You might use your auto insurance to fix a smashed fender or other major damages. But you'd never use it to get an oil change (or pay for gas!). For some reason, health insurance is currently being used for the equivalent of oil changes for humans - routine physicals, office visits, simple blood tests, and minor procedures. This just doesn't make sense. We forgo insurance payments in order to save our patients from the arbitrary, intrusive decisions that come with using insurance. Charging a direct monthly fee frees us from the typical contractual agreements that prevent non-DPC physicians from offering wholesale prices on laboratory tests, imaging, and medications.



I don't have insurance - can I still join?

Yes, we take care of any patient regardless of your insurance situation. Since we work completely outside of the insurance system, none of the billing for care here is eligible for insurance reimbursement. We offer all imaging studies and labs at substantially discounted rates! This is regardless of your insurance status. We do recommend insurance though – but this is for the rare big things like surgeries, true emergencies, chronic diseases such as cancer. Think of it like car insurance – we maintain it because it’s the law and to help us pay for any major problems. We don’t use car insurance to cover your car’s routine maintenance or small problems, so why should we use health insurance like that? There’s a reason our premiums keep rising! Because all of your primary/urgent care needs are met with our low monthly membership fee – we recommend a high deductible plan or healthshare program.



As a patient, will I still need health insurance?

Yes. We recommend our patients continue a major medical plan with a high-deductible and health savings account. If you experience a major health issue, you will still need insurance to help cover it. We’re happy to refer you to insurance representatives who can help customize an insurance plan to your specific needs.



If I have Medicare, can I still join?

Yes. You need only sign a one-time waiver declaring that neither you nor your doctor will directly bill Medicare for our services. Even though Medicare will not pay us for any services you receive in our practice, your Medicare benefits will otherwise remain unchanged and can continue to be used for all other medical care received outside of our practice. Medicare will still cover any laboratory testing, imaging, medications, or hospitalizations prescribed by our offices.



How does DPC work with the Affordable Care Act/Obamacare?

As the Affordable Care Act was being drawn up, several doctors worked very diligently to insert into the health reform bill a clause that allows for Direct Primary Care practices like ours to be a legal option under the health reform bill. Once the health exchanges open in October, many people will understand that a Direct Primary Care practice is an approved option. In short, the best option for many patients will be an “exchange qualified” major medical type plan combined with a Direct Primary Care provider like our practice. This combination will save the maximum amount of money, while also allowing for a maximum amount of health care for patients. The Direct Primary Care practices have the ability to decrease the cost of insurance by 30-50%, thus eliminating the need for significant government regulation because we can make health insurance affordable again.



Is the membership fee eligible for HSA or FSA reimbursement?

Yes! A recent executive order has enabled you to use your HSA or FSA to pay for membership, imaging studies, blood tests, and any pay-as-you-go visit costs. We also recommend that you consult your attorney or accountant to discuss this issue.



Is my membership fee tax-deductible?

Unfortunately, this is somewhat unclear. You can use your HSA/FSA to pay for these services now, so please confer with your tax consultant to clarify tax consequences in your particular circumstances.



I already have health insurance. Should I join?

Perfect! Like stated above, we believe it is important to have health insurance to help cover the big expenses. If you’re worried about “paying double”, don’t forget you already do! You pay once with your premium and then again with your deductible and out-of-pocket. At Synergize DPC, we will work to save you money by minimizing total out-of-pocket expenses with our predictable monthly fee and our value-rich clinic! Or better yet, change to a high deductible plan as this will most likely bring you the best savings when pairing it with our clinic. We’re happy to refer you to insurance representatives who can help customize an insurance plan to your specific needs.



Do you work with small businesses?

Yes. We’d love to talk to your business about helping offer an affordable and ideal healthcare solution to your employees!



About Synergize DPC

Can I contact my physician after hours?

The beauty of Synergize Direct Primary Care is that our enhanced access allows you time to speak to your doctor in the middle of the day and also after-hours. We will offer after-hours communication for urgent needs and emergencies, however communication will be triaged and your doctor has 24 hours to respond appropriately. If you have a life-threatening emergency, please call 911 immediately. For non-urgent issues after-hours, please contact us by leaving a voicemail or sending an email. That’s the beauty of Synergize Direct Primary Care and having a "real-ationship" with your doctor!



Why should I choose Synergize DPC?

Synergize Direct Primary Care is the solo Family Medicine practice of Dr. Felecia Sumner. This practice was founded because we believe your healthcare should be personalized, accessible, affordable and comprehensive. We don’t accept insurance because we believe the only people involved in your healthcare should be you and your physician.Because of the nature of our practice, we are not a walk-in clinic. We are by appointment only, though that appointment could be same day. We’ve all had the sudden horrible sore throat right before leaving on a trip. Or actually been on the trip and gotten sick. Or had a kitchen mishap and needed help with the wound. Or wondered about that new weight loss drug they saw an ad for. Or not understood your doctor’s instructions, but it was too painful to get through the office lines and myriad of nurses to get an answer. The list goes on and on! In our practice, you will develop a "real-ationship" with your physician and be an active partner in your healthcare. Why wait any longer? Take control of your health today and experience a revolution in healthcare at Synergize Direct Primary Care.



How many patients do you care for?

Our enrollment is limited to 600 patients. A traditional primary care clinic maintains approximately 3,000 patients and an urgent care typically see more than 600 in a week!! By keeping our total member enrollment low, we can continue to offer unparalleled access and individualized care!



What are your office hours?

Monday through Friday we maintain general hours of 9a-5p EST and we can arrange for visits outside of these hours if appropriate.



What is "telemedicine"?

If the doctor deems you don’t need to come in, let’s avoid the hassle. Many questions can be answered without an in-person visit, so we offer texting, email, phone calls, and video-conferencing to our members at no additional fee. We also offer home and work-site visits for an additional fee.



Get Started

Sign up

Are you ready to become a member? Great! We’re excited to have you on board. Just fill out the form to get the ball rolling and we’ll be in touch.

SIGN UP

Learn More

Still want to learn more about direct primary care or our practice? Check out our FAQ page for answers to many common questions.

SEE FAQs

Get in touch

Get in touch! We’re happy to chat and answer questions, at no obligation to you.

CONTACT US