Direct care is a model of medical practice that highly values the doctor-patient relationship and the provision of timely, accessible care.  Patients pay their doctor directly rather than going through insurance, which enables the patient to remain the first priority, not the insurance company.  

The need for this model has stemmed from patients and doctors alike growing frustrated at the decreasing ability to find high quality care in the insurance-based setting. Insurance-based clinics typically have long wait times with poor avenues of communication with the doctor. This is because the doctor is typically responsible for providing care to 1500-3000 patients, necessitated by the poor reimbursement in the insurance-based model. In direct care, the doctor is usually responsible for 300-600 patients, enabling greater attention for each individual patient.

Endocrinology is a medical subspecialty that specializes in medical conditions in which an imbalance of hormones in the body causes disease. Commonly treated conditions include diabetes, thyroid disease, and osteoporosis.

At Impact Endocrinology, your endocrine health needs are our top priority. We believe your health care should be directed by you, not your insurance. We provide timely scheduling, price transparency and clarity of communication. Dr. Grethen knows the importance of listening fully to each of her patients to understand their endocrine concerns. The result is exceptional endocrine care. 

No, we do not take any insurance. This includes Medicare. Patients pay the doctor directly for services. This enables Dr. Grethen to maintain a lower total number of patients, which allows for much more timely and accessible care.

No. Concierge practices typically charge a monthly or annual fee AND bill your insurance. This means the patient would pay a fee to the concierge practice plus any fees or co-pays owed to the insurance. Since Impact Endocrinology is a direct care practice, there are no surprise bills. 

Yes, absolutely. We recommend you maintain health insurance for needs such as hospital care, procedures, medications, etc.

Yes, lab tests at wholesale prices are available for patients of our clinic, if desired. This is not required - you may use your insurance for lab testing if you choose to do so.

Yes, but please understand that Dr. Grethen has ‘opted out’ of Medicare, which means Medicare cannot be used for payment of services, and cannot / will not reimburse patients for these services.

Some insurance policies allow reimbursement for out-of-network providers. We recommend you contact your insurance provider to verify this. If this is allowed, a receipt which lists detailed medical codes, or ‘superbill,’ will be provided to you which can be submitted to your insurance for possible reimbursement. Since we do not accept insurance, we will not be contacting your insurance carrier directly.

Yes, typically HSA (Health Savings Account) and FSA (Flexible Spending Account) money is accepted. However, patients are asked to contact their HR department first. 

No. Patients have the option of non-membership, where visits and any extra services are billed individually. This is most appropriate for patients who require no more than 2 visits per year and do not require care between visits.

Yes. Telemedicine enables patients to have access to excellent endocrine care when they need it. Telemedicine visits are available for patients who live in the state of Indiana. Those who live outside the state of Indiana are able to be seen at an in-person visit.

All major credit cards are accepted. Payment is required at the time of service. For memberships, payment occurs on a monthly basis.