CURRENT PATIENTS
FOLLOW-UP VISITS FOR ESTABLISHED PATIENTS
A substantial percentage of our patients have multi-system illness, are more debilitated and require extensive therapies for stabilization and symptom management. Many are receiving relatively poor care from their primary care physicians, often bouncing from one doctor to another having their treatment very compartmentalized. Therapies provided are generally only for symptom management with no real effort being made to find the underlying cause. As a result, we are often the last place where many come when nothing else has worked so we have an obligation to provide a level of care and service that they have never received. Providing this higher level of service creates significant challenges for our office and staff but it comes down to the fact that these complex patients need much more time in our encounters in order to cover the multiple issues often present.
How to Get The Most for Your Money
Be Prepared:
Bring a list of all supplements and medications along with their doses. Also, bring the actual bottles with the supplements and medications in case we need to understand ingredients or strengths better.
Keep a journal, diary or calendar so you know exactly what is happening week by week between your office visits. Being able to quickly provide useful information about your progress will allow you to get more out of your time with the provider.
Keep a list of questions to ask the Provider at the end of your appointment.
Review Your Treatment Plan:
Take notes in your office visit, ideally having your support buddy with you to do the same.
Be sure to make your follow-up appointment as soon as possible after your last visit as our schedule fills up quickly.
Make sure your appointments are scheduled as recommended in your Treatment Plan. Often patients who cancel their appointments have gaps in their treatment plan and relapse having to start over, costing more money.
Time Management
It is important that patients allow enough time to get everything done that is needed when they come for their office visits. Typically 15 to 30 minutes is needed prior to starting your office visit to obtain vital signs, review insurance/demographics, complete health questionnaires and review current medications and supplements.
After this intake, you will then be seen by the Practitioner and typically every 2nd or 3rd visit will also undergo a Meridian Stress Assessment. Following the visit, additional time will be needed to review your plan with our Treatment Coordinator as well as purchasing any recommended supplements. The last step at check-out involves paying for your office visit, scheduling your next visit and receiving Assessment and Plan. Alternately, we may post your plan on our Portal within 24-48 hours.
Overall most patients should allow approximately 2 to 3 hours to complete all these steps depending on the type of visit.
Arrive at least 15 minutes prior to your scheduled appointment time so all forms can be completed and nothing will delay your start.
Be aware that you are being charged for your appointment slot so if you are late, you will have less time to spend with your provider. Your appointment time will not be extended as there are other patients scheduled after you. If you are more than 30 minutes late, that is considered a "no show" and you will still be charged the full amount.
Please note, we are specialists and try to spend our time figuring out how to use our special knowledge and therapies to help you. Asking us to handle tasks that a non-specialist could take care of us costs you much more money than asking your primary care physician to do these things. The more things you can get your primary care physician to do (such as maintaining routine prescriptions, handling urgent issues unrelated to your care from our practice, and keeping up with screening tests like bone density scans, etc) will save you time and money.
Telehealth Office Visits
Ideally all initial office visits should be in person although these can be done by Telehealth if the next visit will be in person. Subsequent visits with our providers can be either in-person or by Telehealth and, if needed, by telephone. All patients are required to be seen in person at least once a year Telehealth visits are performed using Zoom – we will send a link prior to your visit.
It is our intention to be ready to join the visit at the scheduled appointment time. Please understand, however, that we may be late due to unforeseen issues with other patients in our office. It may even be necessary to reschedule the visit if there has been an emergency in the office and the medical staff has gotten too far behind.
Patients who have a scheduled Telehealth office visit should join the meeting on time although our provider may not join immediately, it being best to allow an additional 20 or 30 minutes for the visit due to unforeseen events. If you cannot make this additional time available, then you should select another time when delays will not be a problem. Please be present on Zoom at the scheduled time. If you do not join within 10 minutes, we will assume the visit is a “no show” and you will be subject to a fee and must reschedule the appointment at another time.
Frequently Asked Questions
What is the rescheduling policy?
We can reschedule an office visit with 14 days notice free of charge. If you cancel an office visit with less than 14 days notice (or you are a no-show), but you reschedule within 7 days to be seen within the next two weeks, the cancellation fee will be reduced by 50%.
What is the cancellation policy?
We require at least a 14-day notice to cancel an office visit. If you fail to give us this notice, there will be a $150 fee charged. In addition, if you fail to give us 2 business weekdays advance notification of this change, the cancellation fee will be the full charge for a standard appointment ($448). Be aware that we are closed on Fridays and we do not accept incoming calls on Saturdays, so cancellation requests must be received no later than Wednesday morning to cancel a Monday appointment.
How often do I need to been seen to be considered an "Active Patient" of the practice?
Once stable and in maintenance, we require our patients to maintain regular follow-up visits at least every six months. We understand that many primary care physicians are only concerned about an annual check-up; thus patients often assume that is all they will need at the Carolina Center. However, because we embrace a more proactive and preventive approach to medicine, we require our patients to be seen every six months to ensure that we are staying on top of risk factors and adequately monitoring their health.
I am an existing patient but I have not been to the office for a while. I would like to come back, do I have to start over?
Any patient who has not been seen for a follow-up office visit in at least three years will be considered a “New Patient” and must complete the Four-Step-Process to Becoming a New Patient.
Follow-Up Visit Fees for Established Patients:
Basic
Follow-Up Office Visit- The “Basic” office visit is based on a 45 minute patient encounter time with an additional 15 minutes of work required after the visit. This is the shortest office visit we provide, only applied to patients who have met their goal of stabilization and are on a simplified maintenance program. This can allow for shorter office visits at a lower cost. This type of visit is scheduled for patients who wish to maintain “Active Status” for their 6 to 12 month follow-ups.
Standard
Follow-Up Office Visit- The “Standard” office visit is our typical appointment recommended for the majority of existing patients most often due to working to address complex/chronic conditions.
- The fee for this visit is based on a 60 minute patient encounter time and approximately 30 minutes of additional work required prior to and after the appointment to prepare and develop questions, and to develop a treatment plan.
Extended
Follow-Up Office Visit- The “Extended” visit is charged when patients need a much longer and more comprehensive visit, this being the charge for all First Follow Up visits with Dr. Pittman. The fee for this visit is based on a 75 minute encounter time and approximately 30 minutes of additional work required prior to and after the appointment.
- This type of visit can be requested if a patient needs more time with our Providers. An Extended visit is required if patients have not been seen in the practice for more than one year.
Purchasing Nutritional Supplements
As a convenience to our patients, our associate business, Total Health Nutrition Center, Inc., provides many of your recommended nutritional and herbal supplements for purchase.
Bring All Supplements and Medications to your Follow-Up Visit
It is also very important for our medical staff to know all the medications and supplements you are taking including their strengths, frequency of dosing and how long these have been taken. Regardless of whether these were provided by our office, please bring to each office visit all the medications and supplements you are taking. If you have supplements you aren’t taking but wonder if you should, bring those in as well so we can help you determine what to do with them. For those patients may have completed a course of pharmaceutical medications but still have some left over, bring these in as well so we can determine if they can be used again.
Donation of Medications and Supplements