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USMA Questions & Answers
What can I expect at the first visit?
During the first visit a detailed medical history will be obtained, any lab results you bring will be reviewed, your vital signs will be taken, and a short physical performed. Explanations will be provided concerning the rationale for the lab work we will order and the way we approach diagnosis and treatment. Bring with you all lab results from the prior months, and questions. Be prepared to have lab drawn right after the visit. This will be done at the LabCorp about a block and a half from our building. You do not need to be fasting but you should be well hydrated. The initial visit cost is $650 and will last about an hour. Lab costs are extra (see below).
Do you accept health insurance?
We do not accept or file insurance and we are not Medicare providers. Medicare patients will need to pay out of pocket and will not be able to seek reimbursement. Patients with HMOs will also not be able to be reimbursed for their costs. However, patients with PPOs may submit our walk-out bills to their insurance companies for reimbursement under their "out of network" expenses. Most PPO patients are reimbursed according to the percentage specified by their plan.
Why do the office visits seem so expensive?
There are many reasons why medical doctors who treat Lyme disease do not take insurance and seem to charge a high amount. For a detailed explanation click here to download pdf of an article on this topic by Dr. Savely.
How much will the lab work cost?
If you have insurance, bring your insurance card with you and you may present this to LabCorp at the time of your blood draw. Most of your lab work will be billed directly to your insurance. If you do not have insurance and have to pay for your LabCorp labs out of your pocket, the cost of these will vary greatly, depending on what needs to be ordered. Make sure you ask the lab technician to tell you up front how much each test costs.
If you have an HMO, only lab work ordered by an in-network provider will be covered. Some patients are able to convince their HMO primary care provider to order some of the labs for them so that they will not have to pay for these out-of-pocket. Even if you have insurance, the tests we will order from the specialty lab, IGeneX, will need to be paid for up-front by credit card. The total charge for this lab work will be approximately $800. If you have Medicare there will be no charge for the IGeneX labs. (You must bring your Medicare card with you!) If your Medicare is managed by an HMO, however, your IGeneX lab tests will NOT be covered. If you have a PPO, you will be able to submit the receipt from IGeneX for reimbursement under your out-of-network expenses.
When will I find out about my lab results?
We ask that you not call or email our office for test results. These will all be reviewed with you at the first follow-up visit. However, if there are any results that are critical and urgent in nature, we will call you right away. The second visit lasts about a half an hour and costs $350. It will occur about a month after your first consult. All of your lab work will be reviewed and a treatment plan will be formulated and discussed at this visit. Prescriptions will be written. Again there will be plenty of time for questions to be answered. We highly recommend that you bring a loved one to help you remember or to take notes.
How much will the prescribed medications cost?
If you have PPO insurance you will be able to pay usual co-pay for any medications prescribed. I you have Kaiser or many other HMO's, your medications will not be covered unless you are able to convince your HMO physician to prescribe them for you. If you have to pay out of pocket for your prescriptions the price of these will vary tremendously, but your monthly costs can be as high as about a thousand dollars. Costco is the least expensive place to buy prescription medications and you do not need to be a member to use their pharmacy. We will also help you in another way we can, such as by giving you samples (if we have them) or helping you sign up for patient assistance programs.
I live far away- what if I have a problem between visits?
Once you are an established patient, you may email or call us between visits with quick questions that do not require that a chart be pulled. If you have complex questions that require a chart review, you may be asked to set up an extra phone visit for this purpose. If you have an emergency between visits you are expected to go to your primary care provider or to your nearest hospital emergency department. We are unable to answer your medical questions until you are our established (seen in the office at least once) patient.
How long will I need to be in treatment?
Experience has shown that our tick-borne disease patients can expect to be on medications for at least one year. Treatment length is highly variable and for some may last as long as 3-5 years. Generally speaking, the longer one has been sick, the longer treatment takes. There are many other variables, however, and we find that some patients are simply more responsive to treatment than others. Our approach to treatment is highly individualized rather than the "cookbook" treatment that you see for many diseases. The type and length of your treatment will be continually reassessed during your ongoing care.
Is the treatment risky?
Patients do very well with treatment and we have seen no dangerous complications. An occasional yeast infection can be easily managed and even avoided with proper nutrition. Monthly lab work assures that damage is not occurring in the liver or kidneys or other vital organs. We have yet to see this happen. Allergic reactions to medications are always possible but these usually present initially as itching or a rash and the medication can be discontinued immediately, leaving no residual problems. We have simply not seen the risks associated with long-term antibiotic use that you often hear about from infectious disease doctors. Careful monitoring and follow-up assure that any potential problems or complications will be caught early when they can be easily handled.
Is it possible to only do phone consultations and why is it important to maintain follow-up visits on a regular basis?
Click here to read an article by Dr. Savely that will answer these two questions.
I was informed by my pharmacist that I needed a prior authorization for a prescription, how do I go about doing this?
Click here to view the protocol for prior authorizations.
What are your office policies?
Click here to download a document on our office policies.
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