Faqs

Direct Primary Care, or DPC, is a model of healthcare that puts patients first by getting rid of the red tape that constrains traditional practices. How? It’s simple: we don’t accept insurance, and – believe it or not – this actually saves you money in the long run.

You won’t have to pay a co-pay for office visits or routine physicals. Also you’ll be able to avoid many visits altogether by sending your questions directly to us via email and text – something you won’t get from a traditional practice. We’ve negotiated amazing deals for prescription medications, blood tests, X-rays, and MRI/CT scans on your behalf. If we had contracts with insurance companies, we would be legally obligated to charge higher prices.

More importantly, since you are getting all this amazing care from us, you can cut way back on your insurance premiums. Most DPC patients find a high-deductible, low-premium insurance plan so they’re covered in the case of a major health issue. But leave the rest of your healthcare to us.

Of course. Everyone benefits from a service tailored directly to them. That’s why we offer truly custom healthcare. We’re here for you if you’re sick or hurt, but we also help you proactively maintain good overall health. Every visit with us will be thorough, relaxed, and as long as you need to address your health concerns. The longer you’re our patient, the more we learn about your health and lifestyle, and the better we can help you maintain that health.

The terms are often mistakenly used interchangeably, but they are not the same. Both DPC and concierge practices charge a periodic fee, however, under the concierge model, this fee only gets you access; that is, it doesn’t actually cover any of your care. Instead a concierge practice still bills insurance for your visits. Under DPC, your visits and other care are included in your fee, plus you’re provided with other incredible benefits like wholesale pricing for labs and radiology studies, deeply discounted prescription prices, direct digital communication with your doctor, and all the rest.

Here’s a few articles that profile the Direct Primary Care approach to medicine:

• FORBES:Direct Primary Care: Restoring The Doctor-Patient Relationship
• TIME Medicine is About to Get Personal
• US News Physicians Abandon Insurance for Blue Collar Model
• AARP The Doctor Will See You But Not Your Insurance
• American Academy of Family Physicians Direct Primary Care
• WRAL Patients Pay Monthly Fee, Not Insurance Co-Pay to See Raleigh Physician

See our prices on our pricing page. We charge a flat monthly fee, and in exchange you get unlimited office visits, wholesale prices on prescription medication, your doctor’s cell phone number, and a whole lot more.

The fee covers excellent primary care through office visits with no copay. This includes the following: annual wellness exams, chronic care office visits, follow-up visits, basic office procedures and treatment of acute illness or minor injuries, all with minimal wait times in the office. The fee also covers direct communications with your doctor: phone, text, video chat or email.

Our patients will also have access to discounted labs, prescriptions and special procedures not included in the membership fees.

We treat all kinds of common everyday problems like colds, flu, strep, rashes and injuries. We also treat more complicated long term medical problems like adult diabetes, high blood pressure, high cholesterol and thyroid disorder.

For starters, having such unprecedented direct access to your doctor will prevent hospitalizations and specialty referrals in many cases. However when those types of care are required, we will certainly continue to work with your hospitalist during your hospital stay as well as work closely with any specialist. Depending on the level of care and the sorts of expertise required, we may rely on those specialized caregivers to manage your treatment.

Of course! Physician access is one of the greatest benefits of the direct primary care model. Because illness and injury do not respect regular office hours, you may call, text, or email your physician whenever you need.

Of course – this sort of care is “baked in” to the DPC model. Because you’ll have your doctor’s email and phone number, you can reach out to us whenever you need, wherever you are. Many illnesses can be diagnosed and treated with a simple conversation. We’ll also locate the nearest pharmacy and order the medications most appropriate for your circumstances.

We maintain high standards of patient privacy. We will never provide your health information to any third party unless you specifically ask that we do so.

Charges will be added and applied to your preferred method of payment.

We expect to have an open, honest, respectful relationship with you. If you have voiced a complaint that we cannot satisfy together, we will gladly allow you to terminate your membership.

Unfortunately, no. Your retainer is not yet defined as a “medical expense” in most states and as such is not deductible. Please confer with your tax consultant to clarify tax consequences in your particular circumstances.

No, fortunately for both you and us. Perhaps the most critical distinction in our model of care centers on a direct, personal relationship between you and your doctor. That directness carries over to our business model as well. You might use your auto insurance to fix a smashed fender or other major damages. But you’d never use it to get an oil change (or pay for gas!). For some reason, health insurance is currently being used for the equivalent of oil changes for humans – routine physicals, office visits, simple blood tests, and minor procedures. This just doesn’t make sense.

We forgo insurance payments in order to save our patients from the arbitrary, intrusive decisions that come with using insurance. Charging a direct monthly fee frees us from the typical contractual agreements that prevent non-DPC physicians from offering wholesale prices on laboratory tests, imaging, and medications.

Yes, we take care of any patient regardless of your insurance situation. Since we work completely outside of the insurance system, none of the billing for care here is eligible for insurance reimbursement. However, we recommend that everyone have insurance coverage, which is still important in the event of a major health issue.

Yes. We recommend our patients continue a major medical plan with a high-deductible and health savings account. If you experience a major health issue, you will still need insurance to help cover it. We’re happy to refer you to insurance representatives who can help customize an insurance plan to your specific needs.

Yes. You need only sign a one-time waiver declaring that neither you nor your doctor will directly bill Medicare for our services. Even though Medicare will not pay us for any services you receive in our practice, your Medicare benefits will otherwise remain unchanged and can continue to be used for all other medical care received outside of our practice. Medicare will still cover any laboratory testing, imaging, medications, or hospitalizations prescribed by our offices.

As the Affordable Care Act was being drawn up, several doctors worked very diligently to insert into the health reform bill a clause that allows for Direct Primary Care practices like ours to be a legal option under the health reform bill. Once the health exchanges open in October, many people will understand that a Direct Primary Care practice is an approved option.

In short, the best option for many patients will be an “exchange qualified” major medical type plan combined with a Direct Primary Care provider like our practice. This combination will save the maximum amount of money, while also allowing for a maximum amount of health care for patients.

The Direct Primary Care practices have the ability to decrease the cost of insurance by 30-50%, thus eliminating the need for ObamaCare-style regulation because we can make health insurance affordable again.

You may want to check with your human resources department regarding the use of Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) as possible payment options for your membership. If you are unable to use these funds to pay for the membership fee directly, there is a good chance that you can still use your HSA/FSA as reimbursement for certain services provided through our office.

Unfortunately, no. Your retainer is not yet defined as a “medical expense” in most states and as such is not deductible. Please confer with your tax consultant to clarify tax consequences in your particular circumstances.

These medications belong to a class called glucagon-like peptide-1 receptor agonists (GLP-1). Your body releases the GLP-1 hormone in the stomach after you eat, which stimulates your pancreas to release insulin. When insulin is released, it lowers your blood glucose levels. It also slows your stomach emptying, so you feel fuller quicker.

Tirzepatide also contains glucose-dependent insulinotropic polypeptide (GIP), a hormone released by the upper gut in response to the nutrients released by food. The GIP hormone is released in the body, promoting insulin secretion after meals, especially fatty food. When GIP binds to receptors in the brain, there is an alter in energy balance leading to a decreased energy intake or an increased energy expenditure, which leads to an anti-obesity effect.

• Nausea
• diarrhea
• vomiting
• constipation
• abdominal pain
• headache
• fatigue
• dyspepsia
• dizziness
• abdominal distension
• belching
• hypoglycemia
• flatulence
• gastroenteritis
• gastroesophageal reflux disease.
• Subcutaneous Injections: common injection site reactions characterized by itching and burning at the site of administration with or without thickening of the skin(welting). If you notice other side effects not listed above, contact your doctor or pharmacist.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing. Report adverse side effects to your doctor or pharmacist. In the event of any emergency, call 911 immediately.

You will be required to disclose all your health information along with the medications you are taking. Possible drug interactions are Anti-diabetic agents, specifically: Insulin and Sulfonylureas (e.g., glyburide, glipizide, glimepiride, tolbutamide) due to the increased risk of hypoglycemia (low blood sugar). Do not take with other GLP-1 agonist medicines such as: Adlyxin®, Byetta®, Bydureon®, Ozempic®, Rybelsus®, Trulicity®, Victoza®, Wegovy®, Mounjaro®, Zepbound® (THIS IS NOT AN ALL-INCLUSIVE LIST). For other medications used in diabetes, please tell your provider about any medications that may lower your blood sugar.

No, compound medications are not approved by insurance. Brand name weight loss medications such as Wegovy® (Semaglutide) and Zepbound® (Tirzepatide) usually require prior authorization by most insurance.

Compound pharmacies can prepare a compounded version of medication if the branded medications are on the FDA’s Drug Shortages list.

Our compounding pharmacies are in good standing with the State’s Board of Pharmacy, FDA-inspected, and accredited.

Some exclusions include a history of Medullary thyroid cancer (MTC), gastroparesis (slowing of the stomach), history of gallstones or pancreatitis, or already on a GLP-1 injection. Rx for medications is reviewed by a medical provider to determine eligibility.

This is individualized to the patient. Some patients have lost more weight with Semaglutide than others. Tirzepatide tends to have less nausea/vomiting than Semaglutide in some patients however again this is individualized to the patient. Additionally, while Semaglutide is a GLP-1, Tirzepatide has two active ingredients, GLP-1 and GIP, which work on the stomach and the brain.

Anything you do to try to lose weight without making a lifestyle change, the weight will return. For example, if you are dieting and working out and lose a significant amount of weight, then you stop dieting and working out, then the weight will most likely return. This is the complexity of obesity, which makes it a chronic disease. This should not be used as a fad diet but as an assistance in losing weight. To be successful in weight loss and keeping the weight gone, one must make a lifestyle change and stop “dieting.” Lifestyle changes include a behavioral component that requires a person to change the way they look at food and their eating habits. Once a person has reached their healthy goal weight, if they have successfully changed their lifestyle continue to make better food choices, and continue to exercise, the weight will stay off without the assistance of medications.

Our personalized weight loss medications may be perfect for you! Reach out to us by phone, text, or email to see what is right for you.

To lose a pound of fat, your body must be in a deficit of 3500 calories. On average, most people eat about 2,000 or more calories a day. The medication works on your gut by decreasing glucose levels leading to decreased glucose storage as fat and delaying gastric emptying, so you feel fuller quicker. In essence, medication alone can decrease your caloric intake, however, we do advise starting a low-fat diet by cutting out junk food, fatty, greasy foods, or foods high in carbohydrates. Most on average will lose an average of 1-2 lbs. a week.

• Eat a fibrous diet. Focus on fruits and vegetables that are high in fiber.
• Eat small protein meals as digestion is slowed down while on this medication.
• Avoid foods high in fat as they take longer to digest.
• Limit alcohol intake as this medication can lower blood pressure.
• Drink at least 32oz of water a day to avoid constipation.

No refunds will be granted. The price includes prescription medications that are in your name and shipped directly from the pharmacy to you.

All plans include unlimited virtual visits with your provider, medications, syringes/needles, Zofran (PRN), annual labs at Quest Diagnostics, shipping, and alcohol swaps.

• Complete metabolic panel (CMP)
• Thyroid Stimulating Hormone (TSH)
• Lipid panel
• Hemoglobin A1c
• Complete blood count (CBC)

All plans include unlimited virtual visits with your provider, medications, syringes/needles, Zofran (PRN), annual labs at Quest Diagnostics, shipping, and alcohol swaps. It also includes virtual primary care services as well.

Your medications are always ordered on the day of your full payment. The pharmacy usually takes 3-4 days for processing, although it may take up to 7 days.

Zofran is included in first order and can be sent with refill for additional $10. You can also request an e-prescription to be sent to your local pharmacy for Zofran at the time of consultation and refills.

• Connecticut
• Delaware
• Idaho
• Montana
• North Dakota.
• Florida

(Additional states will be added soon.)

NAD+ (Nicotinamide Adenine Dinucleotide) is a powerful coenzyme derived from Vitamin B3 (Niacin).
Found in the mitochondria of every cell, NAD+ plays a crucial role in:

• Energy production
• DNA repair
• Cellular metabolism
• Brain function and neurotransmitter support

As we age, our NAD+ levels decline, leading to fatigue, cognitive changes, and slower cellular repair.
Supplementation with NAD+ may help reverse these effects and promote overall wellness.

• Increased energy and stamina
• Improved mood and mental clarity
• Enhanced athletic performance and muscle recovery
• Reduced fatigue
• Reversal of visible aging effects
• Restoration of brain chemistry
• Protection against DNA damage
• Reduction in inflammation
• Overall improvement in appearance and quality of life

Best Time to Inject:

• Morning is ideal for a boost in energy and mental clarity.
• Before exercise, it may enhance endurance and performance

Injection Guidelines:

• Inject subcutaneously (just under the skin)
• Use areas like the abdomen, hips, or buttocks.
• Always rotate injection sites to reduce irritation.
• Inject at a 45-degree angle after pinching the skin.

Storage:

• Unopened vials: Good for 12 months at room temp
• Opened vials: Store in the refrigerator and use them within 3 months
• Protect from heat, light, and temperatures above 85°F.

NAD+ is stable at room temperature for several weeks and begins to degrade only after several days at temperatures above 85°F. For best results, store in the fridge upon arrival.

Most patients tolerate NAD+ well. Side effects, if any, are typically mild:

• Redness, bruising, or soreness at the injection site
• Headache, flushing, nausea, cramps, fatigue
• If side effects persist, stop use and contact your provider

NAD+ (Nicotinamide Adenine Dinucleotide) Therapy – Patient Education Guide 1
Bruising Tip: Apply light pressure (not massage) after injecting. Ice may reduce swelling. Avoid injecting near a bruise until healed.

Some feel energized immediately, while others notice gradual improvements over days to weeks, depending on individual health and goals.

Your body can generally handle extra NAD+, but excessive dosing may reduce effectiveness. Always follow prescribed instructions.

No. There is not enough evidence to confirm its safety during pregnancy. Consult your OB/GYN before using any supplements.

No. Do not share your medication. It must be prescribed and dosed individually under medical supervision.

We do not recommend NAD+ for individuals with active cancer, as some data suggest it could support cell growth. Consult your oncologist first.

It may sting, especially when cold. Let NAD+ sit at room temperature for 30 minutes before use. Repositioning injection sites may also help.

Opening the Vial:
Remove the inner metal circle seal to access the vial. Wipe with an antiseptic swab before each use.
Eliminating Air Bubbles:

• Tap or flick the vial to bring bubbles to the top
• Swirl gently
• Let it sit briefly
• Inject a small amount of air into the vial before withdrawing medication
• Drink at least 32oz of water a day to avoid constipation.

Getting the Last Drops:

• Tilt and swirl the vial
• Draw liquid from the pooled area
• Push in air to increase pressure

Disposal Instructions:

• Use a sharps container for all needles and vials
• Do not dispose of needles in regular trash
• Options for sharps containers:
• Pharmacies or medical suppliers
• NAD+ (Nicotinamide Adenine Dinucleotide) Therapy – Patient Education Guide 3
• Some clinics/hospitals may offer them
• Drop-off or mail-back programs may be available in your area

➤ Visit SafeNeedleDisposal.org for local options

• Dropped injectable?
  If uncapped and hits the floor, discard in your sharps container.
• Injection hurt or bruised?
  Don’t reuse the same area. Ice the area and avoid injections until it is healed.
• Excess dose?
  Don’t panic — but follow your regular schedule and consult your provider if needed.

Contact your provider if

• You experience unexpected or severe side effects
• You have questions about dosage, technique, or results
• You need a replacement or refills

LaBanks Medical Services, LLC – Dr. Leslie-Ann Banks, DNP, ARNP
Helping you feel younger, think clearer, and live better — one cell at a time
(954) 378-8119| info@labanksmedical.com | LaBanks Medical Service