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Doctor and Patient

FREQUENTLY ASKED QUESTIONS

At Mahoning Valley Direct Primary Care, we believe in transparency and providing information to our patients. Here are some commonly asked questions and their answers. If you have any other questions, please feel free to contact us.

  • What is direct primary care?
    Direct Primary Care is affordable primary healthcare without the interference of insurance companies or other third parties. No insurance is billed for services provided. Typically, services are paid for by a monthly fee paid directly to the office. Since having a large number of staff to coordinate care with and obtain payment from the insurance companies is no longer necessary, we have lower operating costs. This savings is passed on to you, the patient. Patients get to spend more time with their physician since the doctor is not trying to see upwards of 20+ patients a day to pay for bloated operating costs. Appointments generally last from 30-60 minutes, during which time your doctor will get to know you more personally and truly become a partner in your health. With more available time, your physician is also able to be more easily accessed outside of traditional office hours. E-mail, text, and phone options are used to connect with patients 24/7. Because your doctor knows you better, care for minor issues can be handled via these means, without the need to come to the office. It's affordable, quality, accessible healthcare on your time!
  • Why choose direct primary care?
    Ask yourself the following: Do you want more time with your doctor? Are you tired of waiting days or weeks for an appointment when you call your doctor? Do you want more proactive than reactive healthcare? Do you wish your doctor was more of a partner? Do you want more access to your doctor when you need it? If you answered "yes" to any or all of these, then DPC is right for you! Furthermore, our costs are transparent. You will always know what your services cost upfront. You will not receive any surprise billing after your visit or find out that a service provided to you in the office was not covered.
  • How is direct primary care (DPC) different from "concierge medicine"?
    DPC practices do not have contracts with any insurance companies, and only accept payment at the time of service directly from the patient or in the form of monthly membership fees. In contrast, most concierge practices are contracted with insurance companies. Concierge practices will provide routine care to patients which is billed to the insurance company, but then also offer additional "premium" services for an extra fee (not payable by insurance) that may be of value to certain patients. For example, a concierge practice's fee may cover priority scheduling for appointments to decrease wait time, extended length wellness exams, or 24/7 access to the physician.
  • How much does it cost?
    There are two different ways we charge for care at Mahoning Valley Direct Primary Care. 1) monthly membership You can enroll in our monthly membership program for a cost of $80 per month per patient, payable by recurrent monthly charge on a major credit card (we accept Visa, MasterCard, and Discover). This fee covers the costs of any and all office visits that you have with us for the time you are enrolled. Also included are all the tests and procedures we perform in office (listed on our "Services" page). Appointments in the office will generally be made available for the same day or next business day from the date of request. You will also be given information on how to contact DR Bailey outside of regular office hours (email, text, phone). You may cancel your membership at any time, but we kindly request a 30-day advanced notice of cancellation. 2) pay per visit For those who believe a monthly membership is not within their budget, we still want to help you and provide quality care. As such, we also offer a pay per visit option of $60/visit. This fee covers the cost of that day's visit for consultation, evaluation and development of a treatment plan by DR Bailey. This is also payable by cash or major credit card (Visa, MasterCard, and Discover). Note that you may be recommended tests or procedures as part of your treatment plan. Some of these tests and procedures can be performed in the office (see our "Services" page). The cost of those tests will be provided on request and will always be disclosed prior to being done in the office.
  • If I currently have health insurance can I still be a patient?
    In most cases, yes. Because of the unique model of care we provide, we are unable to accept any patient who is covered in some way by a federal sponsored health plan (including, but not limited to, Medicare, Medicaid, Tricare/Champ VA, Railroad Medicare, or the VA). If you have commercial/private insurance which is not funded by any federal health care program, then we are able to accept you as a patient. Your membership will cover the cost of all care provided in the office. If you decide to pay per visit instead, that day's visit will need to be paid the day of your visit. We do not bill your insurance company for any care, and we do not perform any balance billing. Note that you may be able to obtain reimbursement for some or all of the charges associated with your visit by submitting information to your insurance company for care provided by an "out of network" physician. Check with your insurance company to determine eligibility for submission and the necessary information you need to provide to them.
  • I do not have any health insurance. Can I be a patient?
    Yes! In fact, if you do not have health insurance, you are likely to benefit the most from the cost savings that we provide compared to a traditional medical office that contracts with insurance companies. Offices that contract with insurance companies can be prohibited from charging lower fees to patients without insurance than those who have insurance. We offer the same low rates to everyone.
  • What provider will I see when I have a visit?
    You will always be evaluated and treated each and every visit by our board certified physician, Dr. Thomas Bailey.
  • Does the membership program you offer qualify as insurance?
    No. Our membership program is not insurance and does not meet federal or state requirements for qualified insurance under the Affordable Care Act. We strongly recommend patients to have insurance to cover the costs of referral to and treatment by specialists, treatment in a facility (hospital, ER, etc.), and lab and imaging studies that we deem necessary for your care.
  • What specific services do you provide?
    We offer comprehensive evaluation of all non-emergent medical conditions. We estimate that 80-90% of the care you need can be provided to you by our office. There are times when additional testing outside of the office or specialist referrals are necessary for your health. If that happens, we will work to set up the necessary test or refer you to the appropriate specialist. When doing so, we will look for the most cost-effective provider to perform those services for you. Our complete list of services include: Routine preventative care visits/physicals (excluding GYN/pelvic exams) School/work physicals (excluding Dept of Transportation physicals) Management of chronic medical problems (examples include but are not limited to high blood pressure, diabetes, congestive heart failure, coronary artery/heart disease, thyroid disorders, COPD/asthma, high cholesterol, digestive disorders, anxiety and depression) Non emergent sick visits (examples include but are not limited to upper respiratory illness, urinary tract infections, musculoskeletal injuries) Ear wash for removal of ear wax Removal of stitches/staples Trigger point injections Injections of the shoulder/knee for relief of pain from arthritis and other musculoskeletal conditions B12 injection for documented B12 deficiency Nebulizer treatment for asthma/COPD flare Injection of promethazine for nausea treatment In office lab studies Random glucose/blood sugar Urine dipstick for evaluation of urinary tract infections Urine pregnancy testing Rapid strep test Rapid flu test Rapid COVID test Fecal occult blood test to detect blood in the stool 12 lead EKG
  • What services do you not provide?
    We are unable to provide any emergency care. If you are having a medical emergency, you should call 911 or go to your nearest emergency room. We currently do not perform suturing of lacerations in the office. If you have a serious cut or laceration, you should go to the ER. We currently do not offer any blood draws or imaging studies in our office, but can certainly refer you to local centers that perform these services if your care requires it. We do not dispense any prescription medications on site. We currently do not prescribe long term opiates (Vicodin, Percocet, Oxycontin, etc) for chronic pain management or benzodiazepines (Ativan, Xanax, etc) for chronic anxiety. However, we are more than happy to evaluate these conditions. We will refer you to the appropriate specialist to assist in the care of these conditions if it is necessary to be maintained on such medications.
  • What is your "Good Faith Estimate" policy?
    Per the "No Surprises Act" that took effect January 1, 2022, if you aren’t using health insurance to pay for your care, your health care provider must give you a good faith estimate of expected charges if you request one or schedule services at least 3 business days in advance. You may download the "Good Faith Estimate" policy here.
  • What is your office's HIPAA policy?
    Our HIPAA policy can be downloaded here:
  • Have a different question?
    We are here to help answer any additional questions you don't see an answer to in our FAQ section. Feel free to call us directly at 330-953-3250 or email our board certified physician at tbaileymd@mahoningvalleydpc.com. We hope to be a partner in your health journey!
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