FMSF Policies

Patient Policies

 

Please refer to:

Working with FMSF

Initial appointments are  made via the patient portal in MD-HQ (once you have registered)

We will email you an invitation to our secure, online medical record system (MD-HQ: Patient Portal) where you will be able to fill out our new patient intake form and other details. You are required to complete your intake forms prior to scheduling.
Please upload any prior lab results, supplements and medications you may be taking to your “Patient Portal” in MD-HQ.
Established Patient: request an appointment time via the Patient Portal.

Please be aware that your scheduled appointment time includes time the physician utilizes to review your chart, update chart notes, interpret labs and communicate on your behalf with other practitioners.

The New Patient consult includes 90 minutes of face-to-face interaction
Dr. Daniel spends time after the appointment reviewing chart paperwork and preparing other forms directly related to your individual care.

If you are late for your scheduled appointment you will be seen for the remainder of your scheduled appointment time and billed for the entire appointment.

If your appointment extends beyond the scheduled time you will be billed for that time in 15 minute increments depending on the time actually used by the provider in coordinating your care.

Phone/Video Appointments:

Functional Medicine SF offers patients the ability to communicate via the videoconferencing platform, Zoom.us, if, the arrangement is agreed to by both parties.

Zoom places security as the highest priority in the lifecycle operations of its public and hybrid cloud networks. Zoom strives to continually provide a robust set of security features to meet the requirements of businesses for safe and secure collaboration.

Host and Client authenticated meeting: A host is required to authenticate (via https) to the Zoom site with their user credentials (ID and password) to start a meeting. Client authentication process uses a unique per-client, per-session token to confirm the identity of each participant attempting to join a meeting. Each session has a unique set of session parameters that are generated by Zoom. Each authenticated participant must have access to these session parameters in conjunction with the unique session token in order to successfully join the meeting.”

For more information about Zoom.us security and privacy, please see: https://zoom.us/docs/doc/Zoom-Security-White-Paper.pdf

Agreement

I have been informed of and understand the risks and procedures involved with using the videoconferencing technology, Zoom.us. I agree to the terms listed above and I hereby voluntarily consent to the use of Zoom.us for sessions with my provider. I agree that Functional Medicine SF should not be held liable in the event that any outside party passes Zoom.us’s security and discovers personal or confidential information.

***  You must provide your consent to be able to use Virtual Video Appointments  ***

Phone or video consultations are available for patients who live in or out of the area after scheduling your initial appointment in person. Phone/video appointments will follow the same fee schedule. Virtually all services that can be done in person can be done via phone or video consultation. Lab tests can be ordered that can be performed in your area, and we may also order medication from your local pharmacy or that can be shipped to you.

To ensure that each patient understands their commitment and expectations and to increase our quality of care we would like to point out the following:

  • Follow-up consultations must take place per patient recommendations.

Continual failure to comply with protocol recommendation timeline will result in dissmissal from functional medicine SF.

When Provider time is purchased in advance via a bundle option and the patient chooses to not move on with Functional Medicine SF and continue our services the prepaid amounts will be refunded as following: A $150 Administration fee will be deducted as well as a $25 per month from last provider follow-up. These will be refunded and processed as our normal workflow and you should see the amounts credited back to your account within 3-5 days from the date we process the refund.
 

Functional medicine works to identify the root cause of particular symptoms and then uses a personalized approach to help your body restore balance. This process involves an initial intake appointment to review your medical history, health goals, current lifestyle habits and symptoms and to identify the type of testing that is needed to further identify the root cause. At the end of the initial visit, you will leave with lab orders that may include blood testing, salivary testing, urine testing and stool testing.

Whenever possible, Dr. Daniel does her best to order testing that is available within your insurance coverage plan. For PPO based insurances, most blood testing is covered at an in-network lab such as Quest or LabCorp.

We do work with specialty lab companies, which offer blood panels that are lower than retail for patients who do not have adequate insurance coverage. Initial blood testing panels for patients with no coverage or minimal coverage are on average, less than $500 or may not cost anything at all if you have an HMO, including Kaiser or any PPO based insurance. Urine cortisol testing is available for $200, urine hormone testing is also $200, comprehensive stool testing runs $345 with some insurances offering coverage and SIBO breath testing is roughly $200 or may be covered by insurance. Generally speaking, we can get a lot of information from a complete blood panel and comprehensive stool analysis. The second visit is the first follow-up appointment. For the second visit, we allow 60 minutes, to ensure enough time is available to review all of the lab work and implement a comprehensive and personalized plan. Thereafter, follow-up is recommended in the acute intervention phase every 2-8 weeks for the first 3-6 months depending on your case and set of circumstances. Most patients can expect on average 4-5 visits in the first ~ 6-9 months and then annual or bi-annual maintenance visits if medication or hormone refills are required.

The number of visits and time in between visits is dependent on the complexity of your case, how quickly you want results and whether or not there are medications being used that require titrating to the optimal dose, as is the case with hormone replacement or thyroid disease. We can give you an idea how often you’ll need to follow-up in the acute phase at your first or second appointment when the case is better understood. Generally speaking, how effective the protocol is and how quickly results will be achieved is often reflective of the amount of time, attention and commitment you put in to the process.

Functional medicine is just as much about removing hindrances to imbalance as it is about implementing personalized dietary changes, lifestyle changes, micronutrient replacement or hormone balancing and we are in partnership together on this process. Please expect a minimum three to six month commitment to achieve lasting change and set your expectations and budget in line with that commitment.

We are very much invested in you achieving the goals you desire and want you to have every opportunity to experience the difference. In the ideal situation, we have an intake and testing phase (1 appointment) where we assess the issues, an initial intervention phase (1-3 appointments) to implement a personalized protocol, a monitoring phase, when minor adjustments if necessary can be made (0-2 appointments) and a reassessment phase (1 appointment), where we see how well the first layer of intervention did in achieving your health goals. For the vast majority of cases, you can expect a 50-100% improvement after this process. Diving back in for round 2 will be required and necessary if your goals weren’t fully met or you have new goals you want to work on, in which case we usually proceed with more testing and implementation of a new plan or direction.

Functional Medicine SF does not accept insurance. We provide a Superbill, which can be submitted to your insurance company for reimbursement if you have an insurance that provides an out-of-network benefit. If you are unsure, call the member services number on the back of your card and inquire about your plan. You can let them know you are planning an appointment with an out-of-network physician and want to know what percentage of your visit will be eligible for reimbursement.

Common codes used for appointments include 99205, 99215, 99214 and 99354.  

For virtual appointments, we use the following code most frequently: 99443 and 99444.

Again, HSA and FSA accounts are accepted.

Portal Messaging communication with you will be limited to answering questions regarding side effects or clarification of therapy.

Any communication that requires clinical decision-making will best be addressed in an office visit or by a scheduled phone consultation.

The best determinant is: does your question require a “yes” or “no” answer. If so, email communication is welcomed and your inquiry will be addressed within 48 hours. If not, we will request that you call the office to schedule either a brief phone consultation or to schedule an office visit.

Dr. Daniel receives many inquires and won’t always be able to respond to your updates or to messages that are not related to your current regimen.

When time allows, she will do her best to answer quick questions, but this is not guaranteed. All email correspondence should be done via our secure Patient Portal messaging system once you are an established patient.

If you are expecting a response and do not get one within 48 hours, please call the office during phone hours if you need to reach us. (415) 390-2060.

If your inquiry seems to require a change in your protocol or you are experiencing new onset of different symptoms, this usually indicates it is time to make a follow-up appointment.

Email communication is done only through the patient portal and will be limited to answering questions regarding side effects, clarification of therapy or logistical questions. Any communication that requires clinical decision-making will best be addressed in an appointment. The best determinant is: does your question require a “yes” or “no” answer. If so, patient portal communication is welcomed and we will attempt to address your inquiry within 48 business hours or as soon as possible. If not, we will request that you request an appointment via the appointment section of the portal. Dr. Daniel and Dr. Cole receive many messages and won’t always be able to respond to your updates or to messages that are not related to your current regimen. When time allows, they will do her best to answer quick questions, but this is not guaranteed. All patient portal correspondence should be done via our secure messaging system in the patient portal, MD-HQ, once you are an established patient. If your inquiry seems to require a change in your protocol or you are experiencing new onset of different symptoms, this usually indicates it is time to make a follow-up appointment.

If you are out of state and have not had an initial in person consult, Dr. Daniel can still work with you on a consultative basis. This means she can take a look at your history, lab reports and current treatments and advise you on how she would approach your case if you were her patient. She can make suggestions for further testing you may need, and offer suggestions for interventions and changes to your regimen that could further support you in finding optimal health. She cannot, however, order labs or prescribe medications unless she has seen you at least once in person in her office. Many out of state patients have been able to achieve the optimal wellness they are seeking by working with Dr. Daniel in conjunction with their own doctors who can follow the recommendations offered to them.

We are a registered Medicare Opt-out facility