Insurance Information

Direct Pay Specialty Care is an insurance free care model. We do not accept or bill insurance. I receive payment directly from the patient, so there are no administrative issues that interfere with the doctor-patient relationship. My only loyalty and duty is to you, the patient. There are no added costs or time associated with insurance coding and billing and many other tasks that come with accepting insurance.

The fee structure for follow up appointments is typically a monthly membership; however, many specialty practices also offer fee for service options as well. In the direct pay membership model, access to your physician is included in the membership fee as part of a comprehensive package of services. There are no co-pays, and your insurance is not billed for those services. You can use “Reimbursify” online on by an APP to submit claims to your insurance for reimbursement.


Why would I choose membership over the fee for service payment?

We offer both membership and a fee for service model. The first visit is fee for service. At that time you will have the choice to continue as fee for service or convert to a membership plan. In the fee for service model, you pay by credit card as a single payment each time you come for a visit. This is appropriate for patients who may need only a single consultation or infrequent follow up.

How is this affordable? How can some people save money in this model?

Patients who have insurance with copays, deductibles, coinsurance, and high out-of-pocket maximums can save money in a direct pay care membership model where the fees tend to be lower.  It may be hard to predict, as the visit fees charged by in-network practices/hospitals for doctor’s visits are often not transparent, and patients are unaware of the charge and their cost until the bill arrives.

An indirect way in which families save money with direct pay care is through time saved. Time waiting on phones, time in waiting rooms, time staying up at night worrying, time sorting out questions, time finding parking, etc.

Will insurance reimburse any of the fees?

This depends on your insurance plan’s out-of-network benefits (individual, family deductible, coinsurance, out of pocket maximum), the insurance’s “allowed fee” for the visit, and how much you have already submitted for out of network reimbursement in the plan period. We cannot guarantee that your insurance will reimburse you. 

You can also use the Reimbursify APP to directly submit to your insurance for reimbursement. Just ask me for an invoice and take a picture of it or upload it to the app with your insurance information.

https://reimbursify.com/individual-page/

If you don’t take insurance, can you still write prescriptions?

Coverage for prescriptions depends on your insurance policy. Therefore, what you pay for prescriptions is determined by your benefit plan.

What about prescription refills?

Follow up visits within the recommended time frame are necessary for prescription refills. Prescriptions will be sent to your pharmacy through e-prescribing. Anyone for whom, I prescribe medication for is encouraged to participate in the membership model. Prescriptions will be processed by insurance.

Can I do televisits?

Yes. This is the primary method of the visit for most patients. Patients receiving care through telemedicine must have residency in, or physically be in, a state in which I am licensed to practice medicine: VA, MD, FL and Iowa.  In office visits are sometimes necessary for a physical exam.

Do you offer in-office blood draws?

I am not offering in-office blood draws currently due to cost. I will, however, write prescriptions for bloodwork which you can take to your preferred blood drawing center. It is important that you state you would like the fee to be sent through your insurance. 

What about a patient portal or app? 

I am using a new Electronic Medical Record system called “Elation” that is specifically set up for improved communication between patients and physicians in direct-pay care practices. Text and emails can easily be entered and assigned to patients’ charts if appropriate. It allows for attachments and photos as well. Some features are still in development.

We also use the Spruce APP which is a HIPAA compliant text messaging and phone system that allows patients to directly message me or any staff. We ask that you download the Spruce APP (Free) on your phone if you sign up for a memebership. This APP will better protect your medical information and allow for Direct communication with the clinic.

What happens if I need to go to the hospital or see another specialist?

We can coordinate with your primary care physician and any specialist. If you are admitted to the hospital, the in-house physicians will care for you and Dr. Mehra will be available for consultation. 

Why did you open The Mehra Clinic?

After working in both academic medical centers and private practice settings as well as working in industry and corporate medicine, I decided that I really wanted to provide care to my patients in a more meaningful way. During the COVID-19 pandemic, I became very well experienced in providing care for patients with PCOS and diabetes through telemedicine. I wanted patients and their parents to continue to have flexibility with scheduling around my patients and around my family. I wanted to utilize short wait times, immediate access by patients to their results and I wanted to have more time to communicate with primary care providers and develop a ‘medical home’ for patients with chronic conditions like Diabetes, PCOS, irregular menstrual cycles, concerns about weight, growth and thyroid disease. I also wanted to provide a safe space for teens and young adults to get medical care. I researched several care delivery models and thought that I wanted to focus more on educating families about their conditions and helping them learn how to self manage.

I want spend more time on patient care than on billing systems and data gathering. I am not alone. Direct pay specialty care and direct primary care are growing rapidly in the United States as physicians and patients become more frustrated with the state of medicine.

How do I enroll and make an appointment?

I am still open to enrolling new patients. If you are interested in enrolling your child to be seen, please send me an email to make sure that it is appropriate for me to see your child and if so, I will direct you to the enrollment link. The Fee Schedule is also on this website.

Will I have to pay out of pocket for x-rays and labs?

These will be processed through your insurance.

What type of conditions do you treat?

 I see patients with endocrine related conditions such as growth problems, diabetes, thyroid disease, early or late puberty, PCOS, weight issues, insulin resistance and menstrual irregularities. I am licensed to see patients ages newborn through 21 years. 

Do you evaluate children for their height and growth?

I am seeing patients for concerns about growth. A big part of the evaluation of growth is making a diagnosis. Often, parents want to make sure that a diagnosis is not missed, or that the treatment their child is receiving makes sense.  If growth hormone testing is required, I am utilizing the Inova Sedation Unit for Growth Hormone Stimulation testing.

Many children have reasons other than growth hormone deficiency for growth concerns, and I am happy to discuss these other reasons and prescribe alternative therapy if indicated.

Where do you see patients?

l continue to see patients by televisit, or in my office in Vienna, VA or a hybrid of the two. 

If you have any further questions, please do not hesitate to call.