Frequently Asked Questions

What is Direct Primary Care?

Direct Primary Care (DPC) is an increasingly popular model of healthcare that restores the care relationship between patients and physicians. Patients get high quality, convenient, responsive care that has become next-to-impossible when dealing with insurance. DPC practices do not bill their services through insurance, getting rid of frustrating rules, hidden costs, surprise bills, and confusing benefit coverage. Instead, they charge a predictable and affordable monthly fee. All of the services provided by the clinic are included. It’s as simple as that. DPC practices often do not even have a billing department, giving physicians time and flexibility to devote to their patients.

Why change to a direct primary care office? What are the benefits?

By eliminating one of the most frustrating parts of modern healthcare, dealing with insurance companies, DPC practices can give you the personalized care you deserve. We can offer more direct access and communication, using video chat, phone calls, email, and text directly with your pediatrician, without arbitrary rules about coverage. We can spend as much time as we want on your concerns, or even handle more issues without office visits, because we do not have to follow the rules of an insurance company. We can follow up on any decisions we make or tests we order, without extra charges.

It also benefits us physicians. Kids who want to be doctors do not picture themselves coding diagnoses, fighting with insurance companies, or telling patients, “I’m sorry but you’ll have to make another appointment for that.” At DPC practices like ours, we get to care for our patients the way we always thought we would.

Is Lighthouse Pediatrics the right fit for me?

Are you unable to get into your pediatrician when you need to? Do you wish you could take your sick child to your pediatrician who knows you best, instead of a provider at Urgent Care who does not know you at all? If the answer is yes to either of these, we would be a great fit for you.

Have you had concerns about your child that could not get addressed by their pediatric office because of scheduling, insurance, or overworked staff? Have you been left in the dark about test results for days and days? Have you had questions that only the pediatrician could answer, but you could only speak to a staff member? Do you hate phone trees? If the answer is yes to any of these, we would be a great fit for you.

Have you been frustrated by the copays, surprise bills, hidden fees, or confusing benefits? If yes, DPC clinics are the perfect fit for you.

Do you want to feel more connected to your child? Do you want to feel confident helping your child navigate their most important challenges, like learning language, making friends, succeeding in school, managing their emotions, and more? Are you concerned that your child may have autism, ADHD, anxiety, depression, or anything else that needs more support and more attention? If so, Lighthouse Pediatrics is perfect for you!

My kids are healthy. Why should I choose Lighthouse Pediatrics?

Parenting is equal parts wonderful and challenging, rewarding and demanding. And its wonders and challenges are different at every stage. At Lighthouse Peds, we have the training and expertise to help you understand what’s going on in your child’s world, in order to best manage, or even prevent, their biggest challenges. Teaching your toddler basic social skills like joint attention may help them as a preschooler who knows how to cooperate and share. Teaching your 2nd grader how to regulate when they are upset may help them as a teenager with peer relationships and school pressure. And with the DPC model, we have the time and opportunity to offer this kind of guidance that other clinics do not have.

Also, parents with children who do not have a chronic illness are often surprised when they look back at how many doctor’s appointments they had for minor illnesses and injuries. These are the kinds of issues that need prompt or immediate attention, which often means Urgent Care with a provider who does not know your child. The cost for these visits also add up quickly. HSA plans, copays, or unmet deductibles mean that even with insurance, the out of pocket costs for a single visit can be more than $150. A single bad cold that requires follow up visits can often cost more than $400.

At Lighthouse Pediatrics, you will be seen by the pediatrician who knows your child the best. Plus, all of these visits are covered, no matter how many there are or how often they happen.

I have a newborn and the visits are all covered by Insurance. What can Lighthouse Pediatrics offer?

Parents with newborns love having easy access in those critical early months. Scheduling a same day office visit around feeding and naps, packing everything in a car, waiting in a lobby are all things that are hard for newborns and their parents. At our office, direct, rapid responses by text, email, phone calls, or video chats are available for unexpected issues, and can sometimes replace the office visits required by insurance companies. We still have the same schedule of well baby appointments in order to ensure your newborn is thriving, and we make it as easy as possible.

Should we cancel our insurance if we sign up?

No. Insurance is still necessary for other medical costs for your child, including specialists, emergency rooms, hospital stays, outside lab testing, imaging clinics, catastrophic events, or other unexpected health costs. A DPC membership is NOT a substitute for insurance. It is a good idea to talk with your agent and financial advisor for specific advice on insurance policies, and there may be less costly options when using a DPC clinic. You may also want to ask them about the possibility of covering our services with Health Savings Account or Flexible Spending Account funds, as that will be determined by the specifics of your policy.

Contact us! We’re happy to answer any questions you have.

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Phone: 425-357-7082
Email: hello@lighthousepeds.net

Address: 1505 NW Gilman Blvd, Ste 8, Issaquah, WA 98027

Frequently Asked Questions

Have a question that isn’t answered here?

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