What is direct primary care (DPC)?
The American Academy of Family Physicians defines DPC as an innovative model where patients typically are charged a monthly, quarterly, or annual fee (i.e., a retainer) that covers all or most primary care services. This benefits patients by providing substantial savings and a greater degree of access to, and time with, their physician. Every DPC practice can inherently be different in their structure, including pricing and services offered.
Is this concierge medicine?
Not exactly. While the two models are similar, they are not synonymous. Generally, in a concierge practice, the patient typically pays a higher retainer fee plus other health insurance plan obligations (e.g., co-pays or out-of-pocket expenses,) and the practice continues to bill the patient's insurance carrier.
What is Totoe Medical Group’s direct primary care model?
Located in Abilene, TX, Totoe Medical Group’s direct primary care is a new internal medicine experience. We provide quality personalized primary care for a low monthly membership fee. Our membership includes a yearly physical examination and doctor’s visits. It also includes labs at wholesale prices and basic office procedures.
What are the benefits of joining Totoe Medical Group’s direct primary care?
Let's start at the beginning. Whether you have amazing insurance, mediocre insurance, or no health insurance, Totoe Medical Group’s revolutionary membership model helps you achieve financial control over your healthcare.
Did you know that between 85%-90% of typical healthcare needs can be taken care of by a primary care physician? When you need to see yours, you won't have to wait weeks (or even days!) for the next open appointment. You won’t spend an hour or more in the waiting room to see a doctor for 5 minutes. We offer timely same-day/next-day appointments, and we can even come see you at your home or work — no more waiting!
Our doctors are also available by phone or via text, email, and video chat. Whether it's a quick question or you're just out of town, often your problem can be solved without even making a trip to the office.
Do you want your loved ones involved in your care? They can be!
Need longer visits to go over complex problems? Done!
Are you tired of feeling like you blinked and your doctor was already out of the exam room? Not anymore!
When you need to see the doctor, you won't be rushed or feel like you're coming back later "so they can bill you again." We can get you in and out quickly, or have extended visits depending on your needs that day.
Bottom line: Your care is always tailored to YOU and YOUR HEALTH.
To top it off, all in-office procedures are already included in your membership fee. (administered meds at cost) Labs and imaging are offered at heavily discounted prices, or you can use your HSA/flex/insurance. We are even working to get substantially discounted prices on medications!
As our practice grows, so will our in-house member benefits. In our opinion, the best part is having a physician who cares for you like a family member. Save money, save time, and receive outstanding healthcare with Totoe Medical Group.
Why monthly fees?
In our current healthcare system, doctors are incentivized to see as many patients as possible during the day. After all, a health clinic 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, the doctor might 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 the visit. Because of deductibles and out-of-pocket costs, patients often get bills later. We’ve all been victims of these unpredictable bills…it's not only stressful, but frustrating!
Having a low monthly membership fee and leaving out complicated insurance billing allows us to operate the practice on a different financial basis, building in costs for our patients so you never receive unplanned bills. Our goal is to be transparent with our pricing and services, while offering our patients a luxurious healthcare experience they’ve dreamed of: extended appointments, full access to your physician (not a nurse help line), a relaxing clinic atmosphere, and a true partner in your healthcare decisions.
How many patients do you care for?
Our enrollment is limited to 500 patients per provider. A traditional primary care clinic maintains approximately 3,000 patients, and an urgent care typically sees more than 600 patients in a week! By keeping our total member enrollment low, we can continue to offer unparalleled access and individualized care to every patient. You also have the choice of either a male or female provider depending on your preference.
Do you take insurance?
No. The only payments you’ll make for primary care are directly to our clinic for your membership fees, and discounted lab/imaging if necessary. By removing insurance carriers as the middleman, we significantly reduce costs for our office staff, since they no longer have to deal with complicated billing questions. Instead, we are able to offer our services directly to you using just our simple fee structure.
Can I still join Totoe Medical Group if I have Medicare?
Yes. You only need to sign a one-time waiver declaring that neither you nor your doctor will directly bill Medicare for our services. Medicare will still cover laboratory testing, imaging, medications, or hospitalizations ordered by our office.
What if I need labs or imaging done?
We have negotiated wholesale prices with local labs. See our example price list here, or view a full price list in the clinic. You’ll never see hidden fees or big bills a few weeks later!
Note that it is possible to use your insurance to pay for labs and imaging. To make this decision, think about your health insurance similar to car insurance. You might not submit a tiny fender bender to your insurance if your deductible wasn't met — so why worry about submitting small, affordable lab expenses?
I have a lot of health problems. Do you charge extra?
Our monthly membership fees are the same regardless of pre-existing conditions. Some labs, tests, and procedures may cost extra, but we will always negotiate wholesale pricing on these for our patients. We will manage your health problems to the extent of our practice limitations, and will refer you to a specialist if necessary. If a referral is needed, we will still act as your “healthcare quarterback,” making sure everyone is in the loop and helping you call the best plays to move your wellness forward.
What if I'm healthy and never see the doctor?
This is a great problem to have, and we’re happy to hear that! But shouldn't your doctor also focus on helping you prevent disease and maintain wellness? When was the last time you had an in-depth preventative wellness visit?
As our Abilene practice grows, we plan to continue offering more holistic wellness services including nutrition counseling, personal training, functional medicine, etc. (all included with your membership, of course!).
In the meantime, we still think you’ll find value in having a doctor on call who’s available when and where you need us. Whether you're traveling or at home here in Abilene, we're here for you! Remember, you won’t have a wait time and can expect same-day or next-day visits no matter when you call. Getting ready to travel internationally? We can use telemedicine to help solve most medical problems while you're abroad. Never again do you have to worry about finding a random urgent care or wondering about a provider's skill level. Think of our simple fee structure as a way to help cap your medical expenses, no matter where you are.
Can I use my HSA or FSA to pay for your service?
It is our position that you should be able to pay for your membership fees through your HSA or (FSA) account because the services we offer are qualified services; however, different plans have different requirements. You may want to confirm with your plan administrator.
What if I need to see a specialist?
Usually, we can make referrals like any traditional primary care doctor. This can get a little trickier if you have an HMO since they require a “gatekeeper,” but rest assured we will work with you.
At Totoe Medical Group, we allow for longer appointments to truly discuss your health issues, which sometimes results in minimizing referrals overall. If you do need to see a specialist, your membership includes e-consults with specialists through RubiconMD in an effort to decrease the need for formal referrals. This connects your doctor with a specialist in just 4 hours on average! Much better than the traditional 4-week wait, don’t you think?
What if I need to be admitted to the hospital?
If you feel you have a life-threatening emergency, call 911 immediately.
Totoe Medical Group providers do not currently make rounds at any hospital, though we do have admitting privileges. If you need to be hospitalized, we will work to help coordinate your care during and after your hospitalization. While no one can predict if your appendix will rupture, for example, our goal 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 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, there is always the possibility that some medical issues may require evaluation at an emergency room. Remember, you can always contact your primary care doctor on call and get our recommendation before deciding to visit the emergency room.
Does my membership count as health insurance under the Affordable Care Act?
No, it does not.
What if I don't have health insurance?
Totoe Medical Group does not require our patients to carry health insurance. We offer all imaging and labs at substantially discounted prices regardless of your insurance status! We still recommend that you carry insurance to cover things like surgeries, true emergencies, or chronic diseases such as cancer.
If you’re deciding whether to purchase health insurance, think of it like car insurance: we all maintain car insurance because it's the law and we’ll get help in the event of any major problems. But we don’t turn to car insurance to cover routine maintenance or small problems —so why should we use health insurance like that? Because all of our patients’ primary and urgent care needs are met with our low monthly membership fee, we usually recommend a high-deductible plan.
What if I already have health insurance?
Perfect! As mentioned above, we believe it is important to have health insurance to help cover the big expenses that could always arise. If you're worried about "paying double," don't forget that you probably already do! You pay once with your insurance premium, and then again to meet your deductible and out-of-pocket obligations.
At Totoe Medical Group, we save you money by minimizing your total out-of-pocket expenses with our predictable monthly fee and our value-rich clinic. Better yet, you can always change your insurance to a high-deductible plan, as this will most likely bring you the best savings when paired with our clinic services. If you have further questions, just ask — we're happy to help guide you to the right avenues to find appropriate plans that meet your needs.
Do you work with small businesses?
Yes. We'd love to talk about offering an affordable and ideal healthcare solution for your employees!
How do I pay?
We accept all major credit cards and direct bank transfers (ACH). You will be billed monthly for your membership. If 30 days passes without payment, a warning notice is issued. With 60 days without payment, the membership is terminated without option to renew. Please call with any other questions.
Can I cancel at any time?
Of course. You can cancel your membership anytime before your next monthly bill is due with a simple 2-week notice. If you decide to rejoin our clinic after cancellation, there is a re-enrollment fee of $250 (subject to availability and approval).
What happens when the doctor goes out of town?
Our physicians are always available via telemedicine, and patients will be notified of any such events ahead of time for your scheduling convenience. This is one of the big differences between Totoe Medical Group’s direct primary care model 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 your physician is unavailable, we will partner with trusted area physicians to ensure our patients receive quality care.
Can I reach the doctor after hours?
Of course!! We created this clinic to give you access to your own doctor when and where you need them.
Twisted your ankle playing basketball and don't know what to do? Now you know who to call!
Cut your finger while cooking dinner? Text a picture, and we'll discuss what we need to do.
Who hasn't come down to their last pill before they realized they were out of refills? Just let us know and we’ll get a prescription ordered.
There are countless examples of after-hours healthcare needs. That's the beauty of Totoe Medical Group’s direct primary care: a real relationship with your doctor when it matters most!
What do you NOT do?
We do not manage NEW CHRONIC PAIN patients. If this is part of your healthcare, we will manage your other healthcare needs and coordinate pain related care with a pain management professional. We do not carry narcotics or controlled substances in our office. At this time, we don't provide vaccinations and do not do DOT physicals. See above for information specifically on Medicare. Please call us with any other questions or discuss any specific needs with your doctor during an upcoming visit.
What are your office hours?
Our Abilene office is open during normal business hours Monday through Friday, and we can arrange for visits outside of these hours if appropriate. However, we are always available via telemedicine (see below).
Are there other types of "visits?"
If your doctor suggests that you don't need to be seen in person, you can avoid the hassle. Many questions can be answered without an in-person visit, which is why we offer text, email, phone, and video call support to our members at no additional fee. We also offer home- and work-site visits for an additional fee.