FAQ
Why a membership/DPC model?
- Alicia worked for a number of years in a traditional pediatric clinic and understands the frustrations of the insurance based model. With a membership model, you can have higher quality, more personalized access to your childs’ nurse practitioner without the hassle or uncertainty of knowing where to take your child when sick or if you will be able to get your child in for an appointment to address all of your concerns.
- With the direct care membership, you get direct access 24/7 to your nurse practitioner and the relief of knowing your nurse practitioner has the time to give you the best quality of care. This is because her patient panel is no more than 500 instead of the traditional panel size of 2000+.
- This is a win-win, for both the families and their children. Dr. Alicia will get to know you and your children well without you having to repeat the child’s history or concerns.
Why pay for a membership?
- Membership models have been shown to decrease referrals to specialists or unneeded ER/urgent care visits, thus saving families money in the long-term.
- You won’t have to think twice about bringing your children in no matter the reason. We’ll have an appointment for you. You won’t have copays for every sick visit and follow-up that might be needed.
- Many families will take their children to the ER because they are not able to access their provider with questions or concerns, this is not the case with a membership model.
How do I pay for my membership?
- Memberships are paid in full for 1 year after signing a new contract with the option to renew annually thereafter. This means you pay once and get access to your pediatric nurse practitioner for the whole year! You can pay by check, debit card, or HSA with no additional cost. Credit cards can be used, but you will be charged an additional 2.99% for the credit card processing fee. There are no other hidden charges or fees.
- Other family members or grandparents are welcome to cover your membership for you as well!
- The only additional out of pocket cost would be for blood work/labs sent out from the clinic or imaging ordered outside of the clinic. There may also be additional charges for any other medical equipment you may need to purchase.. You can use your health sharing account or private health insurance for these if you’d like.
What is covered in the membership at no additional charge?
- All wellness and prevention appointments – longer, more personalized appointments
- Development/behavioral screening
- Follow-ups as needed
- Remote/telehealth as needed
- Unlimited texts, email and direct access to your pediatric nurse practitioner 24/7
- Mental health screening and management
- Acute visits/treatments as needed: medications or breathing treatment needed in office, wart cryotherapy, in-office testing – UTI, strep throat, RSV/influenza, etc. Labs that are sent out will have an additional fee (e.g. throat or wound cultures)
- Chronic conditions screening/follow-up: ADHD, eczema, asthma, behavioral concerns, etc. We have more time to spend due to our small patient panel to make sure your family/childs’ needs are met
- We will coordinate with specialists as needed – this is why it’s essential to have some type of healthcare insurance coverage.
What is not covered in the membership?
- Labs (only initial wellness labs and one time follow-up labs are covered in first membership fee)
- Imaging
- Specialist care
- Prescriptions/medications/supplements
- Vaccination
Do you provide home visits?
Currently, our only house visits are with the 4th trimester package that is your infant’s first month through the 3rd month of life. We may be able to accommodate house calls on an as needed basis depending on availability at an extra cost.
How do you handle vaccination?
We do not currently carry vaccinations in our clinic, but Dr. Alicia can provide information per the CDC vaccine schedule and discuss with you your options to make the best decision for your children. If you would like to vaccinate your children, she will direct you to the local health department or a local traditional pediatric clinic for any routine vaccinations. We do not coerce or discriminate based on your or your childs’ vaccine status.
How are office visits handled?
You will have direct communication with the clinic and your nurse practitioner. If your nurse practitioner can manage your needs over the phone you will not need to bring your child in. If Dr. Alicia needs to see your child, she will schedule you an appointment with the goal of the same day or the next day with no added cost. The goal is to prevent Emergency or Urgent Care visits, but this isn’t always possible. If necessary, she may direct you to take your child into the ER or UC.
Do you have after hours or weekend visits?
Since work-life-balance is important to keeping your practitioner healthy to continue to be able to take care of you, currently after hours and weekend appointments will be offered on an as-needed basis as concerns arise. Dr. Alicia will ask you to please try to contact her during normal business hours with any concerns so she can meet your needs prior to non-business hours. She knows some illnesses occur unexpectedly so she will be available to support you at all times as needed.
What if my child needs to go to the Hospital?
Alicia will help direct you on this. She would encourage you to reach out to her first so she can determine if you need to take your child to the ER or if she can help you prevent this. If you put URGENT on your message she will know to get back to you promptly. If you feel you don’t have enough time to contact her, please call 911 or go straight to the ER.
Do I need separate health insurance?
This isn’t a requirement, but yes, we recommend having some type of health insurance coverage. This can be catastrophic or a community shared ministry insurance so that emergencies, surgeries, or specialty care will be covered to an extent based on your enrollment plan. If you don’t currently have health insurance coverage we can help you with this. Please call our office. (208) 930-4177.
If my child is covered under medicaid can I do a membership model?
Yes, you can, but you have to know that your DPC practitioner has to opt out of medicaid. This means that she can not order tests or medications that will be covered under medicaid. You will need to sign a form stating you will not submit any bills to medicaid for reimbursement. For this, we recommend you have an established medicaid provider who can order these tests and do referrals as needed. We can collaborate with your medicaid provider on care when needed.
What is a DNP, APRN, PPCNP-BC?
- DNP is Doctorate of Nursing Practice. APRN is an Advanced Practice Registered Nurse. PPCNP-BC is Pediatric Primary Care Nurse Practitioner – Board Certified.
- Basically, your nurse practitioner is not a Medical Doctor, but she is doctorally prepared and can give the same quality of care as an MD. Idaho and Washington are full practice states for Nurse Practitioners, so she does not need a medical doctor to sign off on her work. She will collaborate with other providers as needed if questions arise she is not able to answer.
How do I join and forms to complete?
- Call the Optimal Living Institute: (208) 930-4177. Our staff will help you to get signed up and get you all the forms you will need. They will also be able to answer any further questions you may have.
- If you’re not sure if you want to join or want to meet the nurse practitioner, you can schedule a 30 min meet and greet appointment at no cost. You’re welcome to come on your own or bring your children to see how Dr. Alicia interacts with them and if it’s a good fit! Please call (208) 930-4177.
Contact Optimal Living Institute
Phone: 208-930-4177
Optimal Living Institute Fax: 208-930-4174
OLI Pediatric DPC Fax: 208-930-4691
Address
2775 N. Howard Street, Suite B Coeur d' Alene, ID 83815
Hours
Monday: 9-3
Tuesday: 10-5
Wednesday: 9-3
Thursday: 10-5
Friday: 9-1