Practice Policies

Insight Integrative Health

4232 Adams Ave

San Diego, CA 92116

We are looking forward to working (or continuing to work) with you.  We have prepared this notice to acquaint (or update) you with the current general policies of our practice.  These policies apply to all new and existing patients.

Initial Appointments – Initial Appointments with your IIH practitioner are considered to be  “in consultation” to encourage you to be intentional about deciding to work together. If either party feels there is not a good fit, we will encourage discussion about this and will do our best to suggest other options.

The initial appointment is reserved exclusively for your care. Therefore your initial appointment requires a  25% credit card deposit to hold the space. This deposit is non-refundable. If you need to reschedule your initial appointment, IIH requires at least 2 business days notice.  If you provide such notice, we will transfer your deposit to your re-scheduled initial appointment. If you do not provide 2 business days of notice for a cancellation, your deposit will be forfeited.  This deposit requirement and policy applies only to your first appointment. All subsequent appointments do not require a deposit and are subject to the policies explained below under (5).

2) Services provided – Insight Integrative Health provides services “in consultation.”  We do not provide primary care services, and ask each patient to document their primary care physician.  Under certain circumstances we can work with individuals without a primary care physician, with the understanding that for primary care services they will be required to establish care with a physician or organization that provides primary care.  

3) Cerbo by MDHQ patient portal – To protect your privacy and comply with HIPAA requirements, IIH uses a patient portal for all clinical issues.  You will receive an invitation to create an account to your email.

4) Contact Information:

Scheduling:  For Fastest service, please request new appointments through the patient portal.  Patients may also request appointments at or through our phone number, though these requests are filled after portal requests are processed.  Please do not include any clinical questions or information in appointment requests.

Billing and Refill requests:  Please use the patient portal for billing and refill inquiries.

Issues that cannot wait until our next appointment:  Note that email and phone calls are not appropriate for questions about treatment planning. Those kids of questions should be addressed during scheduled appointments. If you have a brief question that absolutely cannot wait until our next appointment, please reach out to IIH through the patient portal.  Any questions outside of scheduled time should be non-urgent, bried, concise, and ideally answerable with a “yes” or “no”. If your questions or concerns are beyond the scope described above and/or require more time and attention, you will be invited to schedule a brief follow-up appointment.

Urgent Issues:  The office does not have the capacity to manage urgent care issues.

Emergencies:  As always, if you have an emergency, please call 911.  In addition the San Diego Crisis Line # is 1-888-724-7240.

5) Billing – Payment is due at the time of service.  We can at that time bill the credit card on file but also accept cash or check.  We can provide paperwork for you to file a claim and seek reimbursement from your insurance provider, if available, but reimbursement from you insurance, if available, is your responsibility.  There is a charge of $25 for returned checks.

5) Missed Appointments/Rescheduling/Cancellations – our policy is to charge for missed appointments.  We require at least two business days of notice for any rescheduling or cancellation requests. (For example, to cancel an appointment scheduled for Monday at 9am, you should contact our office before 9am on the previous Thursday.)  Any rescheduling or cancellation requests with less than two business days of notice will result in a full charge for the originally-scheduled appointment time. If you provide two or more business days of advanced notice, we will make every effort to reschedule your appointment as soon as possible.  We run a small practice with limited time slots for patients, many of whom book their appointments months in advance. Therefore, we ask that you do your utmost to keep your originally scheduled appointments and please understand that rescheduled appointments may result in a significant wait.

6) Virtual appointments – It is possible to meet online via a HIPAA secure teleconferencing software.  Currently, licensing and practice guidelines allow Dr. Flagel to see patients who reside anywhere in California.  It is necessary to meet face to face once, preferably for the initial appointment

7) Weather – All appointments will remain scheduled regardless of weather.  In exceptional circumstances, we will attempt to make accommodations for virtual or phone appointments for your ease during extenuating circumstances.

8) Requests to Refill Medications and/or Prior Authorizations – The office requests 3 days of business notice for refills an/or to complete prior authorizations.  Please plan for this and contact our office through the aptinet 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.

9) Supplements – We recommend supplements and botanicals, when indicated as part of the treatment plan.  These recommendations are based on extensive training in Integrative and Functional Medicine, clinical need, as well as researched on purity, quality and price.  We have spent significant time researching companies we trust. Some of these companies often offer discounts that are divided between IIH and the patient, resulting in lower prices to you.  Please know that not all supplement 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.

10) Additional Services – In addition to your time with a IIH practitioner, we will provide certain complimentary services as part of your appointment fee, including regular contact and coordination with you other care providers, laboratory interpretation, customary insurance reimbursement paperwork, (see “Billing” above), ordinary pre-authorization requests for your medication from your insurance company, and completion of mediation refill requests as appropriate.  Other services, including employment-related forms, letters, phone call and email appointments, coordination of care with providers that becomes extensive, etc will be billed according to your practitioner’s prorated hourly rate.

We encourage you to discuss any concerns you have about our policies.  By agreeing to continue treatment, you agree to these terms.