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Porchlight Pediatrics is a concierge, direct-pay pediatric practice serving the greater Spokane, WA / Coeur d'Alene, ID area. Families pay a flat monthly membership for direct access to their provider, with no insurance billing and no waiting rooms, and with same-day telehealth and in-home visits when needed.

No. Porchlight is a fully self-pay (direct-pay) practice and does not bill any insurance. If your family has private insurance you are welcome here: we simply don't bill it, and membership and visit fees are paid directly by the family. Medicaid and Medicare are different: see the next question. HSA funds may be used toward membership costs, subject to IRS guidelines (HSA may not cover the full cost of care for every plan; consult your tax advisor).

No. By law, Porchlight cannot see any patient who is on Medicaid or Medicare. This includes Medicaid as a second plan alongside private insurance, and a parent seen in the same visit. This is not a billing preference, and we cannot make exceptions. If the patient has Medicaid or Medicare, please do not book a visit or a membership with us.

Aubrey Bot, Nurse Practitioner. Aubrey has been a nurse since 2014 and a nurse practitioner since 2018, with experience in pediatric intensive care, the pediatric ER, family practice, general pediatrics and emergency medicine.

Either. Families can use Porchlight as their child's primary ongoing pediatric care, or as an occasional resource for one-off visits (non-member rates apply if you're not enrolled in membership).

Monday to Friday, 7:00 am to 5:00 pm.

In Idaho: Coeur d'Alene, Post Falls, Hayden and Rathdrum. In Washington: Spokane, Spokane Valley and Liberty Lake. Farther out, like Spirit Lake, Athol, Sandpoint, Kellogg or Cheney, we can see you by telehealth, or come to you for an extra travel fee.

When you call, text or send a request, Aubrey or a nurse reaches out, usually within 90 minutes during business hours, and right away if she isn't with a patient.

Download the Spruce app. It's HIPAA compliant, so it's the best way to text or call us.

We recommend texting the practice line even outside business hours. If a provider is available, we will respond. However, after-hours response is not guaranteed. For true emergencies, please go to the nearest emergency room.

Any life-threatening or severe symptom (difficulty breathing, uncontrolled bleeding, loss of consciousness, severe allergic reaction, suspected broken bone, any fever of 100.4°F or greater in an infant 8 weeks old or younger, etc.) should go straight to the emergency room. Porchlight is not an emergency service and cannot replace emergency care.

Members receive a 90-minute response window for messages sent during business hours (Monday to Friday, 7 am to 5 pm).

Yes. Well-child visits, sports and school physicals, and developmental screening are included as part of membership.

Yes, we prescribe and manage medications electronically to your preferred pharmacy for acute and chronic conditions. For many common medications, we can also dispense directly at the visit, with no separate pharmacy trip needed.

Yes, school notes and accommodations documentation (including for ADHD evaluations) are part of our services.

Yes. We coordinate referrals to specialists, and can also refer for services we don't provide directly.

We don't have on-site X-ray equipment, but we can order X-rays for you and send you to an imaging facility, where a radiologist will read the results. We also carry crutches, walking boots, and wrist splints for immediate at-home use. If casting is needed, we refer to orthopedics for that specific care.

Yes. We offer both ADHD evaluations and mental health evaluations (depression and anxiety) in-house, each with its own pricing. We do not diagnose autism spectrum disorder; that is referred out.

In-home IV services and blood draw services are available in Idaho, and in Washington depending on RN availability. We'll confirm at the time of scheduling whether we can support this in your area. Other services, including telehealth, in-home sick visits, well visits, and ADHD and mental health evaluations, are available across our full service area in both states.

We partner with Quest Diagnostics for lab draws and testing. Quest bills you or your insurance directly for the lab itself.

If you need to be seen right away, call or text us. If you'd like to sign up now so you're ready whenever you need us, sign up online through Hint Health, our membership system, from the Pricing page. Use the code FIRST50 if you're one of our first 50 founding families.

Direct messaging with your provider, same-day telehealth for sick visits, in-home sick visits (after telehealth triage), well-child visits, developmental screening, sports and school physicals, and chronic condition management.

All included as part of membership. Well-child visits, sports and school physicals, developmental screenings, and any forms you need completed (school, camp, activity, etc.) carry no additional charge beyond your membership fee.

Yes. Point-of-care testing (rapid strep, influenza, COVID-19, and RSV) is included as part of membership at no additional charge. This does not include urinalysis or cultures, which are sent to an outside lab.

Yes, a 3-month minimum commitment for standard membership. 30 days' written notice is required to cancel after the minimum is met.

Yes. Pay 10 months upfront and receive 12 months of membership.

Re-enrolling families pay the enrollment fee again at current rates and are billed at standard (not founding-member) pricing.

If a parent has the same illness as the child being seen, the parent may be evaluated and treated during the same visit, at the provider's discretion, limited to the same complaint. This is available as an add-on to both telehealth and in-home visits.

Yes. Clinical supplies and medications used during a visit (for example IV supplies, numbing cream, medications given) are billed separately, in addition to the visit or procedure fee.

Credit or debit card and HSA card.

Yes. Payment plans through Cherry are available for urgent care visits, procedures and medications. See what you could pay on our Payment plans page.