FAQS
Process
The initial visit is considered “in consultation” designed to encourage us to be intentional about our decision to work together. Once this decision has been made, it is recommended to meet monthly for the first 3-6 months to initially set forth a treatment plan, then track progress and adjust as needed.
Payment
We are contracted with PacificSource Commercial Insurance Plans and Regence Blue Cross/Blue Shield of Oregon. This means we can bill insurance for other Blue Cross/Blue Shield plans as well. A valid credit card is required to book appointments and will be charged for the remaining balance that insurance does not pay directly due to copay or deductible requirements.
Cancellation
Due to the preparation that goes into each appointment and the difficulty in filling these slots on short notice, we ask for cancellations or rescheduled appointments to be made at least 48 hours in advance. Changes made after this will result in a late cancellation fee of 50% of the charge of the appointment.
Costs and Fees (Private Pay)
Functional Medicine Assessment and Intake
For those ready to hit the ground running, this is a 60-90 minute initial appointment, in addition to review of labwork records and questionnaires prior to meeting. Further coordination of testing and test interpretation. – $600 (more info link to blog post)
Subsequent Follow-Up Visits
Follow up are routinely scheduled for 45 minutes, although under some circumstances 30 or 60 minute follow ups are more appropriate depending on needs and complexity.
Private Pay rates are as follows:
30 minutes – $250
45 minutes – $350
60 minutes -$450
Out of Network Reimbursement:
For those outside of contracted insurance, a “superbill” can be provided and submitted for reimbursement. These are typically reimbursed at “out of network” rates.
Coaching
Extra support is often needed to put lifestyle plans into place. While no longer directly under the Insight Integrative Health umbrella, I know one excellent and qualified health coach. She has certifications from both the National Board of Health and Wellness Coaching (NBC-HWC) as well as the Functional Medicine Coaching Academy (FMCA). She happens to be married to Dr. Flagel and with permission, collaboration and communication tends to happen easily! If interested in these additional services, please visit:
https://www.heatherflagelcoaching.com/
Insurance
Currently contracted with PacificSource Commercial Plans and Regence BC/BS of Oregon, Dr. Flagel bills these and some closely related insurance plans. It is our goal that blood work would also be covered by insurance, however, some specialty functional testing is not covered.
Unfortunately, Dr. Flagel may not be able to see individuals with Medicare at this time. The Medicare system requires doctors to “opt out” of the system altogether in order to accept private payment from those who are covered by Medicare. Other obligations currently prevent us from opting out at this time, although this may be possible as early as summer 2023.
Disability paperwork/Workers Comp/Support Animals
A disability evaluation takes an entirely different approach. As we are focused on helping to find ways to improve functioning, making determinations of disability creates a conflict of interest that interferes with our shared goals. For this reason, I do not complete disability paperwork or do workers’ compensation evaluations.
We recognize pets often provide significant emotional well-being. Despite this belief, our office however is not able to write letters in support of emotional support animals. Patients are encouraged to visit www.certapet.com
Functional Testing
It is our intent that blood work can be run through insurance. Specific functional testing (eg. comprehensive stool testing, Organic Acid Testing, Food sensitivity Panels, etc) are not covered by insurance. To try to decrease cost burden to patients, billing for these tests is run through Insight Integrative Health. Please note these will be added to patients account when ordered, but not billed until they have resulted. When resulted, the CC on file will be charged. This enables us to pass on some discounts for testing provided to our office. Please note we do not “upcharge” for any functional testing beyond our costs for the test.
Medications
Dr. Flagel considers the use of psychiatric medications conservatively and uses them in a fuller integrative context. Full informed consent regarding their possible risks and benefits is important, and a plan for when to try to come off of them. He typically does not prescribe benzodiazepines (Xanax, Ativan, Valium, etc.) as they are more highly dangerous and over time tend to cause more harm than good. In addition, Dr. Flagel does not prescribe stimulants (Adderall, Ritalin, Concerta, Vyvanse, etc.) as long-term studies do not show them to be beneficial and there are many evidence-based approaches to improving concentration
Supplements
We recommend supplements and botanicals, when indicated, as part of the treatment plan. These recommendations are based on extensive training in Integrative Medicine and are based on clinical need, purity, quality, and price. We have spent significant time researching companies we trust. Some of these companies often offer discounts that are divided between Insight Integrative Health and the patient, resulting in lower prices to you. Please know that not all supplements brands are created equal and the quality of supplements cannot be guaranteed from unchecked online sources. Therefore, while patients are welcome to source their supplements elsewhere, we urge caution given quality is not guaranteed everywhere.
Medication refills
Requests to Refill Medications and/or Prior Authorizations: The office requests 3 days of business notice for refills and/or to complete prior authorizations. Please plan for this, and contact our office through the patient portal for requests or updates. Medications requiring physical prescriptions should be requested during in-person appointments. Requests to mail such prescriptions will be considered on a case-by-case basis and, if approved, are subject to a $25 fee.
