Cost and Commitment

Quite often we are asked if we "accept insurance?"

Let's clarify a few things:

First, this is actually the incorrect wording as we "accept insurance," however the truth is that your insurance won't pay for what we do. The correct question is "Will my insurance cover your services?" and we can pretty much guarantee the answer will be "no" for the following reasons.

Functional Medicine is more of a Holistic Approach: Functional medicine takes a holistic approach, considering the whole person and their environment, rather than focusing solely on a specific disease or condition. 

While this approach is very beneficial, there is no universally accepted set of standards or guidelines for the insurance companies to determine what to cover. 

Functional Medicine’s Focus is on Prevention: Functional medicine places a strong emphasis on prevention and lifestyle changes, which can be difficult for insurance companies to evaluate and quantify in terms of medical necessity. 

While preventative care can ultimately lead to long-term health benefits, it is not considered as essential or urgent to your insurance company like it would consider emergency care with traditional treatments for specific medical conditions. Therefore, insurance companies will not cover the costs as they do not view functional medicine treatments as medically necessary.

The term they are going to use is called "Medical Necessity." When you call, you will need to ask if they consider the services listed in our website tabs "medically necessary."

DEFINITION OF MEDICAL NECESSITY:

"Medically Necessary" or "Medical Necessity" refers to health care services that a health care provider, exercising prudent clinical judgment, would provide to a patient. The service must be:

· For the purpose of evaluating, diagnosing, or treating an illness, injury, disease, or its symptoms

· In accordance with the generally accepted standards of medical practice

· Clinically appropriate, in terms of type, frequency, extent, site, and duration, and considered effective for the patient's illness, injury, or disease

· Not primarily for the convenience of the patient, health care provider, or other physicians or health care providers

· Not more costly than an alternative service or sequence of services at least as likely to produce equivalent therapeutic or diagnostic results as to the diagnosis or treatment of that patient's illness, injury, or disease

For these purposes, "generally accepted standards of medical practice" means:

· Standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community

· Physician and Health Care Provider Specialty Society recommendations

· The views of physicians and health care providers practicing in relevant clinical areas

· Any other relevant factors

Since we do not practice "medical medicine," nor diagnose or treat, and are primarily performing the services for the convenience of you, the patient, to know the true causes; insurance will not cover our services.

It is essential to understand your insurance plan's is designed to only cover a diagnosis that can be treated in the medical realm and that the patient will be responsible for the cost of their own functional medicine wellness program.

We agree with you that our services should be covered and we do not like this any more than you do. But, we are not in any position to argue with the rules of your insurance carrier.

The pricing of our wellness programs, therefore, is flexible and completely based on your decisions. You have the power to choose the options that align with your goals, budget, and personal preferences. 

You can decide which options are essential and which ones are simply desirable, ultimately shaping the overall cost of the program. This allows you to build a wellness program that is both effective and cost-efficient, ensuring you get the most value out of your investment.

Our goal is to provide you with a personalized wellness experience that caters to your unique needs while staying within your budget.

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Discover if Dr. Lori's "Customized Women's Wellness“ Program will help you! 

Our wellness program cost is as flexible as you need it to be. 

It's a lot like preparing a home-cooked meal. You have control over the ingredients you choose, how much you use, and how elaborate the dish becomes.

If you're on a tight budget, you can create a simple yet nutritious meal. But if you want to splurge a bit, you can opt for premium ingredients.

Our wellness programs are designed like above, it’s personalized to your needs and budget. 

You select the services you require - it could be as simple as basic dietary guidelines or as comprehensive as a full package, including personal health coaching, tailored diet plans, or medical wellness consultations with Dr Lori. As such, the cost can be very flexible.

Regarding payment, we absolutely provide payment plans. We understand the financial commitments can be a burden, and we're committed to making wellness accessible to everyone.

It's a lot like paying off a big-ticket item over time, like a new smartphone or a car. You receive the benefits immediately while paying in installments that suit your budget.

You just let us know what you're comfortable with and we can tailor a plan that works for you.

Share Your Personal Health Story!

Discover if Dr. Lori's "Customized Women's Wellness“ Program will help you! 

We understand that discussing financial matters may often seem intrusive and perhaps uncomfortable. Yet, it is with immense respect and compassion that we aim to broach this sensitive topic. Not as an invasion of your privacy, but rather as a necessary step in tailoring a wellness program that matches your unique needs and resources.

To better illustrate the essence of discussing budgetary considerations, let's consider a parallel in another aspect of life – travel planning. Imagine planning a vacation. Before a travel agent can create a personalized itinerary for you, they need to understand your budget. 

This isn't because they're interested in your financial status, but rather because they want to tailor a plan that offers the best possible experience within your resources. For instance, knowing your budget, they can suggest the best destinations, accommodations, and activities that you can comfortably afford. They aim to prevent the disappointment or stress that could arise if you fall in love with a plan that’s outside your financial comfort zone.

Similarly, in the realm of health and wellness, understanding your budget is crucial for us to design a program that is effective and sustainable. It helps us identify the best resources - from dietary recommendations to fitness routines, therapy sessions, health coaches, and more – that align with your financial capacities. It's not about how much you can spend but about optimizing what you can. 

We understand that everyone's financial circumstances are different. Some may have the capacity for a comprehensive, all-inclusive wellness program that incorporates everything from a personal trainer to a nutritionist, while others might be looking for a more cost-effective approach using digital resources, community classes, or DIY methods. Neither approach is superior to the other; the most effective program for you is the one that fits comfortably within your lifestyle and means.

We want you to understand that this conversation about budget is rooted in respect and empathy. We want to avoid recommending a program that could cause financial stress, as it would counteract the very essence of wellness we strive to promote. When you share your budget with us, it allows us to serve you better and ensure the journey towards health and wellness is a joyous and sustainable one, free from any undue stress.

Our ultimate goal in asking about your budget is to make sure your wellness journey is effective and sustainable. We want to ensure the strategies we develop together offer the best return on your investment, not just in terms of financial cost, but also in the valuable currency of your time and effort.

Please remember, your wellness journey is deeply personal, and you are in control. We are here merely to facilitate, guide, and support you as you navigate this path. We believe in you, and we respect the trust you place in us.

Remember, investing in your wellness is one of the greatest investments you can make. We are here to help you do that wisely, effectively, and compassionately. It's not about prying into your personal finances; it's about ensuring we create the best path for your unique journey towards better health and wellness.

Share Your Personal Health Story!

Discover if Dr. Lori's "Customized Women's Wellness“ Program will help you!