Frequently asked questions
Answers to frequently asked questions about weight loss services, hormone therapy, lab work, insurance, and more.
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Does Dr. Scott’s Restorative Health Take Insurance?
Our current health insurance industry is based on a “sickness” model of care, while ours focuses on preventive and “root cause” treatments for optimal health. This system is doomed to fail, as more insurance companies are dictating treatments intended to line their pockets rather than treat a patient’s illness. Accepting insurance is eventually tying our hands in how we treat our patients and the time allowed to see them, and this goes against our core beliefs in how we operate our clinic.
To that end, our office does not directly submit any insurance claims for services. However, we can give you the most appropriate codes available, which you can submit to your insurance carrier for potential reimbursement for your expenses. Note: the codes available are general wellness, nutrition, or diagnostic codes. Our office can not guarantee reimbursement of any kind; please get in touch with your insurance carrier for further information on reimbursement. Besides providing appropriately coded invoices, we are not involved with other insurance processing.
If you would like our office to provide you with a “coded” invoice or superbill, please notify the front desk BEFORE your appointment, and we will gladly give that to you. Once your daily paperwork is processed, it can’t be changed without a $5 charge per superbill needed, so don’t wait until the end of the year if you’re trying to seek reimbursement. We apologize but we do not have extra staff to handle miscellaneous insurance requests.
What can you tell me about lab testing?
Many of the lab companies we work with DO accept insurance (with some exceptions).
We strongly recommend paying out-of-pocket for your lab tests. When a lab company submits a bill to your insurance company, the prices submitted are at Usual and Customary Rates (UCR), dramatically higher than the out-of-pocket pricing they offer directly to patients. Occasionally, the insurance company will opt not to pay for specific testing, and the lab company will, in turn, bill the patient for any outstanding UCR balance, which, in most cases, will be more than the original out-of-pocket price. Paying for the testing right from the start helps to protect you against a very unpleasant “balance-bill” situation.
Whenever possible, we strongly recommend paying us directly through our clinic. Paying us directly can get you much better pricing than you might get through conventional medical clinics or insurance. In the past, some of our patients have been billed by the lab or their insurance company as much as $2000.00 for labs that would have cost them $225-$295 if paid through our clinic. You may always file for reimbursement through your insurance, and filing for reimbursement after paying upfront will save you money 90% of the time.
Please rest assured that insurance coverage does not influence Dr. Scott’s decision-making, the standard of care, testing orders, or other recommendations. Whether or not you carry insurance coverage, you will receive the same thorough treatment and high-quality care.
NOTE: We are considered an out-of-network provider and do not accept insurance payments for any services. However, we will provide you with a statement of services and fees paid, which will document diagnosis, laboratory, and procedure codes. This invoice will suffice for insurance reimbursement, and if not, it should undoubtedly apply toward a deductible or flexible spending account. Patients cannot file any claims with Medicare because we have “opted out” of Medicare. If you are unsure of what your insurance may reimburse you, we’ll give you codes to contact before your visit.
If I need blood drawn, how does that work, especially if I live out of town?
No worries! Many of our patients travel from different parts of the US and other countries. If our office isn’t convenient for you to have labs drawn before your appointment, we can arrange for you to have labs drawn at LabCorp, Quest or another lab near you. We can also arrange for labs to be drawn at work or at home for an extra fee. Other labs, such as saliva tests, can be mailed directly to your home. Certain appointments require specific labs, so please contact us if you have a question about which panel to purchase. You can pay our office for them, either online or by call-in. We will email you a requisition to take to your blood draw facility; the results will be sent to us directly.
When you come for your 1st appointment, we will give you a copy of your labs after Dr. Scott has reviewed them. Lab work costs range from $85 for weight loss to $295 for a comprehensive hormone plus weight loss panel. We also offer over 4,000 tests we can order for you. If you are curious about your blood levels without the cost of a doctor’s report, we can call those for you and send the results via email. Lab profiles and pricing can be found on our Labs Page HERE.
Whether it is court-ordered paternity testing, drug testing, or employment screening, we have you covered. We also offer several tests that can test for specific disease markers such as Breast cancer, cardiovascular diseases, menopause, hormones, food sensitivities, pathogens, mold, etc. Please have a look at our Lab Test section for more information. If you would like, Dr. Shapiro can review your results with you by phone or TeleMed for $100 if purchased through our office. We also have comprehensive written reports available for purchase for $75.00. These may include recommendations for further testing or recommended nutrient supplementation. This report will be emailed within 48 hours of all tests when they have resulted. They are in a convenient format to print and share with your primary care provider.
How often do I have to be seen?
For Hormone or Thyroid Treatments, follow-up labs & visits are required every three months in your first year of treatment. Once levels and symptoms have stabilized, appointments are every six months. If you are on testosterone or another controlled substance, the law states that you must be seen by a doctor every three to six months, depending on the prescription. If you are on an all-inclusive TZone or AlphaZone Plan, most of these visits and labs are covered in your monthly fee. If not on an all-inclusive plan, follow-up labs average $79, and Follow-up visits are $195; For Weight Loss, LDN, or general visits, we offer Telemed and prescription services once you’ve been given clearance by Dr. Scott. For weight loss phone consults, you must have a digital blood pressure cuff and scale available for TeleMed sessions. Patients are always welcome to follow up in the office, but most prefer the convenience of follow-up visits by phone or via TeleMed; for hormone consults, follow-up labs are generally 7-8 weeks after your 1st visit or 6-10 weeks after a medication change. After your levels stabilize, we will recheck your levels every six months unless other problems arise. Virtual consults are the same prices as in-office consults.
Are there any monthly or annual contracts?
You will never be obligated to sign up for a monthly program or annual contract. We are NOT a SALES clinic that pays commissions based on bookings; we are a PHYSICIAN’S clinic that seeks the best care for you at the most economical price possible. If you prefer a monthly payment plan for budgeting purposes, we’d happily arrange that through our business office. If you opt for contract pricing, we ask you to commit to the contract for at least five months, as optimal benefits and tweaking medications may take that long. After five months, if you are on an “auto-ship” program, please give us 30 days’ notice, so we can have plenty of time to cancel your auto-ship through our participating pharmacy.
Are there side effects associated with BHRT?
There are very few side effects associated with BHRT, but rest assured, we will discuss them with you before you and Dr. Scott decide on a course of treatment. Most patients find them minor compared to how they feel once their levels are restored.
Can I have my Primary Care Physician order my blood work so I can bill insurance?
Generally, for convenience, we draw labs in our office. If it’s more convenient for you to visit a lab corp near you, we will send you a lab requisition. You can have your lab work performed through your primary care physician’s office or a different lab facility. We will provide you with the recommended labs and a superbill with all the correct codes so you may submit it to your insurance company for reimbursement. Please note that should your insurance company not cover your lab work, other lab facility charges can be astronomical. If you aren’t sure, we recommend obtaining your labs with our office and submitting them to your insurance provider afterward.
My Doctor doesn’t seem happy that I’m seeking bioidentical hormone treatment or considering the HCG diet. How do I talk to them?
Often doctors are uncomfortable with treatments not covered in medical school or are alternative. With regards to the HCG diet, many physicians dismiss it as a “non-FDA” approved use of the medication, often ignoring their own “off-label” use of drugs they write for their patients every day. An excellent example is how physicians used Viagra for ED before 1998, and before this time, the FDA only approved Viagra as a heart medication. Physicians may not know the science behind how HCG works and may not realize that your body is NOT just living on 500-800 calories per day but is burning and utilizing your abnormal fat stores that have been mobilized into your bloodstream for energy.
As with ANY low-calorie diet, you will lose weight with or without HCG. The most significant delineation is that without HCG, your body is not using that rich source of fat stores for fuel and, instead, burning muscle mass which is unhealthy and ultimately SLOWS your metabolism rather than revving it up. Dr. Scott has been utilizing the HCG diet for over ten years. “The proof is in the pudding.” When those same physicians see the amount of weight loss in their patients, they become “believers,” too. We have doctors who refer their patients to us for weight loss and some who come to see us as patients.
Will I know my costs ahead of time?
Every patient is different. Thus, costs may vary for each one, depending on the visit. We can, however, give you a GENERAL range of pricing and try our best to ensure there are no surprises with the costs of treatments. Cost estimates can be given after your initial consultation.
What happens after I book my appointment?
Please complete the patient questionnaire 48 hours before your appointment so Dr. Scott can familiarize himself with your history before you come in. If you book last minute, please return your paperwork to us as soon as possible.
“I love Dr. Scott and all the staff! Dr. Scott truly cares about results and comfort during and after procedures. I look 10 years younger than I did prior to the procedure! I never could have imagined I could look this young without having surgery. Thank you, Dr. Scott, for caring and giving me results above and beyond what I EVER could have imagined! With Gratitude, Your Forever Patient…”
Lisa H. ~ October 2019, BirdEye Review