FREQUENTLY ASKED QUESTIONS
What can I expect at the first visit?
During the first visit a detailed medical history will be obtained, any lab results you bring will be reviewed, your vital signs will be taken, and a short physical performed. Explanations will be provided concerning the rationale for the lab work Dr. Savely will order and the way she approaches diagnosis and treatment. The visit will last about an hour and a half. Bring with you all lab results from the prior 3 months, and results of any Lyme tests you have ever had done. If you have not faxed or emailed the consent forms due at the first visit, please bring these with you. Also bring a list of your questions. You will be sent home with lab slips.
Do you accept health insurance?
We do not accept or file insurance and Dr. Savely is not a Medicare provider. Medicare patients will need to pay out of pocket and will not be able to seek reimbursement. Patients with HMOs will also not be able to be reimbursed for their costs. However, patients with PPOs may submit our walk-out bills to their insurance companies for reimbursement under their “out of network” expenses. Most PPO patients are reimbursed according to the percentage specified by their plan. However, some insurances do not cover visits by nurse practitioners who are in solo practice so you may want to check this out in advance.
How much do the visits cost?
All of the information about costs will be included in the new patient information that will be E-mailed to you after you send an email to LymeDC@gmail.com requesting it. This new patient packet also includes the forms you must complete and return in order to schedule your first appointment.
How much will the lab work cost?
If you have insurance, take your insurance card with you when you go for your blood draw. Most of your lab work will be billed directly to your insurance. If you do not have insurance and have to pay for your LabCorp and Quest labs out of pocket, the cost of these will vary greatly, depending on what needs to be ordered. If you have an HMO, only lab work ordered by an in-network provider will be covered. Some patients are able to convince their HMO primary care provider to order some of the labs for them so that they will not have to pay for these out-of-pocket. Even if you have insurance, the tests we will order from the specialty lab, IGeneX, will need to be paid for up-front by credit card. If you have Medicare there will be no charge for the IGeneX labs. (You must send along a copy of your Medicare card !) If your Medicare is managed by an HMO, however, your IGeneX lab tests will NOT be covered. If you have a PPO, you will be able to submit the receipt from IGeneX for reimbursement under your out-of-network expenses
When will I find out about my lab results?
We ask that you not call or email the office for test results. These will all be reviewed with you at the first follow-up visit. However, if there are any results that are critical and urgent in nature, we will call you right away. The second visit (first follow-up visit) will occur about a month after your first consult. All of your lab work will be reviewed and a treatment plan will be formulated and discussed at this visit. Prescriptions will be written. Again there will be plenty of time for questions to be answered. We highly recommend that you bring a loved one to help you remember or to take notes. You will be provided with a treatment manual that will go over many aspects of your care that Dr. Savely does not have time to discuss during the visit (exercise, supplements, nutrition, etc.) There will be no lab work drawn at this visit unless you are already on antibiotics.
How often are follow-up visits required?
Monthly follow up visits are required. Later in treatment, these may be able to be extended to every two months. Follow-up visits may be either in person or by telephone; however you must appear in person once a year. If more than 6 months lapse between in-person office visits, a one hour follow-up appointment will need to be scheduled.
How much will the prescribed medications cost?
If you have PPO insurance you will be able to pay your usual co-pay for any medications prescribed. If you have Kaiser or many other HMOs, your medications will not be covered unless you are able to convince your HMO physician to prescribe them for you. If you have to pay out of pocket for your prescriptions the price of these will vary tremendously, but your monthly costs can be as high as about a thousand dollars. Costco is the least expensive place to buy prescriptions medications and you do not need to be a member to use their pharmacy. We will also help you in any other way we can, such as by giving samples (if we have them) or helping you sign up for patient assistance programs.
I am eager to start treatment ASAP, even before lab results are back. Is this possible?
Yes, with signed consent you may choose to do this. However, be aware that your treatment plan may change significantly once your lab results are back.
I live far away – what if I have a problem between visits?
Email is our preferred method of communication and we require that all of our patients have easy access to the internet. Once you are an established patient, you may email Dr. Savely between visits with quick questions that do not require that a chart be pulled. If you have complex questions that require a chart review, you may be asked to set up an extra phone visit for this purpose. If you have an emergency between visits you are expected to go to your primary care provider or to your nearest hospital emergency department. We are unable to answer your medical questions until you are our established (seen in the office at least once) patient.
How long will I need to be in treatment?
Experience has shown that Morgellons and tickborne disease patients can expect to be on medications for at least one year. Treatment length is highly variable and for some may last as long as 3-5 years. Generally speaking, the longer one has been sick, the longer treatment takes. There are many other variables, however, and we find that some patients are simply more responsive to treatment than others. Dr. Savely’s approach to treatment is highly individualized rather than the “cookbook” treatment that you see for many diseases. The type and length of your treatment will be continually reassessed during your ongoing care.
Is the treatment risky?
Patients do very well with treatment and we have seen no dangerous complications. An occasional yeast infection can be easily managed and even avoided with proper nutrition. Monthly lab work assures that damage is not occurring in the liver or kidneys or other vital organs. We have yet to see this happen. Allergic reactions to medications are always possible but these usually present initially as itching or a rash and the medication can be discontinued immediately, leaving no residual problems. We have simply not seen the risks associated with long-term antibiotic use that you often hear about from infectious disease doctors. Careful monitoring and follow-up assure that any potential problems or complications will be caught early when they can be easily handled.
May some of the lab work be done in advance of the first appointment?
If you have a local health care provider who is willing to order any of the tests for you, you are welcome to do this and it may help expedite the process of your diagnosis and treatment. See Lab Testing for a pdf list of the tests. However, be aware that there still may be other required tests based upon your unique symptoms and exam. These will be determined at your first office visit. YOU DO NOT NEED TO HAVE THESE TESTS DONE IN ADVANCE. However, some patients want to get the process started and are lucky enough to have a health care provider who is willing to help them with this. Be aware that since Dr. Savely would not the provider ordering the tests our office would not be able to answer questions about how to have the tests done or what the results mean. If you do obtain results for any of these tests, either bring them with you to the first visit or fax them in advance to the office at 800-692-4880. See the Lab Testing tab for a pdf of the tests or click here.