New Patient Information

 

Please carefully read all the materials contained in the links below prior to completing or submitting any forms or payment. 

Types of New Patient Visits – We offer several types of visits, although most will do the Standard Comprehensive Visit.  If unsure of your needs, speak to our New Patient Coordinator. 

How Do I Become A Patient – Detailed information about each step in this process, what is included in the new patient visit and the “Introduction to the Carolina Center” orientation session with variations that might occur based on individual circumstances. 

I am Ready to become a New Patient, What do I do next? – Explains the steps for filling out the proper paperwork to return to our office

The Patient Experience – an overview of what to expect in the initial and subsequent office visits

Payment and Insurance Information – information on payment and how we work with insurance


All New Patient candidates will be screened by our medical staff before acceptance.  Based on our review of the Medical History Questionnaire, past medical records, and overall assessment of patient’s health status, we will make the determination as to whether candidates will be accepted and if so, which type office visit will be appropriate. 

While optional, we strongly recommend that all new patients/parents attend the “Introduction to the Carolina Center” New Patient Orientation, ideally prior to the initial office visit although this can also be done the same day as the office visit for out-of-town patients.


Types of New Patient Visits

As an integrative medical practice, we work with a wide variety of types of patients from those interested in general wellness to very complex patients with debilitating chronic illnesses.  We offer two options for New Patients wishing to be seen:

 

Individual New Patient Visits:  Best for patients who feel they need more individual time with the provider and with more complex health problems. 

  • Individual New Patient Visit - $974
  • Individual New Patient Visit – Patients with Cancer - $1007

 

Combined Family Visits:   We frequently get requests to see multiple members of a family and are able to provide Combined Family Visits although this is typically limited to two individuals.  A discount of $75 per person will be given for the combined visit.  The charge for a Combined Family Visit is $899 per person.

 

Group New Patient Visits:   A trend in many Integrative Practices is performing Group New Patient Visits for patients with similar health issues since much of the general information about evaluation and treatment is fairly uniform and consistent.  Many patients do well in this setting but if more one-on-one time is needed, the Individual New Patient Visit will be better.  Patients can usually get in to a Group Visit sooner than an Individual Visit.  This visit does not include an initial MSA. 

  • Group New Patient Visit - $822
  • Group New Patient Visit – Patients with Cancer - $855

 

Expedited Colon Therapy:  Individuals with a particular interest in only Colon Hydrotherapy as a treatment to support detoxification and prevention of disease may choose the Expedited Colon Therapy Program.  This type visit is only appropriate for individuals without major health issues or for those with only mild digestive symptoms.  This is not the setting in which complex chronic health issues can be addressed.   

  • All candidates for this type visit will be screened by Venica Harris-Thomas, Certified Colon Therapist to assess appropriateness of this request with final approval being given by one of our health care providers.    
  • Based on screening we may deny acceptance as an Expedited Colon Therapy Patient and require such patients to be seen in an Individual or Group New Patient Visit.   
  • Included in office visit is:
    • Intake and Colon Therapy Teaching
    • Brief initial intake with health care provider
    • Initial Colon Therapy

TOTAL:  $367

 

Urgent Lyme-Tick Borne Illness:  Based on our schedule, for those individuals who are acutely ill with Lyme Disease or other likely tick-borne infections who are rapidly deteriorating, we may be able to quickly see these patients.  This Urgent New Patient Visit is primarily reserved for patients who have been ill for less than a month or experiencing a rapid progression of symptoms. 

  • All candidates for this type visit will be screened by one of our clinical staff to assess appropriateness of this request with final approval being given by one of our health care providers.    
  • Based on screening we may deny acceptance as an Urgent New Patient Visit and require such patients to be seen in an Individual or Group New Patient Visit.   
  • Charge is $475

 

 

How Do I become a Patient?

We greatly appreciate your interest in becoming a patient at the Carolina Center.  In contrast with conventional medicine, integrative Medicine involves an entirely different way of thinking about health and the body; and the processes and procedures we follow are not always familiar to most people.  We need to obtain a great deal of information from you in order to provide the best care, and just as importantly, there is much you will need to learn from us.

While optional, it is strongly recommended that all incoming new patients attend one of our regularly scheduled “Introduction to the Carolina Center” Group Orientation during which time you will meet Dr. Pittman and learn the basics of a cellular-based integrative approach. We encourage you to bring along the person who can be a support partner to you during this process—someone who can help you get the most out of this experience and hold you accountable.  The more this person knows, the more he or she will be able to support you.  Hopefully this same person can come to all your office visits, as there is frequently much to take in, and of course, two heads are better than one!

 

Components of the New Patient Office Visit


“Introduction to the Carolina Center” – Group Orientation for Everyone 

Not just for New Patient, the Group Orientation is the best way to obtain more detailed information about the way we evaluate and treat our patients as well as about our office processes and procedures.  While some of the procedures we follow are familiar to many of our current patients, there is much that is new, and this is a great opportunity to better understand these procedures. We invite everyone to attend the Group Orientation sessions as we believe the information provided will be very valuable and even help established patients to get more out of their experience at the Carolina Center. This is an excellent opportunity for our established patients to invite their friends and family to learn more about the Center and understand more about their treatment process.

 

During the Group Orientation, you will learn the following:

  • What makes the Carolina Center for Integrative Medicine unique compared with conventional medical facilities;
  • How we approach health and disease at the cellular and molecular levels rather than the more conventional emphasis on organ systems;
  • How we evaluate health status using a variety of laboratory and other testing techniques;
  • The various treatment modalities we utilize to help our patients achieve their goals;
  • How we utilize diet and nutrition as the foundation of our programs, giving specific instructions as to how to adjust your diet to eliminate any food sensitivities or allergies;
  • How our practice operates with explanations about how to schedule appointments, how to contact us if you have questions, how to maximize reimbursement from your insurance company, and other information about the policies and procedures of our office;
  • What to expect after starting your treatment plan—for example, what the subsequent 4 to 6 months will be like, and potential timetables for accomplishing your goals.

 

You will be given dietary and lifestyle recommendations during this Group Orientation, with suggestions for specific steps to take prior to your actual office visit.  We hope these steps will help launch your healing process so that by the time you have your initial office visit, some health benefits already will have been realized.  In short, our intention is not merely to educate you about the Center and our approach, but to give you some initial guidance so that you can get off to a good start and make the most of your experience at the Carolina Center.


We believe that participating in the orientation session and following the preparatory recommendations we have developed sets the stage for you to achieve the most effective outcome.  We do, however, recognize that some patients need to be seen more quickly or have to travel from greater distances and we are willing to work with those individuals to expedite their visit.  For out-of-town patients it may be possible for us to schedule your New Patient visit on the day of Orientation in order to get the most out of their time in the Center.  Please speak directly to our New Patient Coordinator about your particular situation and we will work to accommodate your needs. 


If you were unable to attend the New Patient Orientation prior to your initial office visit we encourage you to attend the next Orientation prior to your first follow-up office visit. There is still valuable information to be learned that will enhance your understanding of our approach.   

The New Patient Orientation is carried out in our Raleigh location only.



The Office Visit Encounter

At the core of your treatment plan at the Carolina Center is the initial evaluation and subsequent follow-up office visits, each of which is an opportunity for you and our medical staff to review your health status and to assess your progress.  It is in these meetings that your course of treatment is assessed, adjustments made and new strategies reviewed and implemented as needed.   Staying current with these office visits is critical as there are often many components of treatment being carried out that must be monitored on a regular basis.  Whether you are a new patient who is preparing to start a comprehensive treatment program or an established patient who simply comes in for routine office visits, it is important that appointments be scheduled on a regular and consistent basis, and that you make every attempt to keep those scheduled appointments. 

As education represents a fundamental component of the Carolina Center‘s approach, there is much that will be discussed in your office visit and we realize that the input of information can be overwhelming.  Therefore, we strongly urge patients to have a “Support Buddy” who can accompany them on as many office visits as possible, serving as a second set of ears to take in all that we cover.  Even though patients will receive a detailed written plan, it is still helpful to take notes to expand on what is provided.  Our experience is that patients with support from this second person with both individuals taking detailed notes have greater success in following through with their treatment plan and seeing the beneficial results we are striving for.

In the Individual New Patient Encounter, you will spend approximately the first half of the visit with one of our medical assistants during which time many of the details of your medical history will be taken.  You will then be seen by one of our health care providers during which time we will expand your history, discuss current health challenges, and review personal health goals.  We will develop a plan for investigation and a preliminary treatment plan at that time based on all information gathered.   The next step will be laboratory and other testing then implementation of specific treatments as indicated, as well as scheduling the MSA, if included, and Group Nutrition Education.  Your treatment plan will then be fine-tuned at your next appointment, which will occur approximately four weeks later once all laboratory test results have come back. 

 

Our procedure for processing new patients is to collect a $250 non-refundable deposit along with the New Patient Registration Form then schedule the “Introduction to the Carolina Center” Group Orientation if this has not yet been done.  The balance for the initial office visit will be due at the time you schedule your initial office visit.  This additional payment is fully refundable if you cancel your appointment within a minimum notice of two weeks. While strongly recommended, the Group Orientation is optional as we recognize the challenges of scheduling this separate activity however if this is not done prior to the initial office visit, we hope that new patients can return for this session later.  

 

Meridian Stress Assessment Testing (MSA)

Part of the initial office visit experience for non-group visits includes obtaining important diagnostic information that can guide our staff in determining the best course of treatment for your condition.  One of the most effective tools commonly used by integrative medicine practitioners is the Meridian Stress Assessment, a non-invasive computerized test for assessing overall health of organs and systems as well as factors that may be adversely affecting your health or interfering with normal functioning.  Group Visit patients will undergo their first MSA test at the second follow-up. 

This procedure is typically scheduled within a few days of your initial office visit but for out of town patients with advance notice, we can schedule this to be done the same day as their initial office visit.  

 

Group Nutrition Education

Most chronic diseases are caused by or made worse by unhealthy lifestyle habits with conventional medicine only providing Band-Aid treatments while ultimately not addressing the underlying cause.  Therapeutic lifestyle change through physician directed treatment plans with a focus on diet, exercise and stress reduction is recommended by leading health organizations as the first-line treatment option for many of these conditions.  Included in the cost of the New Patient visit is a 90 minute Group Nutrition Education session held on select Thursday afternoons. The goal of this session is to review the various diets and approaches to nutrition that we support and to specifically review the anti-inflammatory elimination diet which we require all our patients to follow. In addition, we will also perform Body Composition Testing also called Bio-Impedance Analysis (BIA), a short non-invasive procedure that will only take a few minutes.  This provides information used to calculate various parameters of body composition such as body fat versus fat free mass and most importantly the phase angle, the best indicator of improving cell health.


Treatment Coordinator Visit

We recognize the challenges many of our patients face in managing their Treatment Plan and therefore offer additional staff time to assist in organizing and implementing our provider’s recommendations.  For New Patients this involves a detailed review of the plans for investigation and treatment, assisting with creating treatment calendars and schedules as needed.  This encounter will typically be with our Treatment Coordinator, Lauren Wagner, or one of our Medical Assistants and may be carried out following your office visit or on another day you are in the office.  Treatment Coordinator Visits can also be carried out by telephone but face-to-face is usually the most effective and is encouraged. 


One of the goals of the Treatment Coordinator Visit is to provide an assessment of your health insurance status with information as to whether you may be able to get any services covered.   With the insurance information you provided prior to your initial visit, we will investigate your benefits and know whether you have the potential to get some services covered.  Our providers will review this in your office visit to determine the best way to approach your evaluation in terms of filing insurance for laboratory testing and other services.  Our Treatment Coordinator will expand on this process to help each of our patients understand the impact that insurance may have on their final charges. 


Other components of the New Patient Treatment Coordinator Visit include: 

  • Preparation and scheduling for lab testing including needed paperwork, review of costs, insurance filing status
  • Preparation and scheduling the Meridian Stress Assessment test with explanation about our recommendations for nutritional supplementation
  • Explanation of our relationship with Total Health Nutrition Center - that patients can purchase supplements from them or wherever they choose
  • Scheduling the Group Nutrition Education session and BIA testing
  • Review and scheduling of any recommended treatments including costs, insurance filing status
  • Review and scheduling of any additional diagnostic procedures such as Infrared Thermal Imaging. 
  • Review and Acknowledgment of Office Policies.  Review of Orientation Materials. 
  • Review of contact information – how to reach our staff
  • Any other steps needed to assist our patients in the implementation of their Treatment Plan

 

 

Screening Thermography

A very important screening tool available at the Carolina Center through our affiliated company Carolina Thermascan is Infrared Screening Thermography.  This procedure is used to assess the health by observing minute changes in skin temperature.  Applications include head and neck, breast, abdomen and extremities.  We consider thermal infrared imaging to an extremely valuable part of the initial assessment and offer an initial upper body screening to all New Patients to include head, neck, chest (including breasts for women), back and abdomen for only $150 if performed within 90 days of the initial office visit.  This is a $345 savings compared to non-Carolina Center clients.  For women, follow-up breast thermal screening is offered to active Carolina Center patients for $100 which is a $135 savings over the standard charge for the procedure.  Any patient seen within the previous 12 months will qualify for this discount.  Please let our staff know if you are interested in undergoing this procedure.

 

Office Visits in Wilmington

As a service to our many Southern Coastal North Carolina and Northeastern South Carolina patients, Dr. Pittman sees patients in Wilmington every six weeks for New Patient and Follow-up Visits as well as IV infusions and our Medical Assistant or Nurse Practitioner performs IV infusions every two weeks in between Dr. Pittman’s visits.  This provides regular access to IV therapies every two weeks.  Dr. Pittman performs Individual New Patient Visits in the Wilmington location with all components of the New Patient visit being available at that location with the exception of Group Nutrition Education.  For these patients, our Nutrition Educator will do a telephone visit to review the main components of this training session.  Group New Patient Office Visits are also available in Wilmington based on demand.

 

Working With Patients Traveling Greater Distances


Despite the widespread and ever-growing popularity of Integrative Medicine, the number of physicians who embrace this approach is still quite limited in the middle and eastern portions of North Carolina, as well as in southern Virginia and South Carolina.  We are used to working with patients who may travel greater distances for care and have recommendations for making the most out of their time in Raleigh or Wilmington.  One of the challenges for out-of-town patients is the need to undergo the various procedures noted above which will also include morning fasting lab testing.  There are also timing issues related to performance of the MSA, trying to do this when individuals are not in such a stressed state.  The ability to do all these things in one day is difficult even for the healthiest individuals and our experience has been that this is often too much for the majority of our patients.

 

Based on these experiences, we strongly urge anyone who must drive more than two hours for their appointment to plan to be in Raleigh or Wilmington overnight to allow time for all testing to be performed. We understand the cost and inconvenience that this may cause some, but we guarantee that it will be worth it and you will be glad you did.   

 

I am ready to become a new patient, what do I do next?

We’re excited that you are ready to take the next step and become a patient at the Carolina Center.  We want to help you navigate this process as easily as possible.  Everything you need is on our website at www.carolinacenter.com, under the PATIENTS tab then NEW PATIENTS.  Once you have reviewed this information, please follow the instructions below:


Step 1:   Please "Pre-Register" online to create a Patient Portal account. Click here to Pre-Register .  Once you have "Pre-Registered", you will receive an e-mail (may take up to 24hrs to receive) to create a Patient Portal account.  Please create your Patient Portal account and complete the Surgical and Allergies questionnaires located on the left side under the tab titled "Questionnaires".  


Step 2:  Download and submit completed the forms below.  You may e-mail the completed forms to angel@carolinacenter.com or fax them to us: 919-571-8968.

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New Patient Registration Forms (PDF)

Lyme Questionnaire (PDF) - (if applicable)

Please carefully review the first page of the New Patient Registration Froms titled "New Patient Instructions - ALL NEW PATIENTS".  Once all the forms are completed and submitted with the nescessary materials, we will be in touch to schedule your appointment (balance will be due at this time). This balance can be refunded up to two weeks prior to your actual office visit. The $250 deposit is not refundable.

If you have any questions about this process, please contact Angel Getz at 919-571-4391, extension 102 or email to angel@carolinacenter.com.


Payment & Insurance Information

 

Payments for all office visits, laboratory testing and other procedures are due in full at the time of service unless other arrangements have been made in advance.

 

Health Insurance Coverage for Services at the Center

 

The Carolina Center does not contract with insurance companies, including Medicare/Medicaid/Tricare.  Moreover, although many of our services have been covered by insurance in the past, we can provide no assurance or guarantee that you will receive insurance reimbursement for any of the charges at the Center.  As a courtesy, these charges will be filed with your insurance company if it is determined that you have out-of-network benefits, and you will receive reimbursement from the Center when appropriate.  The main exception is Blue Cross Blue Shield (BCBS), which will not reimburse for services, regardless of whether you have out-of-network benefit status.  In addition, the Carolina Center will not provide BCBS any records for the purpose of insurance determination if requested by the insurance company or the patient.  Finally, the Center has “opted out” of the Medicare program, and Medicare will not reimburse for any fees paid to the Center or the patient.

 

In summary, your ability to receive insurance reimbursement for any of the charges at the Carolina Center will depend on the specific policies of your insurance carrier.  With the exception of BCBS and Medicare, many insurance carriers are increasingly willing to provide coverage for integrative medicine, recognizing its emphasis on health promotion and disease prevention (which ultimately translates into lower health care costs over time).  If you are among those millions of Americans who cannot afford health insurance, we will work with you, as much as possible, to accommodate your budgetary constraints, and we will plan strategically to minimize costs while hopefully meeting your treatment and health-related goals.

 

Working with our Providers

The Carolina Center utilizes the services Physician Extenders which includes Physician Assistants and Nurse Practitioners.  These are health professionals who are trained in medicine, just like a physician, and who practices medicine as part of a health care team with one or more supervising physicians.  Physician Assistants and Nurse Practitioners are trained to function autonomously (without requiring the physical presence of their supervising MD), but must always be able to consult immediately if need be with their supervising physician in person or via telecommunication.  These providers diagnose and treat illness and injuries, and in that process, often take histories, perform physical exams, develop and carry out treatment plans, order and interpret lab tests, assist in surgery, and/or provide patient education and preventive health care counseling.  A particular P.A. or N.P.’s responsibility will vary with training, specialization, experience, state law, and what is delegated by the supervising physician.

 

Physician Assistants and Nurse Practitioners are employed in all types of health care settings: hospitals, clinics, private physician offices, schools, HMOs, and even in the White House as members of the medical team taking care of the President and the Vice President.  They can be found in communities of all sizes, from the smallest rural town to major metropolitan areas, and in virtually every medical and surgical specialty.  Although the majority of these providers work in primary care medicine – family medicine, internal medicine, pediatrics, and obstetrics and gynecology – many also work in specialty medicine such as cardiothoracic surgery and orthopedics.  Physician Assistants and Nurse Practitioners also work in the area of medical education, health administration, and research.  In general, they can provide approximately 80% of the services typically provided in a primary care practice.

 

 

HEALTH INSURANCE INFORMATION


How the Carolina Center Handles Insurance Claims – Our Policy

The Carolina Center is an Out-Of-Network provider and is not contracted with any insurance companies, including Medicare, Medicaid or Tricare.  Moreover, although many of our services have been covered by some insurance plans in the past, we can provide no assurance or guarantee that you will receive insurance reimbursement for any of the charges at the Center.  Over the years, we have determined in general which insurance companies typically pay better for these out-of-network services, therefore as a courtesy, if you have a plan with one of these better companies, we will file these charges on your behalf.  You are still responsible for payment of your out-of-network deductible which is due at the time of service but overall we have found that this system provides our patients with some coverage by these select companies which improved their ability to undergo a more extensive work-up and range of treatments at a lower out-of-pocket cost. 

As with all other doctor’s offices, we ask patients to provide their insurance information prior to their initial visit so we can contact the company and determine ones benefits which help us to better advise patients in terms of the scope of the investigation and treatment we may recommend.  This information should be updated at each office visit and whenever insurance plans change.  From this information we will look at the following information to help us make the determination as to whether we can file for services:

 1. CARRIER - Based on one’s insurance carrier, a determination can be made whether or not the Carolina Center can file for any services provided to include labs, office visits and procedures.  While this list isn’t complete, from our experience, we have made the following determinations:  

Insurance carriers for whom the Carolina Center can file claims (GOOD COVERAGE):

i.       Cigna
ii.      United Health Care
iii.     Wellpath
iv.     Aetna – we can only file office visits, no other procedures or labs
v.      Inclusive Health

 

Insurance carriers for whom the Carolina Center can NOT file claims (POOR COVERAGE):

i.      Blue Cross Blue Shield (the exception are those therapies for which there is prior approval

ii.     Great West - administered by Cigna but won’t pay.  

iii.    GEHA

iv.    Medicare

v.    Medicaid

vi.     Tricare

2. OUT OF NETWORK BENEFITS – The next most important aspect of determining if anything can be covered, we must determine if their plan provides for out of network coverage at all.  Some patients will have good companies but no out-of-network coverage so it is essentially useless. 

 3. DEDUCTIBLE - The deductible must also be considered as some people will have what is considered “catastrophic” coverage with very high deductibles.  These are being phased out with the Affordable Care Act but still exist.  If a patient has one of the plans for which we can file and requests that we do so, we will require payment for whatever portion remains of the out-of-network deductible. 

4. CO-INSURANCE – Most insurance will require a 20% co-pay for in-network services and 40% for out-of-network.  Others have more or less generous co-pays.  We do not typically collect this co-insurance at the time of service due to being unable to easily calculate what it would be until processed but patients may be billed for some portion of this co-insurance after payment is received from the insurance company. 

5. DATE - It is also important, especially as one approaches the latter part of the year, to look at the effective date of the policy – essentially the date the deductible starts over.  If someone is close to this date and still has a lot of deductible to meet, it may be appropriate to do a minimal work-up now and then do everything else once the date resets.   Effective dates are most commonly January 1st but they frequently are also July 1st and September 1st

6. OTHER FACTORS – It is important to remember that many individuals have Health Care Savings accounts or other types of Flex plans through their employer with this money being available to cover expenses that insurance won’t as well as cover their deductible.  

7. NO INSURANCE – For those individuals who have had no healthcare insurance possibly due to pre-existing conditions or being unaffordable, it is now possible to obtain comprehensive healthcare coverage through the Affordable Care Act at www.healthcare.gov.  Unfortunately, the choices available to NC Citizens are extremely limited with none of these being identified as providing out-of-network coverage for our services, but can be used for in-network lab testing.  We urge anyone who has no health insurance to take advantage of this opportunity to obtain this coverage. 


 In summary, your ability to receive insurance reimbursement for any of the charges at the Carolina Center will depend on the specific policies of your insurance carrier.  With the exception of those companies mentioned above, many insurance carriers are increasingly willing to provide coverage for integrative medicine, recognizing its emphasis on health promotion and disease prevention (which ultimately translates into lower health care costs over time).  If you are among those millions of Americans who cannot afford health insurance, we will work with you, as much as possible, to accommodate your budgetary constraints, and we will plan strategically to minimize costs while hopefully meeting your treatment and health-related goals.  Ultimately however we strongly recommend you obtain insurance through the Affordable Care Act (ACA) so a greater portion of your expenses will be covered. 

At the time of each office visit, our staff will determine if out-of-network benefits are available for each patient.  If such benefits are available, we will file the charges on your behalf.  A partial payment of 80% of the total bill is required at the time of service.  Any payments received from your insurance company will first be applied to any balance due, after which you may receive a refund, be billed for a balance, or owe nothing.

 

Filing for Laboratory Testing

As noted above for those patients we determine have out-of-network coverage with carriers with whom we have had good experience with payment and the plan has a reasonable deductible that is likely to be met quickly, the Carolina Center will submit claims for all services rendered to the carrier in an attempt to receive payment.  In the case of laboratory testing, the Carolina Center will file for these charges and not request payment in advance, other than whatever out-of-network deductible is still owed. 

 

The Carolina Center can only estimate insurance payments based on past experience and communications with various insurance carriers.  Based on these estimated calculations after receipt of the deductible from the patient and other fees and payment to the Carolina Center by the insurance carrier, it may be determined that the patient owes a balance if the insurance carrier considered certain tests to be non-covered.  We will inform all patients of the maximum amount possibly owed in the event the insurance payment and payments prior to testing do not adequately cover costs of these tests. 

 

Be aware that any payments made directly to the patient by the insurance company for the services filed by the Carolina Center is owed to the Carolina Center and must be paid immediately.  The Carolina Center will apply any insurance payments reimbursed to remaining amounts due for non-reimbursed charges.  If there is a credit from the insurance reimbursement, Carolina Center will credit the patients account for funds due.  If there is a credit after these applications, this amount will be itemized and reimbursed within 30 days, unless one is on an ongoing treatment plan at the Center, in which case the Center will retain these funds to be applied to these services.  Patients have the right to request these credited funds be reimbursed and upon written request, these will be provided within 30 days. 

 

 

Why Are These Charges So High?

 

We sympathize with our patients who have to seek care that is not covered by standard health insurance and can be very time consuming and expensive.  Our challenges have been figuring out how to continue to provide the type of unique and in-depth care our patients appreciate and need yet expand our services to meet the increasing need for care and still try to control the costs, something that has been increasingly harder to do.  Some of the factors contributing to these higher costs include: 

 

  1. Healthcare costs in general are going up much faster than the rate of inflation. This is due to increased cost of goods and higher demand for healthcare workers which affects Integrative practices just as much as it does conventional ones. 
  2. Being a high level and unique subspecialty practice with few similar practices anywhere within many miles, we are seeing complex and challenging patients more than ever.  We have had to begin spending much more time with our patients as well as doing more work outside the office visit on the patients’ behalf given the complexity of their condition and effort needed to create their treatment plans.  The length of our encounters is significantly longer than conventional practices and even most Integrative practices. 
  3. Even though we are not a primary care practice, we are more frequently having to take over responsibility of medications we did not originally prescribed due to their not being properly managed.  This includes being asked to provide refills for routine medications which normally would be provided by one’s primary care physician. 
  4. Providing the time needed to take care of all issues:
    1. Our patient encounters are in stark contrast with conventional practices in which a typical visit is no longer than 15 minutes.  Even other Integrative practices spend no longer than 45 minutes with most patients so we provide much more face-to-face time our providers.
    2. Additional time is also needed by our support staff – front office, medical assistants and others who are needed to keep our office operating and who need to interact with our patients. 
  5. Increasing staff size and availability:
    1. As our patient population has increased, we have had to hire more support staff to handle the many tasks required to operate the practice. 
    2. Our staff often works very long hours to meet our patient’s needs, putting in more than 40 hours per week.
    3. To provide greater options and availability, we have routinely been open on Saturdays which requires even more staff to cover the additional hours.
    4. There are also additional expenses to operate our satellite locations to meet our goal of providing services to larger geographical regions where such care isn’t available.
  6. Our years of experience
    1. Dr. Pittman has practiced medicine for over 30 years, nearly 22 years as Medical Director of the Carolina Center for Integrative Medicine.  CCIM is the second oldest Integrative medical practice in the state.  (Second is the practice of Dr. John Wilson in Asheville). 
    2. We have highly experienced staff who are paid a higher salary than staff who have just recently started working.
    3. We have higher education requirements of our staff, needing more specialized training and experience. 
    4. We are faced with strong competition for healthcare jobs – high demand requires higher pay.
  7. Ongoing Continuing Education – We are always striving to learn more and improve our services
    1. Our providers are constantly expanding their education and knowledge by attending various training courses and continuing education seminars. Unlike conventional doctors who can attend simple drug company sponsored events locally, for our specialized practice we must travel long distances, pay high tuition for the courses and stay in expensive hotels in order to have access to the information we need to help our patients. 
    2. Because there are so many new and cutting edge discoveries in our areas of interest, we are typically traveling to conferences 6-8 times a year which also results in reduced income from being out of the office. 
  8. Cost of office operations
    • Cost of technology – continual need to maintain and upgrade computer systems as well as purchase more equipment for an expanding staff. 

Now medical practices are highly technologically advanced using sophisticated electronic healthcare record systems and portals which allows staff to keep up with practice complexities.  These are very expensive systems yet modern medical practices can’t operate without them. 

 

What are you getting for your investment?

  • A well-educated, dedicated and elite team of health care professionals who fully understand the nature of our patient’s conditions. 
  • Our attitude that “The Buck Stops Here” in terms of being willing and able to take on complex patients, many who have been tossed back and forth to various specialists.  Our goal is to get to the bottom of the problem and provide meaningful treatments that lead to progress. 
  • The most cutting edge new concepts in the functional medicine and chronic disease community.