Direct Primary Care

What is Direct Primary Care (DPC)?

DPC is an affordable model of membership medicine that includes all primary care services with a single monthly fee. This allows unrushed 30-60 minute appointments, direct access to your provider, and a quality of care that improves your health. By not billing insurance, DPC removes a tremendous portion of the administrative costs making it affordable and in many cases less expensive than traditional medical practices. This puts the patient at the center of their care with their provider as a trusted partner.

What is included?

  • All preventive care visits, including gynecologic care
  • Care of chronic conditions, for example diabetes, hypertension, asthma
  • Urgent visits during office hours
  • Ability to contact your primary care provider directly when and how you need it through text, secure messaging, portal or phone
  • Procedures as indicated (may have additional charges click to inquire).
    • skin biopsy
    • sutures
    • EKG
    • abscess and cyst drainage
    • joint injection
    • basic wound care
    • ear wax removal
    • contraceptive device insertion and removal
    • endometrial biopsy
    • colposcopy 
    • spirometry
  • Negotiated rates for labs. See PDF for prices.
  • Negotiated rates for studies. See PDF for prices (same as above).
  • In house pharmacy. See PDF for commonly used medications and our cash price (same as above).
  • Newsletter, YOGA, health talks

Do I need insurance?

Yes. DPC is not insurance. It is important that you have insurance if you require hospitalization, surgery, or need to see a specialist.

Are there extra fees?

No! Any services that are completed in the clinic as part of primary care are included.

Will I benefit from DPC if I don’t need frequent medical attention?

Of course. Everyone benefits from a service tailored directly to them. That’s why we offer truly custom healthcare. We are here for you if you are sick or hurt, but we also help you proactively maintain good health. Every visit with us will be thorough, relaxed, and as long as you need to address your health concerns. The longer you are our patient, the more we learn about your health and lifestyle, and the better we can help you maintain that health.

How is DPC different from Concierge membership?

With concierge membership you pay an access fee to join the clinic and then you continue to use your insurance for covered services such as onsite or telemedicine visits, labs, and procedures. You may pay both co-pays, and co-insurance. With DPC, there are no additional costs for telemedicine or onsite visits, and there are deep discounts for labs and procedures offered onsite.

Prescription Refills

How do I get a prescription refill?

  • Ask your pharmacy to contact us, and allow 2 business days for their response. Plan ahead! We may not be able to respond to a Friday request before Monday.
  • For on-going prescriptions, such as for blood pressure or thyroid meds or birth control pills, expect to come in at least once a year. Call for an appointment. If you need a refill in the meantime, ask your pharmacy to contact us.
  • For narcotics or other controlled substances, generally we require a visit every 1-3 months. Schedule your next appointment 2-3 weeks ahead. If you try to schedule an appointment at the last minute, you may run out of meds before we can see you. Our Pain Contract describes our policies regarding these prescriptions.
  • If you need a prescription sent to a mail order pharmacy or phoned to a new pharmacy, call us to give the name of the medicine, strength, directions and quantity you are requesting, the pharmacy phone or fax number, and patient ID number if needed.


Who do I contact if I have concerns regarding my bill?

Billing at 206-932-9025. Please also see our Financial Policy.

Who do I contact with insurance questions?

  • Call the toll free number on the back of your insurance card.
  • See our Financial Policy
  • Or ask for Sue at our office.

What if I have no insurance?

Expect to pay at the time of service. If there is also financial hardship, please tell us.

Does my insurance plan cover your care?

Call the toll free number on the back of your insurance card or visit their web site, to be sure our providers are on your plan.

What medical insurance do you take?

We have contracts with the following insurance companies: Aetna, Cigna, First Choice, Great West, Premera Blue Cross, Regence Blue Shield, Tricare, Uniform, and United Health Care, and others.

Calling the Office

What happens if I call the office with a medical question?

The receptionist will give the message with your chart to the medical assistant, who will then call you back, usually within a few hours. You may be asked to schedule an appointment.

If you are asking for a prescription, please give us 48 hours notice. We will need a pharmacy number, state any allergies, and specifically what medicine you are calling about. You may be asked to schedule an appointment.

What if I want to speak directly to a provider?

Calls “for the doctor or provider only” will be returned within the next 24-48 hours.

What if my provider is not available, or out of town?

If your primary care doctor is out of town, you may choose to wait or you may see any other the other providers in the clinic.


How do I make an appointment?

Initial visits usually can be scheduled with in one to two weeks.

For urgent problems, we can often schedule you the same day with one of the providers.

For less urgent problems, you can usually get in within a few days.

For more serious problems, you may be sent to the emergency room, usually to Northwest Hospital or Children’s Hospital.

For life-threatening emergencies, please call 911 first.

What if I need to cancel an appointment, or will be late?

Please let us know about cancellations promptly, ideally 24 hours ahead.

Otherwise, there may be a $50 charge.

You can leave a message for us after hours.

If you are running late, call to let us know. We may need to reschedule if you are more than 15 minutes late.

Is there a co-payment?

Check on the back of your insurance card. We collect the co-payments prior to your visit when you check in.

Please bring your insurance card.

We accept cash, checks, Visa and Master cards.

We offer a discount to patients without insurance who pay at the time of service.

What should I always bring to an appointment?

A list of your concerns. We may not be able to address all of them at each visit.

Your current med list: a complete list of everything you are actually taking now. It may help to bring in the actual prescription bottles and any over the counter remedies, and those prescribed by other doctors.

Allergies and any meds that have caused any kind of adverse reaction.

Please tell us if there is anyone with whom you would authorize us to discuss your medical care.

Any forms that need to be filled out need to be presented during an office visit or there may be a separate charge for completing them.

Your insurance card and co-pay or medical coupon. Please check to make sure we are on your plan.

Do I make an appointment if I need a form filled out by my Provider?

Yes! Even if you have just been in, we may not have the information we need. If it is important enough to do, then it needs to be done right. Bring the form in at the time of the visit.

Such paper-work may include school or other “physicals,” disability documentation, prescriptions for medical equipment, justification for “un-covered” meds, L&I (workman’s comp), Family Medical Leave Act or POLST (advanced directive) forms, work excuses, retirement home admission forms, etc.

If you are seen regularly for diabetes, pain management or other chronic problems:

Please schedule your next appointment as you leave the office. We like to see patients about every 3 months for these type of concerns.


What do I need to know about referrals? How do I get one?

If your insurance requires a referral in order for them to cover a visit or a test, you must be seen by your primary care provider first.

Referrals may need to be “renewed” after three or more months.

Retroactive referrals are generally not accepted by insurance companies.

Referrals are generally done in our office and may take several days to complete, unless it is very urgent.

IMPORTANT: If a specialist suggests you see another specialist, check back with our office first! Many times, your insurance company will only pay if the referral is from your primary care provider. Please tell us before you see the second specialist!

If you plan to see another practitioner, but don’t need a referral:

Please let us know.

You will get better care if we can send them some of your medical history.

Please ask them to send us a report, so we can take better care of you.

Part of our job is to help coordinate your care to avoid duplication and omission of services.

What if I want a second opinion?

We will be happy to help you arrange for a second opinion.

Lab Tests

Where will my lab tests be done?

We do some tests in the office, including urinalysis, rapid strep, glucose, pregnancy, microscopic exams. We bill for these directly.

Blood work and other tests are usually sent to LabCorps. They will bill your insurance. We will bill for a small specimen collection fee.

You may also request that we fax a prescription for lab work to another lab site, including Children’s Hospital, if that is more convenient. You would generally need an appointment here first to determine what tests are appropriate.

What is a “fasting” blood test?

If you are asked to “fast,” do not eat or drink anything for 8 hours before the test, except water, tea or coffee without sugar or milk.


What immunizations do you offer?

For children:

  • DTaP (diphtheria, tetanus, acellular pertussis)
  • MMR (measles, mumps, rubella)
  • IPV (Polio)
  • Hepatitis B
  • Hepatitis A
  • Rotavirus
  • HIB (hemophilus)
  • PCV-13
  • Varicella (Chicken Pox)
  • Influenza
  • Gardisil (for HPV)

For adults:

  • Tdap (tetanus, diphtheria, acellular pertussis)
  • Influenza

We can write prescriptions for:

  • Hepatitis A and B for adults
  • Gardisil (HPV)
  • Pneumovax
  • Zostavax (for people over 60, to prevent shingles)

Medical Records

Who has access to my medical records?

Your medical records are confidential. Please see our Notice of Your Privacy Rights, which are contained in the Adult New Patient packet for more information.

How will I be notified of test results?

We will report all lab and other test results to you, within two weeks, either by letter or by telephone. Please let us know if it is OK to leave a detailed message. If you would prefer that we send you an actual copy of your lab results, please ask. If you do not get a result within 2 weeks, please call us.

How do I request medical records?

You need to sign a written release. Please bring name, address and/or fax and phone # of your previous provider, so we can request records from them.

There is no charge for records sent to another practitioner for your continuing care.

There is a charge for records sent to an insurance company, or for your own use.

Patient Satisfaction

What if I have bad side effects, or my treatment doesn’t work?

Please tell us, so we can work together to find a better treatment plan or send you to see a specialist, if that is needed.

What if I am unhappy with my care?

Please tell us! It is our intention that you get excellent care. But we can’t fix what we don’t know about. Call, come in or write us a letter so we can work with you toward a solution.

What if I am happy with my care?

Tell all your friends! Put it on the internet! We suggest adding a review on Yelp or Healthgrades. You can friend or “like” us on Facebook. Help our practice to provide excellent care to more people!

Advanced Directives

What about Advanced Directives and Medical Power of Attorney (MPOA)? What is a POLST form, and do I need one?

Physician Orders for Life-Sustaining Treatment form (usually on bright green paper) is a list of medical orders, signed by your medical practitioner, stating what medical interventions you do, or do not, want for end of life care, if you are not able to speak for yourself. Usually you would ask your provider for this form when your death within the next six to twelve months would not be surprising.

Advanced Directives and Medical Power of Attorney statements are more general. If you have these, please bring in a copy and discuss it with your doctor or nurse practitioner. We need to know what you want, so we can order correctly for you.

Any and all medical care is done with your consent, and you have a “line-item veto” power. You would be responsible for the consequences, of course, if you don’t follow medical advice. But care cannot be forced on you without your consent.

Advanced directives, medical power of attorney and POLST forms only take effect when we are not able to ask you. When we are able to ask you directly, we do. And you are entitled to change your mind at any time, regardless of what you have written in the past.

In the absence of any instructions, in a crisis, or when in doubt, we will do everything we can to protect your life. But “tubes” can always be removed, if they are not serving your wishes. And we would always act to keep you as comfortable as possible.

Regarding life-sustaining treatment, the crucial question is – Under what circumstances would your life no longer be meaningful to you? In other words, at what point would you want to be treated for comfort only, and not to prolong your life.

If you have named a Medical Power of Attorney, that person is supposed to authorize for you what you would have wanted if you were able to speak for yourself. Therefore, it is important that you tell that person directly what you would want. It would be helpful if you would tell your practitioner also, so we can comply with your wishes.