Frequently asked Questions

Direct Primary Care, or DPC, is a model of healthcare delivery that allows doctors and patients to work together to achieve optimal health without many of the barriers put in place by health insurance companies.  Imagine knowing the actual costs of appointments, medications, procedures, and being able to make informed decisions with your doctor about the best treatments.  That is what DPC allows.  By paying a low monthly membership fee, you will have access to schedule prompt routine and urgent visits with Dr. McElroy and build a relationship with someone who is invested in your primary care.  The benefits of this model of care are longer appointments, consistent and timely appointments with your physician, and personalized attention.

Cold River Health is also able to provide discounted labs and medications for members with and without insurance.

No, Direct Primary Care is not insurance.  Cold River Health offers membership-based primary care physician services and is not considered insurance and we do not bill insurance companies for any of our services other than for patients with Medicare, who may be patients but not participate in Direct Primary Care due to government regulations.  By not billing commercial insurance, we are able to spend our time taking care of patients, rather than negotiating with insurance companies for payment, and pass along savings to members.  It is recommended that patients maintain insurance for coverage of any unexpected or emergent health conditions that may require care in a hospital, by a specialist, or other expenses such a radiology studies.  

Yes!  By choosing Cold River Health, you will be cared for by Dr. McElroy, a board-certified family physician with expertise taking care of the entire family from newborns to geriatrics, for all of your primary care needs.  For expectant mothers, Dr. McElroy provides primary care and support services alongside your obstetrician who is caring for your pregnancy.  In the postpartum period, Dr. McElroy provides "fourth trimester" care for moms and babies.  Some of her happiest days are welcoming new babies to her practice!

Medical practices that are insurance-based must employ billers, coders, credentialers, and other staff to make sure that the insurance company pays their fair share.  Additionally, insurance companies are known to create new rules, "quality" metrics, and other requirements that physicians have to adhere to in order to get paid.  While on the surface, the idea of paying physicians for quality care certainly sounds like a good idea, after more than a decade of working in this system, Dr. McElroy has not seen care improve but rather the healthcare system has become more onerous on physicians and difficult for patients to navigate.  

Direct Primary Care allows doctors to focus on patients rather than forcing them to limit appointments to short time slots in order to see enough patients in a day to pay the staff required to manage insurance companies.  Multiple studies show that insurance-based primary care physicians spend more time on documentation and paperwork than they do seeing patients in a day, and much of this is after hours.  By providing top notch primary care without the barriers imposed by insurance companies, Cold River Health is part of a growing movement to reclaim medicine and return it to its roots: a doctor/patient relationship.

Cold River Health is contracted with Medicare Part B, or Original Medicare, in order to meet the needs of our seniors on fixed incomes.  By working with only one insurance with standard payment rates, Cold River Health hopes to continue to focus on quality primary care and not negotiations with insurance companies.

Direct Primary Care at Cold River Health may be right for you if you want:

1. Longer visits with your physician with time to focus on wellness promotion as well as treatment of sickness

2. To build a relationship with a physician who is invested in your health

3. Access to appointments with your physician typically within one business day and more flexible options to communicate with your physician including phone, video, text, and portal communications when appropriate

4. Transparent pricing for medical services, labs, and medications

5. The expertise of a board-certified family physician

The exceptional direct primary care at Cold River Health may not be right for everyone.  The relationship between a patient and physician must be built on trust, respect, and shared goals.  There are times when a relationship is not therapeutic for a variety of reasons.  Cold River Health understands that patient needs may change and if we are not a good match for you, you may cancel your membership at any time.

Lifestyle Medicine is an approach to health and wellness that empowers the patient and physician to work together for the patient's optimal health by making changes in day-to-day life.  Lifestyle Medicine focuses on diet, physical activity, sleep, social connections, avoidance of risky substances, and stress management.  This practice is supported by scientific evidence and can be beneficial for all ages and stages of health.  For patients who want to avoid or decrease taking prescription medications, in some cases Lifestyle Medicine can be the key.  For patients who are interested in improving their health but don't know where to start, Lifestyle Medicine may open up the door.  Dr. McElroy will take the time to partner with you and find areas where small changes may have big impacts in your overall health.

Health and wellness are impacted by our lifestyle choices.  Dr. McElroy prides herself on meeting patients where they are at as far as motivation and ability to make lifestyle changes.  You will not be forced to exercise or eat vegetables, but we will likely discuss nutrition and physical activity and how it relates to health problems as part of your comprehensive care at Cold River Health.

Cold River Health has strict prescribing policies around controlled medications which may be used for pain, anxiety, insomnia, attention problems, and other conditions.  These policies are based on Maine state laws and best practices around medications which have been shown to have significant harms.  We will not prescribe long-term narcotics for patients who have chronic pain that is not caused by cancer, regular antianxiety medications called benzodiazepines, or hypnotic sleep aids for nightly use.  If you need assistance coming off of these medications, Dr. McElroy is able to support you with a compassionate taper and lifestyle medicine principles on a case-by-case basis.

No controlled prescriptions will be written without prior records.

Any patient prescribed a controlled medication must sign a controlled medication contract and consent to appropriate monitoring and regular office visits.

Dr. McElroy does evaluate pediatric patients for attention disorders and offer medications when appropriate.  

• Cold River Health has strict policies regarding prescriptions for controlled medications for pain, anxiety, sleep, attention problems, and other conditions.  These medications require outside records to document the conditions for which they have been prescribed prior to any new prescriptions being written at the discretion of Dr. McElroy.  Dr. McElroy does not prescribe chronic narcotics for non-cancer pain, benzodiazepines for more than occasional use, or regular hypnotic sleep aids.

• Dr. McElroy does not provide certification for Medical Marijuana use.

• Vaccine exemptions, except in the rare case of a well- documented medical issue, and mask exemptions are not provided.

• Non-FDA-approved testing or treatments for Lyme disease are not part of the care at Cold River Health.

• Cold River Health does not certify animals as service animals.

Cold River Health values the health and safety of its patients and employees and follows the State of Maine regulations around vaccines for healthcare workers including mandatory vaccines for influenza and COVID-19 amongst other potentially communicable diseases in the healthcare setting.  Additionally, the office is cleaned regularly and air filtration units are utilized.  When possible, natural ventilation will also be used.

Masking is required for staff and patients with active respiratory or GI illness or fevers unless a non-communicable cause is determined.  

Patients are requested to inform the office if they are feeling ill prior to a scheduled appointment so that a determination can be made as to whether the appointment may be rescheduled or if an urgent issue may be addressed without an in-person appointment.  Likewise, if Dr. McElroy or another member of Cold River Health was unwell, you would be informed of the need to reschedule an in-person appointment.

Vaccines save lives and are one of the greatest inventions of modern medicine.  Dr. McElroy recommends vaccines for pediatric and adult patients according to the CDC immunization schedule to protect individuals and the public from communicable diseases.  While the CDC immunization schedule is studied and known to be safe, she will work with families who elect to vaccinate on a different schedule, such as only giving one vaccine at a time.  All families are encouraged to receive the minimum recommended vaccinations.  Unvaccinated individuals may be seen via telehealth rather than in person if suspected to have a vaccine-preventable illness that poses a risk to other patients or staff.  

Cold River Health is an independent medical practice seeking to provide transparency in pricing and affordable healthcare for those who value the relationship and expertise of their primary care physician.  Due to the significant overhead of running a medical practice, including medical school debt, physician licensure, board certification fees, insurance, electronic health records,  supplies, and real estate, a small private practice cannot operate without charging a fair fee for the services provided.  Hospitals and clinics that receive federal funding are able to provide sliding scale discounts based on income as a requirement of the funding that they receive.  While the care at these facilities differs from the personal care that Cold River Health provides, they play an important role in providing coverage for patients who require financial assistance.  On a case-by-case basis, payment plans or alternate forms of payment may be arranged with prior Cold River Health authorization for those unable to afford membership fees.