Frequently Asked Questions
Direct Care is a model of healthcare where the patient pays the physician directly for their medical services. It often includes an inexpensive monthly membership fee in exchange for personalized care with the physician, relaxed appointments, and access to affordable medications and lab work. It prioritizes the patient by removing the “middleman,” the insurance company, from the doctor-patient relationship. As insurance corporation profits continue to rise, payments to medical providers for their services have declined and sometimes get denied. Instead of spending time fighting insurance companies for payment, the physician can spend that time providing direct care to their patients. Knowing that the physician isn’t trying to please an overseer, patients have increased trust in the care they receive. Getting back to direct physician-patient care and removing the bureaucratic middle-men is one way we can start to revolutionize our healthcare system.
No, we are not in network with any insurance plans and we do not bill insurance for any services provided. We will see anyone regardless of insurance coverage or lack thereof (except for Traditional Medicare patients).
No, we are not able to see Traditional Medicare patients but are able to Medicaid patients, but do not submit any billing to Medicaid.
Unfortunately, Federal laws restrict the ability for Traditional Medicare patients from seeing the Providers of their choice, even if the patient is willing to pay cash for the visit. Original Medicare (CMS) penalizes physicians if they elect to enter into a private-contract relationship with patients on Medicare. We apologize for this. We think this is absurd and very unfortunate that our government has such regulation over the patient-physician relationship.
We ARE able to see Medicare Advantage patients as an out of network provider. Additionally, please be aware that although Kentucky and Ohio Medicaid patients can be seen, it is unlikely that these patients will get any reimbursement for the medical services rendered.
Maybe. Depending on your insurance plan’s out-of-network coverage, you may be able to submit your visit Superbill receipt with ICD-10 codes (be sure to request one). It’s advisable to call your insurance company to determine your eligibility and requirements.
“Membership fees” in this practice are actually a type of payment plan for medical visits and the additional medical services provided. So, one may use HSA/FSA funds that cover medical services (but check with your specific plan/ accountant). After each visit, a Superbill for services rendered with receipt of payments (Membership fees paid to date for that visit) can be provided upon request. You may then seek reimbursement from your HSA, FSA, or insurance, following the rules of your insurance plan.
While we do not submit these claims for you, we have partnered with Reimbursify for you to easily submit your claims for out-of-network health insurance reimbursement from your smartphone. In just minutes, you can submit your claim to your insurance company. “Say goodbye to claim forms, snail mail and phone calls.” Download the app and get your first claim free.:
Ultimately, it is because Dr. DiChiara wants to spend more time with her patients. Billing insurance requires more time spent on documentation and extra staffing, which increases the overhead costs to run a practice. In order to keep up with these costs, the doctor must see more patients in a shorter period of time each day. Instead of short, 7-minutes of face-to-face time with the patient, this membership model allows Dr. DiChiara to have 30-60 minute visits with her patients. Instead of having patient panels of 2,000 to 3,000, she can dedicate more time to a panel of 200-300 patients. Personalized, higher quality care can be provided, increasing the satisfaction of both patient and physician.
Additionally, Dr. DiChiara has become disillusioned with big-medicine and healthcare corporatism. Instead of being beholden to arbitrary mandates and checklists of insurance companies and corporate administrators, Dr. DiChiara is free to provide personalized care that is in the best interest of her patients. Therefore, she no longer participates in any health insurance networks. She wants to answer to you, her patient, and you alone.
Unlike traditional medicine that usually treats the symptoms or helps to manage and control disease, Functional Medicine seeks to address the source of disease further “up-stream.” Functional Medicine is medicine that gets to the root-causes of disease. It seeks to find biological causes for why and how disease develops and attempts to restore health by addressing the underlying causes for each individual. Integrative Medicine looks at the person as a whole–their physical, mental, emotional, and spiritual well-being, and may use different modalities to optimize health. Dr. DiChiara uses detailed history-taking, assessment of lifestyle and habits, advanced diagnostic testing, analysis of other contributing factors, and evidence-based scientific principles to create a personalized treatment plan. This plan will incorporate a variety of different means to restore balance and function which may include nutritional supplements, medications, nutrition, lifestyle modifications, coaching, and more to allow patients to LiveWell.
No. As a consultant, Dr. DiChiara requires that all her patients retain a primary care provider as we do not provide urgent/same day care. Healthcare is a team effort, and as a functional gastroenterologist, Dr. DiChiara serves in different roles on this team. Her aim is to help you reach your health goals through gut-healing. Since also Board-certified in Internal Medicine and the understanding the interconnectedness of all the body’s systems, Dr. DiChiara will often address other general concerns such as cardiovascular health, hormone (including thyroid) health, autoimmune disease, insulin resistance and diabetes, inflammatory conditions, and general vitality. In having a whole body-system approach and in restoring their gut health, patients often find that there are improvements in other areas of their health that go beyond the gut. If permitted, Dr. DiChiara will communicate her findings and recommendations to your primary care provider to provide seamless continuity of care.
Yes, for any patients wanting to be seen beyond just the 1st visit, you must become a member of this practice. The first New Consult visit is needed by everyone. If, however, *during* that visit the patient expresses an interest for only a one-time consultation visit with the plan to follow back up with their primary care provider to continue treatment recommendations, then a membership will not be started.
Most people coming to LiveWell Gastroenterology are looking to establish care with a gastroenterologist and want to be seen more than just 1 visit. In that case, enrolling in a membership is necessary to be seen.
For those with bothersome symptoms or those who are ready to take a deep-dive into the root cause of their underlying health concerns then either the Standard or Premium Membership would be what you are looking for. The MSQ (multisymptom questionnaire) score will help differentiate which membership level would be most appropriate (Standard MSQ 40-70; Premium MSQ >70). After achieving your initial health goals, you can then easily switch to the Basic membership for maintenance. *Most new patients entering this practice qualify for the Standard or Premium membership plan.*
For some, they may feel like their GI concerns are doing well and under control with their current medications, but they want Dr. DiChiara to be the physician to oversee their GI care throughout the year, do intermittent lab monitoring, and continue their medication. The Basic Membership would be a good fit. Basic members (as well as Standard & Premium members) have easy access to a gastrointestinal (GI) specialist throughout the year as well as access to wholesale medications and labs, discounts on supplements, semimonthly Gut Chats and group visits with live Q&A. And, if their symptoms flare or new issues arise, they can easily switch to the Standard or Premium membership option for closer care.
LiveWell Gastroenterology is currently a predominately Telemedicine practice, although in-person procedures (ie: colonoscopy and upper endoscopy) can be arranged in particular locations. This will continue to evolve as this practice expands.
Dr. DiChiara is licensed to practice medicine in the states of Ohio and Kentucky and can only see patients who reside here or who are currently in these states at the time of the telemedicine visit.
We are out of network for all insurances and do not process insurance. We can provide you a bill and receipt of your visit of which you can submit to your insurance for reimbursement at the out-of-network rate. Read more in our FAQ.
We are unable to see Traditional Medicare patients at this time. We can see Medicaid patients, but do not process claims. Read more in our FAQ.
A credit card is required to be on file in order to schedule your appointment and will be charged the day of your appointment and charged for monthly membership fee. If you cancel less than 24 hours prior to your new-patient visit or no-show, you will be charged for that visit.
We ask you to complete your pre-visit questionnaires prior to scheduling your 1st appointment. We want you to get the most out of your time with Dr. DiChiara. This will also include obtaining outside pertinent records to review. For your convenience, our office can initiate this record request if you complete the Authorization to Release Medical Records form(s) located in Questionnaires section in your Patient Portal.