What is direct primary care?

Direct primary care is a membership-based primary care relationship in which the patient’s family pays a monthly subscription fee for care. Insurance is not billed in this model of care. In my practice the single monthly fee covers all visits and most associated costs as well as any communication outside of a visit.

Do you accept insurance?

No. It is still important for you to maintain basic insurance coverage though for emergency needs and for coverage of immunizations, labs, imaging, and care provided by specialty providers.

Do I still need insurance?

I would recommend you maintain at least basic coverage. This will ensure you are covered for emergency needs above a level that I can handle and for coverage of immunizations, medications, labs, imaging, and care provided by specialty providers.

Where do visits happen?

My goal is to provide the majority of your child’s scheduled care in your home, both for your convenience and because home is typically the most comfortable and safe space for them. I have a full function home office as well. For families who do not want home visits I will see you at my house. If you need a sick visit at a time when I cannot come to you, you can come to me or I will see you virtually.

What if I don’t live in Charlottesville?

I will do home visits at no added charge if you are within 15 miles of my address. If you live further away I can still come to you but there will be an additional monthly fee of $50 to account for travel time. You are also welcome to come to me for care at no additional cost.

What will we do when you are away?

I do go out of town, but you will still be able to reach me by phone, text, and email when I am away. There is a lot we can accomplish by telehealth. If you ever need a visit with an in-person provider while I am away, I have coverage arrangements with other local providers. My goal is to keep you out of urgent care and the emergency department if at all possible, though those resources remain an option if ever needed.

What ages do you see?

Birth through age 20. I do not accept new primary care patients over the age of 18, but I will continue to follow existing patients until age 21.

What about lab tests, imaging studies, and referrals?

I am able to process some lab tests in house at no additional charge for subscribers. This includes point of care tests like rapid strep, flu, COVID, and RSV testing as well as urinalysis, blood glucose, and hemoglobin. Tests that need to be processed through a traditional lab can be ordered through UVA, LabCorp, Sentara, or Quest and billed through insurance. Imaging studies can be ordered through UVA or Sentara. I have a list of cash prices for labs and imaging, or these can be billed through your insurance. I can place referrals for specialty evaluations as any traditional practice would do.

Will you be able to give my child vaccines?

Yes. All standard vaccines are available to be given at well child checks. I use a company called Vaxcare, which bills your insurance for vaccines. We can check eligibility with Vaxcare to make sure they participate with your insurance.

Do you require vaccination in your practice?

Yes. I am more than willing to work with families who are interested in following a non-traditional vaccine schedule. If you have no plans to vaccinate at any point, I am not the right doc for you!

How do monthly payments work?

You can pay subscription fees via credit card or bank account number. Payment will go through Hint, which is also my electronic medical record. There are discounts for multiple children and a cap for families at $350. I can provide a superbill that you can submit to your insurance as an out of network provider to attempt to make a claim, but it is insurance-dependent what reimbursement would look like. You may use HSA or FSA as a way to pay for your monthly fees.

What if we can’t afford your prices?

Reach out, and we can discuss. I am doing a self-determined sliding scale, so if it is a good fit on both sides I will absolutely work with you on pricing.

What languages do you speak?

Sadly, only English. I have extensive experience using interpreters to communicate with families who are non-English speaking. Communication is critical, and I am happy to explore interpretation options with any families who need it.

I have Medicaid. Can I join?

Possibly, but it would be important for you to maintain a relationship with a traditional practice that accepts your insurance. Medicaid requires providers to be “Medicaid Enrolled” to order medications, imaging, lab work, and referrals.

How do I enroll?

Complete any of the contact forms on this site or email me at drsuepeds@gmail.com and we will set up a time to meet virtually. We can do this with or without your child present, per your preference. If it feels like a good fit once we meet, I will get you enrolled and we will set up an initial visit.

What if I need to cancel?

Just let me know and I will cancel your membership! I do request 30 days notice if at all possible. If you decide to re-enroll at a later date you do have to pay the $100 enrollment fee again.