Relating to the provision of direct patient care by physicians and health care practitioners.

Contracts

• New Templates Required: You must replace "Direct Primary Care" or generic "Retainer" headers with "Direct Patient Care Agreement."
• Mandatory Disclosure: You must create a standalone written or electronic notice provided to the patient prior to contract execution. This notice must explicitly state that the agreement is not insurance.
• Scope Definition: Contracts must clearly define the specific "Health Care Services" covered by the periodic fee to distinguish them from insurance-billable services.

Hiring/Training

• Billing Staff: Implement a strict "firewall" protocol. Staff must be trained that services covered by the subscription fee cannot be submitted to an insurer or HMO for reimbursement.
• Front Desk/Intake: Staff must be scripted to inform patients that subscription fees do not count toward insurance deductibles.

Reporting & Record-Keeping

• Audit Trail: You must retain proof (signature or electronic log) that the patient received the "Not Insurance" disclosure *before* signing the main agreement.
• Billing Records: Your practice management software must be configured to tag "Direct Care" encounters to prevent accidental claims submission to payers.

Fees & Costs

• No New State Fees: There are no filing fees or registration costs with the Texas Department of Insurance (TDI).
• Administrative Costs: Budget for legal review of contract templates and potential updates to billing software logic.