Welcome to the FAQ Page

​For the best possible XO Health experience, please read through all the Frequently Asked Questions below! 

APPOINTMENT SCHEDULING

How do I make an appointment with Stacey or Michelle? ​

All appointments are made through the scheduler located on the portal. Stacey and Michelle publish times that you can select from their availability and book your appointment immediately without any back and forth phone tag or email tag or waiting on hold. Please note that Stacey has set aside specific blocks of time for appointments, but has left other parts of her day open. She uses this time to address urgent needs of members, respond to tickets, and continue taking educational courses; however, she reserves some of this time to be open to members if her regularly scheduled times don't fit a members' schedule. Therefore, if you do not see an available time on the calendar that works for you, you can use the option to request an alternative time. You are not being a bother at all by asking for an alternative time! We just ask that you request these times through the portal rather than emailing, texting, and leaving voicemails. As Stacey is planning her schedule, she takes into account appointments that are booked through the calendar and special requests through the portal. This way, all the appointment requests that she needs to consider are in one spot so she can efficiently schedule special request appointments. If your request is not in that pool of requests that comes through the portal, she will not be able to schedule you.  ​

What if it is urgent, how do I get an appointment with Stacey?

If your need for an appointment with Stacey is urgent, please send a ticket and mark it as urgent. If your need to see an MD is immediate, then a visit to an urgent care clinic or the ER may be more appropriate. There are times Dr. Luetmer has been able to save a member from an ER visit, and she loves doing this when she can! However, this is hit and miss and completely subject to her schedule. Once you submit an urgent request to see Stacey, she will notice the urgent ticket just as soon as she checks the ticket dashboard, which is periodically throughout the day between appointments. Calling or texting Ron WILL NOT accelerate the time frame. He does not interrupt Stacey’s schedule. Doing so would create constant task-switching and inevitably pull Stacey’s attention away from a patient she is currently working with, and at the end of the day, would make her less productive, which benefits nobody. ​

​What if I don’t see a time that works for me on the scheduler?

If you don’t see a time available that works for you, use the option to request alternative times. Please submit 3 alternative times that work for you and Stacey or Michelle will do their best to accommodate your first choice. ​

​What if I want to book an appointment for longer than 30 minutes?

If you need more than 30 minutes, book 2 slots back to back or use the request alternative times feature. ​

How does it impact my credit usage if my actual appointment was longer or shorter than what I booked? ​

Your credits are reduced by the time spent, not by the scheduled time: ie. a 60-minute appointment may end up lasting only 45 minutes, thereby reducing your credit balance by .75 instead of 1. Please keep in mind that time spent documenting your visit adds to the visit time. ​

BILLING

Does XO Health Bill Insurance?

No. We would have to at least double our fees to justify covering the costs associated with becoming an "in network provider" and billing insurance. 

Can I get a superbill to submit to my insurance or healthshare?

Yes; please read the following for clarification:
 
We can provide a superbill for individual clinic visits that include appropriate billing codes for patients who want to submit claims to their healthshare or traditional insurance company for reimbursement. "

This does not mean that a superbill can be created to cover either a monthly or annual membership fee as there are no procedure or diagnosis codes that exist that represent the various benefits of Flourish membership. As a member, you get a certain number of credits that can be used however you wish, whenever you wish, and usage of those credits tend to be irregular throughout the year. The monthly membership serves as a nice way to budget paying for the time those credits represent over 12 months. 

Please keep in mind the following guidelines we must follow to provide superbills without committing insurance fraud:

• We cannot provide a superbill with a dollar amount more than what you have paid to Flourish.
  
• We cannot provide a superbill for services that do not have a corresponding billing code accepted by insurance companies. For example, part of your monthly membership covers the cost and time involved of running the online supplement store and the member side of the website with all the online education and there is no insurance code for "supplement store access" or for zoom member educational meetings, etc. 
  

Under these guidelines, therefore, Flourish provides the following: 
For new members, we provide a superbill upon request at the conclusion of your onboarding process as a new patient. (at the end of your 3-month onboarding). We do this because there are a specific set of appointments with corresponding CPT codes during this period of time. 

Following this initial superbill, Flourish will provide an annual summary superbill of your visits for the year upon request.  Trying to provide interim superbills throughout the year is often impossible because the superbill amount might exceed what you have paid since payment is spread evenly over 12 months and usage is variable. 

Requesting a superbill at any point during your membership period means we have to take the time to see if it is possible and draft a superbill because visit time may not have been paid for if you are using credits that have not technically been paid for yet since you have not completed the year’s payments. This process can be time consuming (pulling payment information and adjusting superbill pricing on a line item basis to ensure everything ties out to make sure we are not committing insurance fraud), and therefore any time spent preparing a superbill will be applied against your credit balance. 
Superbills generated by Flourish will include the following industry standard information.  Time spent responding to requests for additional information or requests for us to contact your insurance company or healthshare directly will be applied against your credit balance. . 
PROVIDER INFORMATION
Provider first and last name
Provider NPI number
Office location where the visit took place
Provider phone number
Provider email address
Provider signature

PATIENT INFORMATION
Patient first and last name
Patient phone number
Patient date of birth (DOB)

VISIT INFORMATION
Date of visit
Procedure Codes and Description (CPT)
Diagnosis Codes and Description (ICD-10)
Modifiers if applicable
Units or Minutes
Fees Charged

​

LABS

Where is the best place to get my labs drawn?

The answer to this question depends on the labs being drawn and the member’s location and insurance. Flourish is able to provide excellent cash prices for labs, so in most situations, paying for labs directly is more economical than using insurance and paying the deductible and copays. Also, your local clinic may not have some of the specialty labs available that Dr. Luetmer might order. For standard labs, those can be drawn at your local clinic and Dr. Luetmer can order those labs. For members who live a long distance from the clinic, you can still take advantage of the cash lab pricing and have your labs drawn at the Labcorp nearest you. ​

Does Flourish make money on labs? ​

No, we charge a minimal lab draw fee to cover the cost of hiring a phlebotomist to conduct the blood draws. We are a part of a lab co-op that provides excellent cash pricing and pass those savings onto our members. ​

How long does it take for my lab results to come back? ​

Labs are shipped generally the next business day following the lab draw date and results come back between 3-7 days depending on the labs drawn. Dr. Luetmer communicates lab results via a support ticket and many times, sharing lab results is associated with an upcoming appointment. If you are wondering whether your lab results are back, please log into the portal and see if there is a ticket with the results. If it has been a couple days beyond the longest date Stacey has told you it would take for lab results to come back, then feel free to submit a ticket inquiring the status and we will follow up with the lab company to find out the cause for the delay. ​

I received an email telling me when the next lab draw dates are. Does that mean I am due for labs? ​

Not necessarily.. We send lab dates to all members in mass mailings as an FYI. Stacey is generally working with a few members and new patients and planning for their labs and we share the lab dates to everyone in case a member has been meaning to reach out and have labs drawn. ​

What happens if I am late for my lab draw? ​

First, we ask that you plan accordingly and arrive on time. However, if something happens and you will be late - we ask that you notify us of your potential arrival time. At that time, you will be notified if we can still do the draw (sometimes Lindsey, our phlebotomist, needs to be elsewhere and can’t stay late - so you will need to reschedule). If she can see you, you will be given the option of coming and paying an extra fee, or rescheduling.

If the lateness will cause her to stay longer than she would otherwise, you will be billed
for that time in order to compensate her (at a rate of $30/hour - prorated to the time to
stay and draw and process your sample).

​

Should I pay cash for labs or use my insurance? 

This depends on the individual labs being drawn, the cash price of those labs, the deductible and copay amounts, and how close you might be in meeting your deductible. Stacey will give you guidance in answering these questions. In most cases, paying the cash price is the best option. ​

MEMBER SITE CONTENT

Why does Dr. Luetmer ask me to watch videos on the website? 

In addition to 4 years of medical school, 3 years of residency, and 20 years of practice experience, Stacey has spent countless hours attending expensive courses to become certified in specialized topics through the Institute of Functional Medicine, A4M, The Kharrizian Institute, The Kresser Institute, The Dr. Wahls Protocol, and others. She has digested this information and produced patient-facing educational content because it is critical for patients to have a base understanding of their conditions in order to participate in making improvements. Rather than Stacey spending valuable clinic time with you explaining “the basics”, by watching video content and reading supplementary content available on the member site, your care becomes more efficient and consequently more economical. Therefore, Stacey will “prescribe” content from the website for you to watch between appointments. ​

MEMBER PORTAL

I can’t remember how to log in or my password, what do I do?

You can access the login screen from the main Flourish website. (www.flourishmd.com) or through the Flourish app. Your username will always be the email address associated with Flourish. If you can’t remember your password, there is a “Forgot my password” option on the login screen. Click that button and follow the prompts on the screen to create a new password. 

​THE TAB THAT HAS THE PORTAL ON IT IS SHOWING ME AN ERROR, WHAT DO I DO NOW?

As a security measure, the portal has an auto-logout feature. If you open the portal multiple times in multiple windows, this may confuse the auto-logout feature depending on the browser you are using and you may experience an error message. If this happens, close out ALL the tabs that you have the portal open, then re-access the login page to login. ​​

Should I always use the same email address when interacting with Flourish?

Absolutely! The email address you provide when you first complete your case review is the email address we use that serves as your login username for the portal and what we use to send member updates, etc. To keep things simple, we autopopulate systems with that email address when you use the portal. For example, when you schedule an appointment, your email address will automatically populate. If you back out this address and put in an alternative address, that will create a separate record in our system under that new email address. Please do not do this as it requires us to then consolidate records to maintain a clean system. If you want to change the email address you are using with Flourish, please submit an administrative support ticket stating the new email address you want to use and we will make the change (which will include resetting your portal access through the new email address) ​

Can I access the portal and submit tickets from my phone? ​

Yes. you can easily log into the portal from your phone using the Flourish Health MD app and access the complete functionality of the portal, including reviewing existing tickets, replying to a ticket or submitting a new ticket. ​

Is there a Flourish Health app for my phone?

Yes! We have built an app for both Android and iOS. The Android app is published on the Google Play App Store. Search for "Flourish Health MD" or here is the link.
We are waiting on approval from Apple to publish the app for iOS (iPhone/iPad)

MEMBERSHIP

What are member credits and how are they used? 

Membership credits primarily translate to consulting time you can “spend” as part of your membership and provide you with the flexibility to connect with Dr. Luetmer and Michelle, our health coach, using the available communication channels that work best for you.  For example, some people prefer using most of their time for in-person appointments; whereas others like to spend more of their credits toward online support to ask Stacey or Michelle ongoing questions.  

• 1 credit equals 1 hour of consulting time with Dr. Luetmer; whereas
• 1 credit equals 2 hours of consulting time with Michelle.​​

How can I maximize my member credits?

There are a number of member benefits that do not reduce your credit balance; from member group events to live Q&A educational seminars. In addition, participating in group clinic visits to discuss health issues and strategies common to the group will only deduct a fraction of a credit. For example, group visits that generally last between 60-90 minutes only “cost” .25 (¼) of a credit. A unique aspect of Dr. Luetmer's practice is the 200+ hours of video education she has produced that is available to members only. This education is designed to elevate a member's understanding of their health issues. Stacey "prescribes" specific videos to patients so members can maximize their appointment time since Stacey is not wasting time "covering the basics" that are addressed in the video education.

How do we utilize the time of the health coach? ​

People who are not familiar with what a health coach can do might initially view a health coach as someone who occasionally checks in to give you a pep talk. In fact, the role of our health coach extends well beyond providing motivation! Most functional medicine practices employ health coaches and have demonstrated success in improving outcomes for patients by doing so. Michelle can work with you in a number of areas that do not require an MD to address such as: 

• Working with you to implement your customized health plan
  
• Providing support on dietary and lifestyle changes you are working on
  
• Answering questions about supplements
  
• Empowering you with the knowledge needed for long term sustainable wellness
  
• Providing specific guidance on recipes, navigating food choices when eating out, self care routines, detox routines, and so much more
  
• Providing accountability and support needed to maintain inspiration and motivation in the lifestyle changes you are making
  
• Stacey and Michelle work alongside each other as a team to maximize each other’s skill set to provide the maximum value to members. ​
  

What happens if I run out of member credits before my membership renewal date? 

You may purchase additional credits at Stacey’s hourly rate ($350). Alternatively, if you are running low close to your anniversary date and commit to renewing, you can just run a negative balance until you renew. If you run out of credits in the middle of the year, you have the option to upgrade your membership mid-year, which is more cost effective as Stacey’s hourly rate within a membership is less than her standard per-hour rate. ​

What happens if I don’t use all my member credits by the end of my membership year? 

Your credit balance will carry-over into the next membership year up to a maximum of 25% of your membership quota. For example, if you are at Silver with 8 credits, you can rollover up to 2 credits. Credit time is meant to be used and part of being a member is to be proactive in achieving your health goals. This means scheduling appointments with Stacey and Michelle to stay on track, participating in group clinic visits, and sending in support tickets when you have questions about your regimen.  We want to be fair in allowing credits to roll over and we also want to incentivize members to use their membership. ​

Can I use my credits if I am not a member?

No. Members must maintain some level of membership in order for credits to rollover. Stacey manages her membership capacity based on the number of collective outstanding credits among all the members. Think of your credits as taking up a “seat on the bus” and Dr. Luetmer reserves that seat for you. We encourage members to use their credits during the course of their current membership year as these are intended to support your health journey. ​

Do I have to use a whole member credit at once? 

No, since member credits translate primarily to time, you can use a credit fractionally. For example, if you submit a ticket that takes Stacey only 5 minutes to respond to, that uses just .083 of a credit (5/60).

What would an example look like of member credit usage for a Silver Member for the year?

Again, some members like more in-person or zoom meetings, while others like to communicate a lot of information through the ticketing system. Regardless, a minute spent by Stacey on a ticket is the same as a minute spent in an appointment. Sometimes it makes sense to spend that time on an appointment, while other times getting a concise written answer to your question is the best use of that time. Given that background, here is what a member’s usage could look like for the 8 credits in a given year: (keep in mind that time with Michelle uses credits at half the rate of Stacey)

Events	Time in Minutes	Credits Used
(4) 30-minute in person follow-up consultations with Stacey	120	2
(2) 15-minute zoom consultations with Stacey	30	.5
(23) Support Tickets that take an average of 5 minutes for Stacey to respond to	115	1.91
(6) 30-minute coaching sessions	180	1.5
(15) Support Tickets that take an average of 7 minutes for a health coach to respond to	105	.875
(4) Group Clinic Visits at an average of 75 minutes each	300	1
(6) Virtual Member Educational Zoom Member Gatherings at an average of 60 minutes each (10-11 are available each year, but this assumes you make it to about half of them)	360
Total Minutes	1,210	7.8
Total Hours of Member Benefits	20.2

Does administrative time use member credits?​

New members are given a grace period of their three month onboarding process to reach out to Ron for guidance on how to best utilize the membership. We expect to spend some time with you up front to ensure you are getting the most out of your membership benefits. We have spent a great deal of time, effort and money to build efficient systems and video tutorials to automate processes and efficiently convey information common to all members. This up-front investment to create efficiencies is one way we are able to keep Dr. Luetmer’s rates well below the industry standard and utilizing our systems as designed help to keep the member fees as affordable as possible. 
Once you have completed your orientation to Flourish, ongoing reasonable and standard administrative tasks will not be billed, but excessive administrative time that is avoidable will consume member credits. Examples of excessive administrative time that will be billed include:

• Texting, calling and emailing questions that are answered in the FAQs or tutorial videos.  
  
• Rather than using the online supplement store, you send an email, voicemail, or text with a list of supplements that you want to purchase. (this generally results in an inefficient string of emails or phone calls clarifying exactly which supplements you want, such as whether you want the 60 or 120 capsule options, asking quantities compared to quantity on hand, etc. and is very time-consuming) 
  
• Time spent gathering additional detail for insurance companies beyond providing the standard superbill information detailed below under the “Billing and Insurance” section. 
  
• Not using the ticketing system: As a reminder, the quickest route to Stacey is by submitting a ticket through the Support tab on the portal. Emailing, calling and/or texting Ron only slows down the process as all Ron will do is create a support ticket on your behalf. When Ron receives a request via email, text, or voicemail with a need that can only be addressed by Stacey, he first checks to see if a ticket has already been created (as he has experienced in the past situations where members both submit a ticket AND call Ron) and then will create a ticket. This creates a situation where Ron is task-switched from what he was working on to create the ticket, therefore a flat deduction of .25 credits applies when Ron creates a ticket on your behalf. If, for whatever reason (in very rare occasions) , the ticketing system is down, this policy would not apply. ​
  

Can I pause my membership?

No. One of the ways Flourish is able to deliver the expertise of a highly qualified functional medicine MD and health coaching at a cost well below the industry standard is through operational efficiency. The administrative time it takes to unenroll a member only to re-enroll a month or two later defeats that purpose. More importantly, it disconnects the member from their lifeline to the Flourish team if they need something during a "pause" period. That said, we understand that at times, members may need to cut some expenses for a period of time. Therefore, if you have available excess credits, you can downgrade your plan to the Base Membership, which still provides you with all the benefits of membership, including the use of your accrued credits. The Base Membership maintains your membership without accruing additional credits. If you want to exercise this option, simply submit an administrative ticket to Ron letting him know. He will adjust your credit balance to reflect the credits you have actually paid for and adjust your monthly membership fee down to the Base Membership rate. For example, Bronze comes with 4 credits; if you downgrade 6 months into your membership, he will reduce your balance by 2 credits since those credits have not been paid for.

Can I cancel my membership before my year is up?

The Flourish membership is designed to be an annual commitment. The main reason is that a disproportionate amount of time is invested in your health plan and coaching in the first few months of your membership so your monthly membership payment is a way to budget this cost over the period of one year.  That said, we understand “life happens” and there are some reasonable cases in which a member may quit early. In that case, any time you used that has not been paid for will be due at the time of cancellation. For example, if you are at the Silver Level with 8 member credits and you want to cancel six months into your membership, you have paid for exactly 4 of those 8 credits. If you have used 5 credits, you will be responsible for paying for the extra 1 credit ($350). ​

SUPPORT (TICKETING SYSTEM)

Do I use the ticketing system for all communication with Flourish?

Yes. Once you have portal access, all communication should flow through the ticketing system. 

While we do use email for sending mass emails to members to update you on upcoming events and other items of interest to the whole membership as well as on a very limited basis for a few administrative tasks such as confirming preferred lab times. However, whenever the content of the communication is specific to a member's health, please access the portal and submit a support ticket. Please note leaving voicemails, text messages, and emails will be replied with a message to submit a ticket.

Why is it so important to exclusively use support tickets  for communication?

There are a number of reasons why using the ticketing system is to exclusive means to communicate:

• Security and Privacy: The ticketing system is HIPAA compliant and provides a secure means of communication to protect your sensitive health information. 
  
• Single channel of communication:  It is much more efficient and communication is not lost. Emails, text messages, and voicemails are easily lost in the shuffle, whereas tickets remain on our dashboards until they are addressed. Also, you can always go back to the support area in the portal to review past communications.
  
• Ensures your question is 100% answered: If Stacey responds to an email, there is not necessarily a feedback loop to confirm she has completed answered a question. With the ticketing system, there is a “close” feature- so when your question is answered, you click on the Close Ticket button, which communicates back to us that your questions is resolved. 
  
• Prioritizes needs: Stacey’s ticket dashboard organizes tickets by order of priority you mark on the ticket, with URGENT tickets listed first. This allows for a very efficient means for Stacey to see who needs a response ASAP, followed by tickets with the oldest tickets listed first. 
  

Facilitates collaboration: If you have a question that might be applicable to both Stacey and Michelle, you can include both on the ticket; or if you ticket Michelle, she can easily tag Stacey on the ticket to get her input. ​

If I send a support ticket to Stacey, should I also text, email and call Ron?

No. This has happened a lot in the past, and Ron, as a people pleaser, has tracked down Stacey or interrupted her flow only to find that a ticket has been created and the issue resolved. This is inefficient and inhibits our ability to effectively serve the whole member group.

How do I know if my support ticket was actually submitted? 

When you create a ticket you will receive an email confirmation that you successfully created a ticket - if you are wondering whether your ticket actually came through to us, look for that email. If you don’t see the email, try creating the ticket again. If you still don’t see the ticket confirmation, check your junk folder and/or look in the support area of your portal account. All your tickets should show up there. ​

Do I create a new ticket each time I have a question? 

Absolutely! This is the best way to keep track of your communication with us. One of the benefits of the ticketing system is to have an achieve of the advice Stacey and Michelle give. By having a separate ticket for each topic, you and your Flourish team can easily access past conversations. If you just reply to an existing ticket with a new topic, finding that information buried in an unrelated ticket can add to the time it takes Stacey to reference past information, and consequently adds cost. ​

It has been a little while since I submitted my ticket and I am growing impatient, should I call Ron to get a status on the ticket?

No. Ron does not interrupt Stacey’s workflow to check on the status of a ticket. That would only slow things down for everyone. Depending on the nature of your question, Stacey may have to do some research before she responds. Just because you have not received a response does not mean Stacey is not working on your ticket. Stacey strives for the following response times:

• Urgent Tickets: Same day response
  
• Tickets marked with High Priority: 24 hour response
  
• Regular tickets: 1-3 business days
  

If your ticket has exceeded these parameters, the best approach is to go into the portal and mark your ticket as urgent.

How do I know when someone from Flourish responds to a ticket?

You will receive both an email and text message when we respond to a ticket. These messages will direct you to go to the portal to view our message/response. These notification emails and text messages are outbound messages only. Do not reply to the text or email messages as we will not receive the reply.  Once you log into the portal and view the ticket, you can respond to the ticket from within the portal. ALL communication takes place from within the portal. 

Effective 2/10/24: As an added security measure, we are no longer sending ticket replies via email. Even though we have not had any security breaches and emails from Flourish are encrypted and sent in a HIPAA compliant manner, we have decided to discontinue this practice due to the security risk of using email (since once the email hits your inbox it is beyond our control). Please initiate all new tickets from the portal. (Do not dig through your email and reply to old tickets)