Once an appointment has been reserved there are several steps that need to be completed to ensure that the doctor has all of the information needed to provide the best care possible. Due to the length of each new patient appointment we do ask for a deposit to schedule, if the appointment is canceled with at least 48 hour notice we refund the deposit. The deposit amount will vary depending on program scheduled. For example, for the most extensive program the deposit is $250.

Our initial paperwork will come via email as a link to complete through Echosign for your security. One part will be requesting your medical history, the length of this one will depend on the program selected. The other will contain forms that must be signed such as an acknowledgement that we are not contracted with insurance companies, Dr. McManus is opted out of Medicare, program specific financial agreement listing the specifics of the program selected, and program specific consent forms. We strive to be as detailed as possible and we are available to answer any questions that may arise during this process. Once we receive all requested forms back the new patient coordinator will take that information and input all the data into the patient record to allow time for the doctor to review the chart prior to the patient getting to the office for their appointment.

All patients are treated individually and for this reason we do not handle any checkouts until after the doctor has seen the patient. During the 90 minute appointment with the doctor she will develop a treatment plan specific to each patient’s needs and will make recommendations for supplementation and prescribe medications as needed. Nutrition is an integral component of each patient’s treatment. Specific guidelines are provided for each program during the initial appointment or scheduled for a later time directly with the nutritionist. For example, patients are given detailed instructions to follow on the weight loss program that is medically supervised, this is the only calorie restrictive diet through TWIHW.

The final step for a new patient appointment is the checkout, the billing admin will review the supplements recommended and confirm the ones that each patient would like to purchase, if any. We then schedule any other appointments needed and collect payment. Follow up appointments are needed as indicated by your medical provider to stay an active patient and will be scheduled with Dr McManus, Dyvette, or Sandra depending on time frame indicated by the medical provider. The providers work as a team to allow for more flexibility for the patient’s schedule.

We start by recommending that you speak with one of the wellness consultants. They have been trained to review your symptoms and make a program recommendation that could help you achieve your wellness goals.

Another great way to learn about the various programs is to attend one of our monthly Lunch and Learn events. The event is free and open to the public, attendees are provided with as much information as possible to allow prospective patients to learn about the various programs and costs involved. Due to the amount of information provided the majority of potential patients call back after reviewing the program details and costs provided when ready to reserve their appointment. However, following the event the wellness consultants are happy to answer any questions you have one on one.

We do not accept assignment from insurance companies.

First, in keeping with a free enterprise philosophy, our policy regarding insurance has always been that we choose to work directly with and for our patients, rather than indirectly through an insurance company. Therefore, we have never joined any HMOs, PPOs or other types of managed care. Furthermore, our doctors have opted out of the Medicare Program, thus they are only able to see Medicare eligible patients who first elect to pay in full for all services rendered and subsequently sign a Medicare “Waiver” in which they agree not to seek reimbursement from Medicare for medical care received at our office.

HMOs, PPOs, managed care entities, and even indemnity insurance plans are not in the business of helping individuals obtain and maintain health and wellness. Rather, insurance companies are in the business of selling medical insurance plans for profit. While we have no problem with an insurance company’s right to make a profit, we do believe that for our practice to sign on with them, giving them permission to reduce reimbursement levels or, even worse, deny you, their client, the right to seek medical treatment or advice without first seeking their approval, is fundamentally wrong and deleterious to your health and the health of all individuals.

We believe that each individual is the best person to decide whether or not he or she needs medical care, not a clerk working for an insurance company, someone who has neither seen nor evaluated the individual regarding his or her health questions.

Second, because we seek to prevent disease and promote wellness, many of our medical services are not covered by most insurance companies.

Finally, though we don’t accept assignment, if you have indemnity insurance coverage, then we will provide you with an insurance-ready receipt after receiving your payment that you can use to submit a claim to your insurance company, with any reimbursement from them being paid directly to you. Many plans will partially cover services such as labs and some medications. In addition, many plans will apply the evaluation costs and other services towards your deductible.

Yes, despite our best efforts, occasionally we will see a patient who is not a good match for our treatment regimen. This has to do primarily with attitude. When individuals do not believe they can get better, it can become a self-fulfilling prophecy. Secondarily, we make every attempt to educate patients prior to their first visit regarding the scope and cost of our treatment regimen. Unfortunately, some individuals are unable to follow through with the financial commitment required over the long term to purchase hormone prescriptions and/or vitamins, and discontinue this treatment regimen. Finally, some individuals get conflicting advice and opinions from other medical professionals, family, or friends which leads them to discontinue treatment. Few medical doctors, and even fewer lay individuals, understand the intricate connection between nutrition, the immune system and hormonal balance. As long as there remains ignorance and confusion about these areas, there will continue to be some individuals who we are unable to help.