Philadelphia Integrative Medicine: Frequently Asked Questions August 2014 Philadelphia Integrative Medicine combines the best of conventional and alternative medicine to inspire you and give you the tools to care for yourself and be well. Does Dr. Tetlow take insurance? Dr. Tetlow does not bill your insurance company for you, but you can submit your appointment bills to your insurance company for reimbursement at an out-ofnetwork rate, after your deductible. Medicare patients are unable to receive Medicare reimbursement due to Medicare s billing guidelines, so clinic costs are out of pocket. You may call your insurance company to see if they provide reimbursement for the following codes depending on your appointment type: new patient appointment (codes 99205 & 99354), follow up appointments (99214), micronutrient test new patient appointment (99204), and micronutrient follow up appointment (99214). You can ask your insurance company how long it will take to get reimbursed. What services does Dr. Tetlow offer and how much do they cost? **See our website www.philly-im.com for more detailed descriptions of our offerings and to sign up for our newsletter Level 1: Free or low-priced offerings Insurance-reimbursed group and online classes (access via the website) Meditation, body scan & guided yoga audio downloads, $9.97 each Online store to purchase Dr. Tetlow approved supplements Free educational newsletters Free 20 min. consultation with Dr. Tetlow to see your next step (1 per person). Level 2
Vitamin D and Me: Integrative Vitamin D recommendations (lab covered by insurance) with 20 minute consultation, $99 Micronutrient Testing: Intracellular micronutrient testing of key vitamins, minerals, amino acids and antioxidants, with a 40 minute individual consultation to review your results. The cost is testing ($190 if you have insurance, $88 if Medicare) plus $245 to cover the 40 minute clinic appointment for interpretation & recommendations. Ask your insurance company if they reimburse your clinic appointment fee (see above for code numbers). Level 3: Regular Patient (most common appointment type): Full pre-appointment chart review followed by 90 minute initial consultation and comprehensive integrative assessment with investigation of root causes, and treatment plan. Initial visit $695, follow-up appointments are $245 for 40 minutes. Executive Consultation: A 3-hour initial consultation (in-person or via phone or video) with pre-appointment testing. Excellent to reach goals faster and minimize time lost to travel, $1500. Can Dr. Tetlow be my primary care physician? Dr. Tetlow is a specialist and works in partnership with your primary care physician (PCP). She is well versed in primary care concerns and has managed internal medicine issues during her four years of medical residency and for the 10 years she has been in practice. She cannot be your primary care doctor because she is in solo practice and chooses not to be on call 24/7, although she is highly responsive. Many identify a primary care doctor but rely on Dr. Tetlow for appointments and simple questions between appointments. Are there any referral bonuses or bulk discounts? Refer a friend and when he or she enrolls as a micronutrient test patient, receive $50 in supplement credit*. Refer a friend and when he or she enrolls as a regular patient, receive $100 supplement credit*. Purchase 3 follow up appointments at once and get $100 supplement credit*. Purchase 5 follow up appointments at once and get the 6 th appointment FREE. *Supplement credit can be used for in-clinic supplement purchases only (not applicable to online store purchases).
We also offer a transition discount for Micronutrient test patients who want to become full patients. Instead of the standard $695 for the first new patient appointment, Micronutrient test patients pay $495 for their first regular appointment. What kind of payment does Dr. Tetlow accept? We accept cash, check, debit cards, and credit cards including Visa, Mastercard, Discover and AMEX (these are listed in preferential order because of associated fees if you prefer a credit card, we prefer Visa!). We also accept FSA (Flex Spending Account) credit cards. Do I have to come to the clinic to see Dr. Tetlow? Dr. Tetlow offers phone and video consultations with patients but in-person is preferred for the first visit (exceptions can be made). To stay in touch and provide some inspiration and keep you informed of new programs and talks, we send out an educational newsletter about once a month. What type of issues does Dr. Tetlow address? Dr. Tetlow commonly treats patients with autoimmune conditions, stress and fatigue concerns, hormonal imbalances, digestive complaints, inflammatory bowel syndrome as well as ulcerative colitis and Crohn s Disease, osteoporosis, cancer recovery and prevention, hypertension, high cholesterol, chronic pain, fibromyalgia, neuropathy, back and neck pain as well as various other pain syndromes. What types of treatment suggestions can I expect? Dr. Tetlow considers the following when developing individualized treatment plans: Environmental inputs The air you breathe and the water you drink, the particular diet you eat, the quality of the food available to you, your level of physical exercise, and toxic exposures or traumas you have experienced. Mind-body connections Psychological, spiritual, and social factors all can have a profound influence on your health. Considering these areas helps Dr. Tetlow see you as a whole person, not just your physical symptoms. Genetic makeup Although individual genes may make you more susceptible to some diseases, your DNA is not an unchanging blueprint for your life. Emerging research shows that your genes may be influenced by everything in your environment, as well as your experiences, attitudes, and beliefs.
That means it is possible to change the way genes are activated and expressed. An integrative approach addresses your body s ability to process past experiences, clean itself of toxins, regulate hormones and neurotransmitters, have a healthy immune and inflammatory response, digest and absorb nutrients, and maintain structural integrity, psychological and spiritual equilibrium and produce the energy you need to live your life. Dr. Tetlow can offer a wide array of available interventions and always customizes a personalized treatment plan. Treatments, including the healing that comes with being listened to and understood, may include: Lifestyle changes pertaining to diet, exercise, mind-body practices and emotional health strategies. Supplement recommendations including herbal preparations, botanical medicines, vitamins, minerals, and amino acids based on validated testing (prescription drugs supplied if indicated). Hands-on treatments, as needed. A comprehensive, individualized plan to meet your goals. How many appointments will I need? With Dr. Tetlow s integrative approach, you might anticipate improvement or resolution in just a few appointments, if your problem is pin-pointed or short-term. If your concern is longstanding, Dr. Tetlow can provide you with an estimation as to how many appointments may be needed to reach your health goals. Making an estimate is easier once all relevant test results are in. Sometimes it takes several rounds of testing to ascertain root causes of complex issues. What are clinic hours? Tuesdays and Fridays 10:00am-4:30pm, Wednesdays 1:00pm-8:00pm. Who works in the clinic? Our virtual assistants Andrea and Julie have office hours Monday through Friday 10:00am to 4:00pm. They work in a remote location. Erin is Dr. Tetlow s in-person administrative and medical assistant and works during clinic hours only.
What is Hello Health and how do I use it? Dr. Tetlow uses Hello Health, a breakthrough HIPAA-compliant web platform for secure email, prescriptions and lab results. New patients sign up for a 30-day free trial to complete their online health record. Annual cost: $48/individual and $89/family (all fees go to Hello Health and can be waived if there is financial hardship). How can Integrative Medicine testing help me and what testing does Dr. Tetlow offer? **Note: We cannot do any specialty testing with Medicare patients other than through Spectracell (Micronutrient Testing, genetic testing, cardiometabolic testing, hormonal, lipid testing area available) In addition to conventional labs, Dr. Tetlow offers additional validated tests. These may require a saliva, blood, urine or stool sample. We do not draw blood in the office, but can help you find a nearby blood draw location and, frequently, a phlebotomist can come to your home for free or low cost. If an initial payment for your test is required, then no additional payment is needed so no surprise bills. Most integrative tests also go through your insurance but your results will not be shared with your insurer without your permission. To complete your testing, you will receive a test kit with instructions, and we are always available for questions. Micronutrient Test: Intracellular test of key vitamins, minerals, amino acids & anti-oxidants. Nutrient deficiencies have been linked to arthritis, Parkinson's, alcoholism/substance abuse, behavioral disorders, cancer, cardiovascular diseases, chronic fatigue, macular degeneration, diabetes, immune disorders, multiple sclerosis, stroke, and osteoporosis. Insurance copay $190, Medicare $88. Additional testing options with the Micronutrient Test: ApoE4, MTHFR (see below). Blood sample. ApoE4 (gene test) how important are exercise and diet to your genes? For some individuals, lifestyle factors are more important, for others, less important. $40 copay. Blood sample. MTHFR (gene test) This test is free with your micronutrient test. The MTHFR gene makes an enzyme which transforms dietary folic acid to its active form. Active folic acid converts homocysteine to methionine, which helps with depression, inflammation and helps convert hormones. Methionine becomes SAM-e in your liver, which is anti-inflammatory, supports your immune system, helps produce and then breakdown brain chemicals such as serotonin, dopamine
and melatonin (this is essential for health), and is involved in the growth, repair and maintenance of your cells. Optimizing methylation also helps you eliminate toxins and heavy metals to reduce your risk of cancer and other health issues. Free with your micronutrient test, otherwise $40. Blood sample. Neuroscience/NeuroLab: Neurotransmitter and cortisol testing. Do you suffer from too much stress, poor sleep, fatigue, anxiety, low mood, poor attention, too little or too much energy, digestive complaints, weight problems, headaches or immune issues? Testing starts at $99, all insurance accepted. Easy testing (saliva and/or urine, no blood draw) for many tests. This test is also available from Genova/Metametrix. US Biotek or ALCAT: IgG Food allergy testing. Inflammation and chronic activation of the immune system due to food sensitivities are linked to digestive disorders, migraines, obesity, chronic fatigue, ADD/ADHD, painful joints, skin disorders, arthritis and more. US Biotek $199 for 96 foods. ALCAT $250 from 50 foods (100, 150 and 200 foods available). Blood draw required for ALCAT. Blood spot (finger prick, no blood draw required) for US Biotek. Genomind (gene test): Genecept Assay looks at 10 genetic/biological markers to best inform how to balance your brain and mood. This test helps Dr. Tetlow identify effective treatment for anyone, as well as those with depression, bipolar, schizophrenia, anxiety, OCD and ADD/ADHD. Test is free, but insurance is required. It partially tests of the MTHFR gene. Saliva. Pathway Genomics (gene test): Tests for illness prevention, family planning and disease condition management. Includes special testing options for weight management, cardiac health, and much more. Cost depends of annual income, and starts at $25/test. Saliva. Genova\Metametrix assesses biochemistry to understand symptoms from the molecular level. Specialty tests: toxicity and heavy metals, small intestine bacterial overgrowth and many others. All insurance accepted except Aetna, Principal, Humana, Kaiser Permanente, Tufts, Federal BCBS, and BCBS of NC. Copay varies depending on test. Doctor s Data Stool Test: Evaluate digestion/absorption, bacterial and yeast balance, parasitic infection, assess for inflammation, hepatic function, toxicity, and nutritional balance. $195 Comprehensive Stool Analysis; $295 Comprehensive Stool Analysis with Parasitology; and other specialty tests are available as well. All insurances accepted. Copay varies depending on test.
Important Integrative Testing and Your Wallet: While you should expect to receive an explanation of benefits, you should never receive a bill from Quest/LabCorp/Health Network for your insurance-reimbursed testing. If you do, please bring this to our attention. Dr. Tetlow does not intentionally order ANY insurance-reimbursed lab tests that are not covered. You are responsible for abiding by your insurance and deductible guidelines. Dr. Tetlow only recommends integrative testing options that do not have hidden costs. You are responsible for the initial agreed upon cost of your testing, but no further payment is ever required. You will receive an explanation of benefits from your insurance company and possibly even a bill since the testing company is allowed by law to bill you up to two times. They are required however to bill you if your insurance has not reimbursed them for the test. Regardless if your insurer covers the test or not, you are only responsible for the up-front agreed-upon charge, and nothing further. Do not pay any bills related to your integrative testing with Dr. Tetlow! Call us if you have any questions or concerns and we d be happy to help. When your test results come in, we will notify you via email! Questions about Dr. Tetlow What are Dr. Tetlow s credentials? How long has she been in practice? Dr. Tetlow graduated from University of North Carolina at Chapel Hill School of Medicine and completed a preliminary internal medicine internship at Albert Einstein Medical Center followed by Rehabilitation Medicine residency (focusing on chronic illness and musculoskeletal care) at Thomas Jefferson University Hospitals. She then graduated from the University of Arizona Center for Integrative Medicine as a sponsored Bravewell Fellow through the Jefferson-Myrna Brind Center for Integrative Medicine in Philadelphia. She has been practicing integrative medicine since 2004 (10 years) after completing 8 years of full-time medical training. How do I reach her? When will she get back to me? The best way to reach Dr. Tetlow is through the Hello Health Portal. She will respond to all messages within 48 hours at maximum, and usually much sooner. Messaging via the portal is limited to several sentences so if you need additional input, we recommend that you make an appointment. Dr. Tetlow can sometimes fit in 20 or 40 minute paid phone sessions for this purpose.