FAQs Page

It is recommended if at all possible that patients elect into some type of health insurance plan that makes sense for each personal life situation, especially to aid in covering catastrophic or emergency events and additionally any other external medical services desired/needed under insurance coverage rather than self-pay. Potential examples include but are not limited to: specialist care, surgery, screenings, medications, labs, and care related to chronic conditions. 

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If you are under a health insurance plan you want to use, it is strongly advised that you verify  that there are no restrictions significant to you against coverage of ordering, prescribing, and referring for external services and for medications by out-of-network healthcare providers, as we are not involved in insurance coverage decisions for any medical services that occur outside of our practice.

Insurance Billing and Participation:

Our practice cherishes the ability to provide healthcare independently of insurance as a self-pay, direct care medical practice. We do not participate with, nor bill insurance. Reimbursement is not permitted for membership fees nor services covered under membership. 

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If you have insurance it may provide coverage within the scope of the policy via our orders for labs, studies, medications, referrals, and other services provided outside of our practice, though we have no relationship with nor can we guarantee what your policy covers. 

Reimbursement Claims: 

If you are interested in submitting non-occupational/non-recreational health/non-monthly membership services for insurance reimbursement or utilizing your existing HSA/FSA account, please check with your insurance carrier to discuss acceptable options prior to requesting a super-bill. ​​​Reimbursement by out-of-network care is not permitted by Medicaid, Medicare, TRICARE, or other similar government-sponsored health coverage program.​

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Work Injuries: 

We are able to accept referrals to Dr. Marshall for osteopathic manipulative treatment (OMT) for L&I-covered workers injuries and can bill L&I. We are unable to serve as the primary attending on work injury cases. 

Yes, absolutely! As life goes, it is usually full of surprises, including little ones, and in the health department this is no exception. Maybe you are someone who is visiting WA State temporarily for only a few months or so and therefore not eligible for your in-network nor local insurance. Perhaps you are in the position of being uninsured. 

It is wise to have a physician “in your back pocket” who understands who you are and is ready to care for you. Why not choose that physician to be a direct primary care physician who can make that attainable and be able to spend more personable time improving their skills and addressing health maintenance needs? 

We do still recommend that you secure appropriate additional coverage for protection in the case of unexpected medical expenses due to emergency and special needs events. 

Yes! We are able to see Medicare, Medicaid or other government-sponsored health coverage program enrolled patients, as long as it is agreed upon that any service delivered directly by our practice cannot be billed or submitted for reimbursement/payment by you as the patient or by us as the service provider. Any service that is NOT directly delivered by the practice our patients can still submit for reimbursement as they would normally cover (such as labs or imaging done elsewhere that participates with Medicaid, or medications at an outside pharmacy that participates with Medicaid).

Yes! We cannot participate with TRICARE in our practice, however, we are able to see TRICARE enrolled patients, as long as it is mutually agreed upon that any service delivered directly by our practice cannot be billed or submitted for TRICARE reimbursement/payment by you as the patient or by us as the service provider. Any service that is NOT directly delivered by the practice our patients can still take to TRICARE for reimbursement as they would normally cover (such as labs or imaging done elsewhere that participates with TRICARE, or medications at an outside pharmacy that participates with TRICARE). 

Dr. Marshall is now able to offer L&I-covered osteopathic manipulative treatment (OMT) only, by referral. The practice is not set up to serve as primary attending on workers' injuries cases, even for members, and does not accept transfers for this. 

The Problems:

Traditional healthcare models are burdened by:

• High costs, inflated costs, and hidden fees.

• Limited access to direct patient-physician interaction.

• Non-medical, administrative opinions that do not guarantee a priority of the interests of patient health and safety first.

• Overextended healthcare providers that lead to long wait times and rushed appointments.

• Healthcare providers who may be out of scope of care.

• Delayed care due to insurance and administrative hurdles, which also often compromises quality.

Our Solutions: 

The DPC and DSC models allow us to eliminate these obstacles by:

• A direct care model that prioritizes quality of your health over quantity.

• Offering affordable, transparent membership plans that directly reduce exorbitant healthcare industry costs.

• Discounted rates on outside services such as outside labs, studies, and imaging.

• Maintaining a small, personalized patient panel.

• Providing timely and direct access to physicians.

• Emphasizing holistic, preventive, and patient-specific care.

• Mitigating insurance-related complexities and barriers, allowing our direct care to be guided solely by medical expertise and patient needs.