Balance Primary Care is Richmond Hill’s first Direct Primary Care (DPC) practice offering a variety of healthcare needs that are accessible, convenient, affordable, and complete to give every patient quality, personalized care.

Direct Primary Care (DPC) is an innovative healthcare model where medical providers partner with their patients to provide primary care services under a flat, periodic membership fee. It is an agreement you make directly with your provider and does not use insurance claims. The patient pays a monthly fee to the medical office, and can then access care as needed, without paying an additional fee at the time of service. DPC typically covers the cost of routine screenings, management of chronic conditions, and acute-care visits.

By moving outside of the administrative burdens of the traditional insurance-based billing system, DPC practices can provide a wide spectrum of care in a transparent, affordable manner. DPC practices—now a grassroots movement numbering over 1000 nationwide—can do this while offering patients a higher level of service, communication, and relationship, than what is often found in our dysfunctional healthcare system.

Philosophically, the model is intended to restore the patient-provider relationship without the intrusion of insurance companies.

Although Direct Primary Care (DPC) and Concierge (VIP) practice models have similarities such as membership fees and small patient panels, there are some very fundamental differences.

• VIP charges significantly higher membership fees PLUS retail prices for medical services
• DPC has much lower membership fees with INCLUDED medical services

No, however, we recommend our patients have a high deductible health plan. That’s because you will lack coverage for other possible health-related expenses, such as emergency and hospital care, as well as certain prescription medications. To prevent incurring medical bills you can’t pay, DPC is typically paired with one or more of the following options:

• A high-deductible health plan (HDHP): This covers services such as surgeries or catastrophic health issues. It also covers emergency room treatment or hospitalization. An HDHP is one way to prevent financial devastation if you need emergency or extensive care.

• A health savings account (HSA): Anyone enrolled in an HDHP is eligible to contribute money to an HSA. You make contributions before income tax is deducted from your earnings. This lowers the amount of your taxable income. You can only use funds in an HSA for health-related eligible expenses, such as prescriptions, copays, deductibles, vision care, and dental care.

• Prescription coverage and/or coupons: If you have health insurance, you can continue to use the prescription plan to pay for your medications. Whether you have health insurance or not, you can use GoodRx to save on medication. Using Goodrx.com or the GoodRx app, will provide a coupon to use at participating pharmacies to save on prescription medications. Additionally, Balance Primary Care negotiates with local pharmacies to secure affordable pricing for generic medications for our members.

No. One of the fundamental components of our practice model is a DIRECT patient-provider relationship. We do not allow insurance or third-party payers to interfere with our patient interactions and determine the value of the care provided. Additionally, the DPC model removes the contractual restrictions that would normally prevent providers from offering wholesale prices on labs, imaging and other medical services. While we think you will find our negotiated wholesale prices are often cheaper for the patient than using insurance, you may still use your insurance for imaging, outside labs, specialists or medications prescribed.

All patients ages 16 and up.

In the event of an urgent medical need, you can contact us via phone call, or a direct message through the patient portal.

Yes, under this DPC model we have the ability to assess, treat and diagnose patients using a variety of telemedicine services.

Here at Balance Primary Care we DO NOT see patients for specific needs of DOT physicals, Flight physicals or any work-related injuries through workers compensation.

Yes, but you will need to sign a contract declaring that neither you nor your provider will directly bill Medicare for our services. Medicare will still cover any laboratory testing, imaging or medications prescribed by our office. Additionally, it will not affect your Medicare coverage with any of your other providers. However, Balance Primary Care will not begin taking Medicare patients until October of 2024.

Our mission is to restore healthcare to the way it SHOULD be, and we want you to be excited about being our patient. If you still have questions, please contact us at 912-445-1231 to schedule a free consultation.