Why Patients Choose Direct Pay
You don't have to choose between insurance and better care. Keep insurance for the big things; use Thrive RX to be heard by a physician who works with you toward better health.
Keep your insurance. Add better access.
We're Not Anti-Insurance
Insurance is a genuinely valuable tool. It's exactly what you want for hospitalizations, surgeries, emergencies, and serious illness like cancer. Keep it. The challenge isn't insurance itself; it's the economics of how everyday primary care gets reimbursed.
For routine primary care, insurance reimbursement is often low relative to what it costs to run a practice. To stay open, in-network offices have to see a high volume of patients, and that shapes the experience in ways patients feel:
Shorter, higher-volume visits
Low per-visit reimbursement pushes practices toward more patients per day and less time per person.
Care split across visits
Concerns get spread over multiple appointments, and you may see whoever is available rather than the same physician.
Prior-auth and step rules
Coverage rules can add steps before some tests or treatments, which can slow things down for some patients.
More reliance on support staff
To manage costs, many practices lean on nurse practitioners and physician assistants, skilled clinicians, but you may rarely see a physician.
Thrive RX steps outside those economics. Direct pay lets Dr. Kiswani-Barley keep visits unhurried so she can listen, prioritize your concerns, and recommend appropriate tests and treatment, while you keep your insurance for what it does best and submit an itemized insurance invoice for potential out-of-network reimbursement.
Two Different Approaches to Primary Care
Same goal: your health. Different economics shape a very different visit.
Typical Insured Primary Care Experience
- Brief, limited visit
- Copay: $30-75 per visit
- See a different provider each time
- Wait 3-6 weeks for an appointment
- Limited time to cover several concerns
- Prior authorization can add steps for some tests and medications
- Annual deductible: $1,500-$8,000 before coverage kicks in
Thrive RX Direct Pay Experience
- Visits built around your questions and history
- $100-$250 per visit, no surprises
- Same physician every time (Dr. Kiswani-Barley)
- Appointments often available within days
- Priorities set together, with follow-ups for what remains
- No insurance prior authorization for Thrive RX visits
- Low cash-pay labs through Access Labs, often below your insurance responsibility; costs vary by test and coverage
- Prefer insurance for labs? We provide the requisition for a lab covered by your plan
- Fill prescriptions at your pharmacy using insurance, or compare savings options such as GoodRx
- Insurance-billed labs and medications remain subject to your plan's coverage and authorization rules
How Direct Pay Works With Your Insurance
It's not either/or. Here's how patients use both.
Use Your Insurance For
- Hospitalizations and surgeries
- Emergency room visits
- Lab work at a covered lab, if you prefer; we provide the requisition
- Prescription medications at your pharmacy, subject to your coverage
- Specialist referrals and imaging
- Dental, vision, and mental health
Use Thrive RX For
- Unhurried physician visits with real time to talk
- Root-cause investigation of symptoms
- Same physician every visit, Dr. Kiswani-Barley
- Cash-priced labs, when they cost less than going through your plan
- Weight loss with GLP-1 medications
- Hormone optimization (HRT, TRT)
- Preventive care and chronic disease management
Our Access Labs cash prices are often below what you would owe using insurance, but costs vary by test, deductible, and coverage. You can choose cash pay or use our requisition at a lab covered by your plan. Compare our cash-pay lab prices with your expected insurance responsibility before choosing.
Transparent Pricing, No Surprises
You know the cost before your visit: no copay confusion, no surprise bills, and no waiting to meet a deductible.
Follow-up visits
Common Questions About Direct Pay
Ready for Care That Puts You First?
Take our health assessment to find out which Thrive RX program is right for you, or book a consultation with Dr. Kiswani-Barley.