Helpful Information Below

What About Insurance?

Long Beach

Within Home Visit Range

San Pedro

Within Home Visit Range

Rancho Palos Verdes, Ca

Within Home Visit Range

Lomita

Within Home Visit Range

Torrance

Within Home Visit Range

Hermosa Beach

Within Home Visit Range

Redondo Beach

Within Home Visit Range

Manhattan Beach

Within Home Visit Range

El Segundo

Within Home Visit Range

Gardena

Within Home Visit Range

Hawthorne

Within Home Visit Range

Inglewood

Within Home Visit Range

Marina del Rey

Within Home Visit Range

Venice

Within Home Visit Range

Culver City

Within Home Visit Range

Santa Monica

Within Home Visit Range

Pacific Palisades

Within Home Visit Range

Topanga

Within Home Visit Range

Malibu

Within Home Visit Range

Direct Pay Labs versus Insurance High-Deductible Plan

Outside of this area?

Please reach out for a FREE meet-and-greet to discuss it

Insurance Lab Billing for High Deductible Plan

Lab Charges from Insurance $1,337.87 (2024)

Oh But Look! They save you $1,199.54 (LOL)

You Pay More Running Through Insurance on this High Deductible Plan

Absurdity of Insurance Lab Bills

Actual LAB Charges When Paying Direct

Same Labs Paying Cash Pay

Iron, TIBC and Ferritin $  10.35
Thyroid Panel with TSH $  10.90
Venipuncture $    2.00
Hemoglobin, Gly HbA1C $    4.80
CBC (General Health Panel) $    4.00
CMP (General Health Panel) $    3.50
Lipid Panel $    6.20
25-OH Vitamin D-3 $    9.00
CRP; High Sensitivity $  12.00
TOTAL $  62.75
Oh but wait Insurance saves you $1,199.54 Huh?

 

FAQ's
Do You Accept Insurance?
  • The practice is not paid by the insurance companies. This is to your benefit. Think about when you are hurried and rushed, do you have time to think about everything, listen, learn and not miss things? Its important to be able to digest information and consider all options – for both patient and doctor. If that is not available – what might be getting missed?
  • Insurance-driven clinics get paid by visit. This is why patients usually wait for their appointment because the clinic over schedules patients to fit as many as possible into the day.  The doctors generally don’t have enough time for everything, neither does the staff which leads to dissatisfaction on both sides.
  • Dr. Sun is able to order labs, imaging and process referrals for virtually all PPO and Medi-Cal Patients. (Please see the respective tab). You can choose to run through your insurance or take advantage of cash-pay pricing.
  • The practice can assist with navigating the system if you need some basic help figuring out what is covered. There is a helpful app available called Reimbursify, that when you input your specific insurance, will outline what is generally covered.
  • A telephone call to the insurance company to find out or their website is another option.
  • If you have a PPO (not HMO) or Medi-Cal (see separate tab for this) you are free to choose your Primary Care Provider (PCP), and that could be Dr. Sun.
  • The practice does not bill your insurance, you pay a fixed cost on a monthly basis. You can be provided a coded bill to submit to your insurance for reimbursement.
  • For any services, should you desire, you can take your receipt to submit to your insurance. However, whether or not you get reimbursed for services is between you and your insurance company.
  • Travel Medicine, D.O.T. Exams generally are not reimbursed anyway.
What If My Child Is Insured by Medi-Cal?
  • You are welcome to join the practice and choose to have a better experience.
  • You will not get reimbursed by Medi-Cal for the monthly fees you pay to Dr. Sun. You choose to come here for more personalized attention.
  • Dr. Sun is an Ordering & Referring Provider with Medi-Cal. This means she can place orders (prescriptions, referrals, imaging) using your Medi-Cal insurance.
  • Many DPC practices across the country have a large portion of their practice from state insured patients. They are tired of the packed waiting rooms and impersonal care they sometimes receive.
Laboratory Blood Work & Specialists
  • Laboratory Blood Work. The practice provides some in-house labs included in membership; the majority can be ordered at a discount; members can also take advantage of a discount imaging network should that be needed. Labs can be ordered and billed to your insurance through Quest, Quest is typically covered, this can be confirmed by calling your insurance company. If you have deductibles, co-pays and other issues, you might just choose to pay direct – most labs are very inexpensive.
  • Laboratory Home Collection. There is an option if Quest services your area to have them come to your home. The fee is $55.00. The actual labwork can still be billed through your insurance or cash-pay – your choice.
  • Referrals to Specialists. can be ordered and run through your insurance. Our practice has a growing list of cash pay specialists should you desire to do away with the insurance red-tape and hassles. Many specialists are tired of dealing with insurance hurdles and red-tape when they know what your treatment needs to be. Again, this model provides you with many options and allows you to be in control again.
  • For any services, should you desire, you can take your receipt to submit to your insurance. However, whether or not you get reimbursed for services is between you and your insurance company.
Do You Require I have Insurance?
  • DPC is not insurance and does not replace it. It is you choosing to have better, more accessible care for your day-to-day primary care needs.
  • Everyone should have some form of health insurance, at the very least to cover the exhorbitant costs of hospitalization, catastrophic event, accident and unforseen circumstances. This service does not replace that, it is primary care which is meant to deal with ~80% of most people’s healthcare issues.
  • ZenithMedicine is a membership only service for primary care; whether or not you have insurance is your decision. It is not required for membership.
  • ZenithMedicine does not bill insurance. You pay for it directly.
  • For a time, Obamacare mandated everyone have insurance. Most States have relaxed the penalties that have gone along with that, however you would need seek legal advice in regards to that.
  • You come to this Practice because you want simple, straightforward care from a Physician who really knows you and you have a relationship with; and to eliminate the impersonal hassle of dealing with traditional clinics and insurance.
How much does insurance reimburse me for an out-of-network doctor?
  • There is a helpful app available called Reimbursify, that when you input your specific insurance, will outline what is generally covered.
  • You can also call their customer service line or login to your portal and the question usually is answered.
  • Generally, however, most PPOs reimburse from between 30%-70%.
  • Compare an awesome experience to sitting in waiting rooms, followed by a rushed 10 minutes with your doctor if you are lucky enough to actually get one (versus a mid-level), then struggling to communicate after your appointment.
  • For most people — the extra expense for the quality of service and care is worth every penny.
Why should I Pay a Monthly Fee for your services if I already have insurance?
  • First and foremost because we human beings live in an ever changing world with ever changing bodies. The saying “Prevention is worth a Pound of Cure” is true. Primary Care goal is to keep you healthy. It is to understand you, your medical history, your family history, your risks, your social environment. So much of medicine is lost because the system is trying to cut so much of the basic, necessary parts of medicine out in order to cram more visits into the day.  Knowing your patient is a cardinal rule and without that, how can one truly adequately diagnose anything?
  • So even if you are overall healthy, it is wise to have your own primary care physician for preventative care.
  • In kids, they are not little adults. This is why after graduating from medical school, it takes another rigorous 3 years dedicated to Pediatrics and is a specialization. Their body physiology is even more complex due to development and maturation. There is so much to monitor – because we want to prevent or catch any issues early. For example, speech delay, if caught early with no other confounding factors – speech therapy properly attended and complied with typically can bring that child back up to their age level.
  • Most people have insurance copay’s that quickly add up. That amount could easily equate to a monthly membership fee. But really, it’s about the relationship and personalized care you receive and the value you place on that. How much do you spend on your cellphone bill monthly?
  • Many people have high deductible plans that they will never reach, and often are paying out of pocket regardless.
  • Why not make your doctor visits a pleasant, relaxed experience?
  • Why not choose to have your time respected, when you make an appointment – it is actually right on time!
  • Life is too short to spend agitated at the doctor’s office and dreading even going. Change that by choosing DPC!
What is Direct Primary Care?
  • The roots of DPC began in mid-1990’s with Harvard Graduate Dr. Garrison Bliss and Dr. Mitchell Karton.
  • Since ~1997 the Direct Primary Care Coalition has worked to carve out the rights of doctors and patients to independently practice medicine.
  • There is now the DPC Alliance whose role is to actively support physicians practicing in this manner.
  • There is now over 2,000 DPC physician offices nationwide.
  • The Podcast ‘My DPC Story‘ shares many of these doctors stories.
  • The movement is growing leaps and bounds and Patients and Doctors finally are finding what was lost while fixing the art of practicing medicine and going back to its roots.
  • DPC Alliance
  • Doug Farrago one of the Originators
  • DPC Up To Date News and Podcast
Is DPC the same as Concierge?
  • Concierge practices are generally known to serve patients and families who are financially secure.
  • DPC goal is to serve everyone and make it affordable. Some think of it as “Blue Collar” concierge.
  • Concierge practices generally bill insurance and therefore remain subject to all their requirements which is exactly what most DPC Docs feel is wrong with Primary Care today.
  • DPC Doctors fundamental tenet is retaining say over how we Practice. In order to do that, we remain completely separate from any Insurance type billing. We can therefore spend more time with our Patients because we do not deal with the Insurance Companies.
  • Concierge practices generally charge an annual fee that can be quite high.
  • DPC membership fees are usually charge monthly and the goal is to be affordable.
Why is DPC So Different?
  • The DPC movement is about ‘taking back medicine’. Regaining that ever so important Doctor-Patient relationship. Practicing medicine and treating a patient takes time – and the system in most traditional clinics is simply not allowing enough time to adequately practice medicine. Those choosing DPC are saying-NO, we went through the training and know what is required, and are not going to skimp simply because some administrator decided that all visits need to be 15 minutes.  
  • Because every DPC Office is run by the doctor for their practice which means you get the care needed. Gone is the labrinyth of unreasonable expectations hanging over the practice and the doctor treating you. 
  • We retain full say over how we Practice.
  • We generally have hundreds (100-500) in our Patient Panel, not thousands (1-4K sometimes).
  • We schedule our days and generally see no more than 8-10 Patients per day. A typical Patient Panel “in the system” is 20-25 Patients per day.
  • That’s because TIME is what is needed in Primary Care.
  • Direct Primary Care Doctors have eliminated all the administrative burdens and simplified the process, creating a direct relationship with you, the Patient.
  • All the rest, well, we don’t need.
Anything you are unable to offer?

Transparency is important, always.  Please be aware of the following:

  • Mental health is such an important part of health. Dr. Sun is able to provide management for depression, anxiety and other psychological challenges. For ADHD, Dr. Sun can provide the required 2-part evaluation; the medical evaluation and the educational. She will coordinate with educational staff and provide the necessary peer-review rating scales. Depending on the evaluation, there are several therapies available. Please note however, Dr. Sun chooses not to prescribe DEA Schedule II-IV medications which includes stimulants used for ADHD or benzodiazepine family for anxiety. Dr. Sun will help coordinate this care with a mental health professional if it is indicated and desired.
  • Although Cannabis has been legalized by California, it still remains not federally legal. Medically, it has not been fully peer-review studied for all the avenues for which some may use it for. Dr. Sun does not write any prescriptions for Cannabis.
  • Dr. Sun chooses not to be credentialed with a Hospital.  This means she is unable to round on your child as an in-hospital treating Physician. Depending on the circumstances, she may, at her discretion and if Parent requests, choose to visit in-hospital as the Outpatient Physician but would not be in charge of the in-hospital care. This will be taken on a case-by-case basis.
  • Dr. Sun chooses not to perform procedures such as circumcisions. This is best arranged in-hospital after birth. There are also local physicians who solely perform these services and she can help coordinate this with you if needed. She can manage after care.
  • Dr. Sun does not perform urgent care or emergency room services such as stitches, fracture settings etc.  She has community resources and will coordinate this care with you. If there is an immediate need – ALWAYS – go to the Urgent Care or Emergency Room first.
  • Guaranteed 365 day/year 24/7 access. Unforseen circumstances occur as this is life. Dr. Sun herself may be sick, in hospital, accidents, cell/technology outages etc.
  • For planned items things will be arranged with you ahead and in plenty of time. Provider back-up coverage would be provided in certain circumstances. 
What is your Office Like?
  • You can expect a humble, small, modest, clean, no-frills office.  There is no administrative staff, nor medical assistants as Dr. Sun performs all her own work. Pictures are below.
  • As you can imagine, the cost to provide a brick-and-mortar location is expensive, then couple that with providing medical services, the equipment and regulations required – it sometimes can be out of reach.
  • For Pediatric Direct Primary Care, many families prefer home visits which is a strong value-add. The brick and mortar location is an additional benefit and a secondary way for your child to be seen. There are many pediatric DPC practices across the nation that only do home visits.
  • If you have an in-clinic appointment, there will never be a waiting room full of people. Appointments are separated by a substantial amount of time.  When you arrive,  the time and clinic is blocked only for you.
  • Dr. Sun was able to create two physically separate suites within what was once fully occupied by a computer shop. Now the suite in the back is the computer repair shop (Suite D2) , and her medical office occupies (Suite D1). We went through ~8 months of work to make this happen with the City of LA and San Pedro.
  • Dr. Sun could never be able to offer a physical location without the generosity, love and support of her life-partner along with many along the way who pitched in to help. A heartfelt thank you:
    • Sal Agredano, ARIS Insurance
    • Bill James Architect
    • Jorge Uriarte of QNSGreen Construction
    • Luis Evora of Evora Electric
    • Abel Medellin of Abel’s Hauling
    • Chris Slater Electrical Engineering
    • Scott Bearden of McKesson Medical Equipment
    • Dr. Deepti Mundkur of My Happy Doctor
    • Love & support of my other colleagues & friends – you know who you are!
Why Make an Appointment Here?
  • Dr. Sun’s practice philosophy and goal is to provide the best care for you while making the experience pleasant and not a chore.
  • Why does going to the Doctor have to be so dreaded?  If you think about it – it’s typically the arduous, impersonal, maze-like process that virtually everyone tries to avoid.
  • This is a low volume, Doctor run office.
  • Simple and straightforward.
  • Make a choice to have a good experience, because every experience you have in life – matters.
  • There is no cutting corners in Medicine to save time at this Practice. 
Baby in life ring with sunglasses

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