Personalized Primary Care—WHEREVER YOU ARE

Primary Healthcare for Rural North Dakota

Healthcare should feel personal, accessible, and built on trust.



James River Family Medicine was created to provide thoughtful, relationship-based primary care for individuals and families in our rural communities. Too often, patients feel rushed through appointments or struggle to access the care they need when they need it.

Our goal is to offer a different experience — one where patients are heard, visits are meaningful, and healthcare feels easier to navigate.

Our Services

Frequently Asked Questions

What is Direct Primary Care?

DPC is a new way to get high quality, comprehensive healthcare from a provider who cares, all for a low, flat monthly fee. It’s that simple. No insurance, no corporate health system, no middlemen. Just healthcare providers and patients.

Practically speaking, DPC is a membership model for healthcare. Every patient pays a flat monthly fee to become a member of the DPC practice. What are the benefits of membership? Put simply: access to a provider that cares about you.

Do you accept insurance?

James River Family Medicine follows a Direct Primary Care model and does not bill commercial insurance for routine primary care services. This allows the practice to focus on personalized care rather than insurance-driven visit limitations.



Patients are welcome to maintain insurance coverage for services such as hospital care, specialists, imaging, or emergencies.

Can Medicare patients receive care at James River Family Medicine?

Medicare credentialing for James River Family Medicine is currently in progress.

Once enrollment is finalized, Medicare patients are welcome to receive care at the clinic and visits will be billed directly to Medicare according to program guidelines. Because of federal Medicare regulations, services for Medicare patients will not be part of the Direct Primary Care membership model.

The Medicare enrollment process for new practices can take approximately 60–120 days to complete. Updates will be shared once credentialing is finalized.

Until that time, Medicare patients will need to continue receiving care through their current provider.

For my current patients:
If a follow-up visit is needed or you are due for medication refills while credentialing is still in progress, I recommend scheduling with a provider of your choice temporarily. If helpful, I am happy to assist with referrals during this short transition period.

I look forward to welcoming Medicare patients once credentialing is finalized and continuing to care for our community.

Do you accept Medicaid?

At this time, James River Family Medicine is not enrolled with Medicaid. Because of Medicaid program regulations, patients who are currently enrolled in Medicaid typically need to receive primary care services through a Medicaid-participating provider.

Can I schedule one-time visit if I am not a member?

Yes. While membership offers the most comprehensive access to care, patients may also schedule a single visit if they prefer. One-time visits are available for a flat fee and may be a good option for individuals who only need occasional care or who would like to experience the practice before joining as a member. 

Please note that certain services, such as DOT physical examinations, are priced separately from the standard one-time visit fee.

Are telehealth visits available?

Yes. Telehealth visits allow patients to connect with their provider conveniently from home. Many types of primary care visits can be handled effectively through telehealth, while in-person visits may be arranged when appropriate. 

Will I still need health insurance?

Your DPC membership is not health insurance. We recommend maintaining health insurance coverage for catastrophic and unexpected health events that require emergency and/or hospital services.

You can also use your insurance for services outside our clinic, such as specialist visits and imaging.

Yes, you'll still need insurance, though you may be able to reduce the amount you pay.

Your DPC membership is not an insurance plan; you'll still need insurance if you have a major health problem. (But when those problems arise, your DPC provider will be next to you to guide you through the system and coordinate your care.) That said, you may be able to save money on your insurance! Since all routine care is covered by your membership, you can switch to a "high-deductible" health plan that costs less per month.

Should I join a direct primary care practice if I'm healthy?

Absolutely! To be sure, your DPC provider will always be there for you if you're get sick or hurt. But they also work proactively to keep you healthy, happy, free of preventable diseases, and living a good lifestyle.

It's hard to break out of the mindset of the insurance-based healthcare system. In "the system", everything is centered around treating illness. It's very hard for a doctor to get paid by an insurance company for detecting early warning signs of diabetes or encouraging a lifestyle change to decrease risk of heart disease. Healthcare providers just aren't rewarded for encouraging all-around good health.

By being in constant contact with your DPC provider when you're healthy, you'll be able to stay that way. By the time you're being treated for a chronic disease, it's usually too late. But if you spend your healthy years under the watchful eye of a healthcare provider that cares, you'll be able to stay out of the hospital for years to come.

Why would I go to a clinic that doesn't take health insurance?

Do you have a high deductible plan? Often times, you never reach your deductible. You pay a monthly premium to your insurance, and pay for all medical expenses out of pocket until you reach your deductible. A DPC membership is almost always much less expensive than paying separately for all of these services when run through insurance.

For example: If you see your doctor 3 times/year: office visits average $350/each, that’s $1,050 out of pocket. That’s slightly more than 1 year of membership at James River Family Medicine. 

And what benefits do you pay for with our membership? High quality care, unmatched appointment availability, access to low-cost labs, low-cost procedures, assistance finding low cost prescriptions, and DIRECT access to your healthcare provider!

But, I have great coverage from my insurance, does it still make sense for me to sign up?

Yes!!

Health Insurance does not equal Health Care. Do you have great access to care? Do you get to spend TIME with your clinician and feel your concerns were heard and addressed? These answers are far too often, “not usually”. Our members always feel heard and know they have a doctor that is working for them. 



Plus, if you have insurance that “covers” everything then you can still use this for labs, imaging, specialist visits, medications, and ER or hospital needs.

What if my health insurance has a high deductible or limited coverage?

Many patients today have insurance plans with high deductibles and limited coverage for routine care. This is one of the reasons Direct Primary Care has become a popular option.

By removing insurance from routine primary care visits, patients can access affordable, transparent healthcare while still maintaining insurance for larger medical expenses.

Primary care providers are able to address the majority of everyday healthcare needs, while insurance can be used to protect against major events such as hospitalizations, surgeries, or other unexpected medical emergencies.

Some patients choose to maintain traditional health insurance, while others explore alternative options such as high-deductible plans or health-sharing programs. Every situation is different, so patients are encouraged to review their options and choose the type of coverage that best fits their needs.

Direct Primary Care works well alongside many different types of coverage and helps ensure patients have consistent access to their primary care provider.

What about lab work?

We have negotiated prices and have now contracted with an outside lab facility to offer “cash-pay” whole-sale labs drawn right in our office. Getting bloodwork completed has never been easier or more affordable.

If you prefer to use your insurance, we will still draw blood right in the office and send the samples to the lab for processing. The facility will bill your insurance, and you will be billed in the “normal” fashion by that facility. However, when using insurance, our contracted pricing cannot be applied.

What about imaging, like X rays and CT/MRI scans?

We do not have imaging available at the clinic but we are able to order imaging to be completed at the facility of your choice, and that facility will go ahead and bill insurance. If you have no insurance or a high deductible, there are options outside our clinic that offer lower cash prices as well. 

Once I enroll, when will the monthly membership charges begin?

Once you join, the one time onboarding fee will be charged. Forms will be sent to be completed and your membership will become “active” approximately 1 week later giving time to get forms back and get records reviewed. Membership fees are charged once your membership is “active”.

You have the ability to choose your membership start date upon enrollment so you can push that start date for your membership to become “active” for up to 3 months after the onboarding fee is paid!

What forms of payment are accepted?

The best payment option is direct transfer from a bank account (ACH) due to the fees associated with credit card payments. However, we do accept most major credit cards, debit cards, and HSA cards. All membership fees are placed on Auto-pay. We also accept personal checks.

Still have a question?