Direct Primary Care FAQs
Orange County, California
Common Questions and Answers About DPC
At OC Sports and Wellness, our Direct Primary Care (DPC) membership offers a more straightforward, more personal approach to primary care — with direct access to your physician, flexible scheduling, and transparent pricing. Below you’ll find answers to the most common questions to help you understand how our membership works and whether it’s a good fit for you.
What is your Direct Primary Care model?
OC Sports and Wellness provides a straightforward membership model. Qualified patients pay our practice directly, bypassing the need to involve their insurance company. Direct Primary Care membership offers a comprehensive range of services for a fixed monthly fee.
Members gain access to a higher level of care that goes beyond the conventional fee-for-service model. Benefits include telemedicine visits via phone or video, text messaging, extended consultation times, the convenience of same-day or next-day appointments for urgent concerns, and personalized attention from Dr. Sunshine.
What is the rationale behind the subscription model?
This structure lets us provide consistent, high-quality care over time. It also helps avoid the over-scheduling and administrative burden that often come with insurance-driven practices.
What are the advantages of membership?
At OC Sports and Wellness, we prioritize empowering you with knowledge and skills rather than relying solely on medication. You will have enhanced access to a doctor who genuinely cares about your well-being. Becoming a concierge member is akin to having a dedicated physician in your family. Dr. Sunshine will virtually be by your side, working with you to maintain optimal health
How much time will I spend with the doctor during office visits?
Appointments are customized to your needs. Typically, visits last between 30–60 minutes, depending on what you’re coming in for.
If your care involves multiple visits, you won’t have to worry about additional copays —those visits are covered under your membership.
How many office visits are included in the membership?
Are there extra costs beyond the monthly membership fee?
Many in-office procedures are already included. Members also receive substantial discounts on additional services, including advanced lab tests, injection therapies, fitness testing (e.g., VO2 max), custom orthotics, and bracing.
If external services such as labs or radiology are required, we can help connect you with local providers offering cost-effective cash pricing. In some cases, we also have arrangements with specialists who provide discounted rates for our referred patients.
What if I need specialists, imaging, ER care, or hospitalization?
While we can manage referrals and orders like any traditional physician, our membership does not substitute for full insurance coverage. If you require care beyond what’s offered at our clinic, you will need either insurance coverage or to pay out of pocket.
For urgent but non-emergency issues, we provide in-office urgent care when possible — helping you avoid unnecessary ER visits.
Do I still need health insurance?
Yes. Your concierge membership is not a replacement for health insurance. We strongly recommend maintaining comprehensive coverage to protect against major events such as hospitalization, surgery, or emergencies.
For some patients without employer-based coverage, joining a medical cost-sharing community (or similar alternative) may be an option — and we are happy to help guide you as you explore those choices.
Can my insurance provider reimburse me if I pay out of pocket?
In many cases, yes. We can provide a “superbill”—a detailed billing statement with CPT codes—that you can submit to your insurer for possible reimbursement.
Depending on your plan, it may also allow you to use a Health Savings Account (HSA) or a Flexible Spending Account (FSA). Coverage varies widely, so we always recommend checking with your insurance provider before committing to any treatment.
Can non-members be seen at your clinic?
Yes. You do not have to be a member to be seen at OC Sports and Wellness. Non-members are welcome and can be seen at affordable cash rates.
If you’d like more details or to schedule an appointment, please get in touch with our office, and our team will be happy to help.
Is membership worthwhile if I’m already healthy?
Absolutely. Preventive care and regular check-ins give you the best chance of staying healthy and avoiding costly problems down the line.
If you’re frustrated with long waits, rushed doctor’s visits, or impersonal care, this model offers a refreshing alternative. We particularly recommend it for proactive individuals — athletes, active adults, busy professionals, or anyone wanting consistent access to a doctor who knows their history.
How is Direct Primary Care different?
How does this practice differ from traditional healthcare?
Instead of adhering to a fee-for-service model, our patients opt for a monthly subscription fee, establishing a more robust patient-doctor relationship characterized by trust and transparency.
Under this membership model, a doctor’s income is no longer contingent on the frequency of patient office visits or the volume of patients seen daily, as is the case with the traditional “fee-for-service” approach. Instead, the doctor is compensated for their commitment to maintaining patients’ well-being. With fewer daily patient appointments, physicians have more availability and quality time to dedicate to each patient, encompassing office visits, phone calls, text messages, and email correspondence.
Furthermore, we embrace a functional medicine approach and offer conventional medical treatments like prescription medications and specialist referrals. We take the time to listen to your medical history and concerns. This approach allows us to explore potential underlying causes, triggers, and mediators contributing to your symptoms. Subsequently, we formulate a comprehensive treatment plan that often incorporates lifestyle adjustments, emphasizing modifiable factors rather than relying solely on prescription medications.
What does my membership encompass?
Your membership grants you uninterrupted access to your physician, ensuring prompt and personalized attention. We eliminate the frustration of communicating with off-site nurses unfamiliar with your medical history. Instead, you can quickly reach, text, or speak directly with your doctor via phone, video chat, text, or email for a transparent monthly fee with no copays.
Additionally, your benefits package includes:
- Most in-office procedures at no extra cost
- Extended consultation times for thorough discussions
- In-depth reviews of advanced lab test results
- Exclusive member pricing on specialized services like injection therapies, fitness testing, and more.
For more information, please visit the About DPC Membership page.
Do I need an appointment?
We do not operate as a walk-in clinic; appointments are necessary. However, we provide the convenience of same or next-day visits for our members.
To ensure a smooth experience, we kindly request that all visits be scheduled in advance. A brief phone call or text to confirm our availability is typically needed. Our members also have the option to address their medical concerns by phone or video chat, from the comfort and privacy of their homes or offices.
Which types of appointments are through telemedicine?
Virtual visits complement in-person care, not replace it.
They are ideal for concerns without physical examination needs, such as managing chronic conditions like diabetes and hypertension via email and virtual consultations.
An in-office visit is necessary for issues requiring a hands-on assessment, including coughs, sinus or ear infections, and new pain.
What if a particular therapy is unsuitable?
Reimbursement is not provided if a specific therapy is deemed unsuitable. The initial consultation serves to explore treatment options and covers the doctor’s time. It is important to understand that suitability is determined during the consultation, and therefore, it does not guarantee the performance of a specific procedure.
How do I obtain a copy of my records?
We are happy to help.
We can provide your records by secure fax, mail, or in-person pickup during business hours. To begin this process, please complete and sign the required medical release form.
A fee of 60 cents per page, plus any postal costs, is required for all copies and must be paid in advance. Please be aware that processing your request may take up to 15 days.
How are my medical records transferred to another provider?
We are happy to assist with transferring your medical records.
The most efficient method is to have your other physician’s office send a formal fax request to our office. As a professional courtesy, we will send these records electronically at no charge. Please be aware that, while we aim to expedite the process, record transmission may take up to 15 days.
In accordance with California Medical Board regulations, we maintain all medical records for a period of seven years.