Frequently Asked Questions
You have questions. We have answers!
What is Direct Primary Care?
Direct Primary Care (DPC) is an innovative way to bring affordability and convenience back to your family. We don’t bill your insurance, so we practice medicine the way it was intended- to work for the patient (not the insurance company) and provide quality, time, and cost-saving perks directly to the consumer. This means you don’t have to jump through the hoops of a traditional medical practice to get the care you need.
Do I still need insurance?
Dr. Mom Pediatrics and Lactation is not a substitute for having health insurance. Your child may need to go to the ER, be hospitalized, see a specialist, or have a special test, procedure, or surgery. In these cases, your insurance will be used. Dr. Bansal does not bill your insurance so there are no co-pays when you see Dr. Bansal. You may opt for a high-deductible or catastrophic insurance plan, or a shared health plan since you will be saving money with Direct Primary Care such as the model Dr. Mom Pediatrics offers.
Why should I sign up when I already pay for insurance?
Simple- it actually SAVES YOU MONEY versus a traditional pediatrician office!!! Even if you have “good insurance”, there are hidden fees that you don’t know about until you get your bill weeks later! This is true of our entire healthcare system, whether it’s a hospital or doctor’s office. If you have a high deductible plan, you will spend $200 or more for EACH AND EVERY sick visit, after one hour in a waiting room, with 2 other children. If you have a shared health plan or healthcare ministry, you will pay $200 or more for every preventive visit plus the cost of developmental screens and lab tests, plus $200 or more for every sick visit, and add labs and medications on top of that! If you go to a retail urgent care, you will likely see an adult-trained nurse practitioner (not a pediatrician) and pay $100 or more with labtests, PLUS a co-pay for a prescription, after a long wait, and still need to follow up with a pediatrician (yet another expense). If you go to the ER for a simple illness, you will get a bill in the thousands. With a low monthly membership, you SAVE money because your preventive visits and sick visits are covered. And that’s not all you save on!
With Dr. Mom’s Direct Primary Care model, the savings for labs, medications, diapers, and home health supplies are passed on to you. Some labs are free, in your home! Some medications are as little as $1.50 for a full course! We don’t charge extra for vision screening, developmental screening, many common treatments, or for filling out medical necessity forms.
How is Direct Primary Care different from a traditional pediatric office?
Your insurance company takes your money, but doesn’t always pay your doctor for the work he or she has already done for you. Due to insurance companies lowering their payments to physicians and facilities throughout healthcare, physicians in a traditional practice need to see an increased number of patients to pay their bills, pay their staff, and make ends meet. This translates into less time with you, in order to accommodate the dozens of other patients they need to see before 5 pm. This means you will get hardly 10 rushed min with your physician, nurse practitioner, or physician assistant in a traditional, insurance-based office. With Dr. Mom’s Direct Primary Care model, there’s a small patient panel limited to just 200 patients (versus 5000 patients in a traditional office), which means Dr. Bansal can spend 30-60 min with you and your child, in the convenience of your child’s own home. Visits are unhurried, with ample time to address all your concerns, and 100% done by a board certified, experienced pediatrician.
With Dr. Mom’s Housecalls model, you don’t have to take off work or school, or miss client meetings or kids’ activities to sit in traffic on the way to the doctor, or in a waiting room for a prolonged period, with siblings who also missed their activities. If your child has a sore throat, Dr. Bansal can see your child in the afternoon or evening, administer a test, provide you with an in-stock medication on the spot, and get your child back to school and you back to work the very next morning. If your child has mobility challenges, sensory issues, or is just shy or afraid of a different environment, Dr. Bansal can help your child feel comfortable with a doctor in your own setting. Your living room is your waiting room!
You get deeply discounted in-stock medications, diapers, and supplies. Some labs are even free! No CO-PAYS for visits! And if you use your FSA and HSA, or if your shared health plan reimburses you, these costs and your membership can be returned to your pocket!
You get a pediatrician at the swipe of your fingers, by text, on weekends, at night, even from your restaurant table on your family vacation. By removing the red tape and corporate management of your child’s healthcare, Dr. Bansal is able to focus on the reason she became a pediatrician- to care for children, not the insurance company. With a traditional pediatric office, you often get a receptionist or nurse on the phone, and rarely the pediatrician directly, if ever.
Vaccines will be administered in your home, when we are able to work with your insurance to order them. Dr. Bansal can also refer you to a vaccine clinic to schedule at your convenience.
Are vaccines included?
Dr. Mom Pediatrics has partnered with a facility to work with your insurance, and to be able to administer vaccines in your home, depending on your insurance plan. Contact Dr. Mom Pediatrics and Lactation for more information! For those situations where this doesn’t work out due to your insurance benefits, we can refer you to a great vaccine center nearby that will bill your insurance for the vaccines only.
What lactation services do you provide?
Dr. Bansal will begin providing in-home lactation consultation services in January of 2020! Dr. Mom Pediatrics and Lactation has partnered with a certified lactation consultant to provide these services beginning in July 2019. Contact us for more information!
What if Dr. Bansal is on vacation?
Dr. Bansal may occasionally be out of town with her family on vacation or at a medical conference. In most cases, she will still be available by text/phonecall/email for urgent medical situations. During this time, for routine questions, Dr. Bansal’s medical assistant can take your text/call and handle administrative matters such as appointment scheduling and medication refills. In the event your child needs to be seen, Dr. Bansal has partnered with a local pediatrician to see your child at no additional cost to you.
Do you offer daycare/school/employer discounts?
Yes! Please have your daycare/school/employer administration reach out to us! We offer a discount for employer-paid benefits as well as benefits worked into a daycare/school tuition.