Intake Forms, Fees, Expectable Costs, Payment, Insurance, and Typical Time-Frames.
The First Steps
The first step to getting into treatment is to contact Dr. Ducat or Dr. Clifford, depending whom you wish to see. If you and the doctor agree that treatment here would be a good fit between the help you are seeking and what the doctor can offer, the next step would be to complete the intake forms . These documents provide data that is vitally important to the assessment and later treatment of whatever conditions for which patients are seeking help. They also include legal agreements that must be received before any treatment can proceed. Each link will take you to a bundle of forms that include consent documents, symptom questionnaires, insurance data forms, and other vital background information. They can be completed on line and sent to us through a secure portal. Patients seeking naturopathic medical treatment with Dr. Ducat should go to the Intake Forms page and click on the one of the first two links, depending on your gender.
Individuals who want only psychotherapy with Dr. Ducat should click on the designated link (the third one down on that page). Even though psychotherapy-only patients may not be seeking help with their physical health problems, the data from the brief medical symptom forms in that bundle can offer useful information on the physical health context in which their psychological concerns are being manifested. For patients wanting couples therapy with him, each partner must complete separate forms. However, only one Electronic Payment Authorization form, which is part of the bundle, is required.
All non-insurance payments from Dr. Ducat's patients are processed through our secure online service, Therapy Partners. Once a credit card is in the system, a patient will be charged at some time within a day or two prior to a scheduled session. This allows the appointment to be wholly devoted to treatment concerns rather than writing checks. And we can spend more of our time helping people, instead of taking trips to the bank. The system also automatically generates insurance-ready invoices for those with PPO insurance plans who want to seek reimbursement for our services or for those who need them for other purposes. This payment process also means that patients who give less than 24 hours notice of a cancellation or a need to reschedule will be charged for the time reserved for them.
Naturopathic Medical Treatment
While this page is devoted to the practical aspects of getting into treatment, it is vitally important for patients, whom we view as essential collaborators in the treatment process, to know something about the guiding principles of functional medicine, which undergird the naturopathic approach taken in our clinic. To that end, we strongly recommend that patients view the video of our colleague, Dr. Mark Hyman, at the top of this page . Because we aim to treat the causes of long-standing chronic conditions, not just the symptoms, genuine clinical progress requires deep and enduring changes in dysregulated physiology. Sometimes the tissue healing and altered gene expression that results from this approach can take from 6-12 weeks to be significantly manifest. Patience, determination, and consistent compliance with the recommended treatment plan will be required in order to achieve meaningful results. Because of the nature of our practice, the clinicians at the Mind-Body Clinic cannot be available for emergency, urgent, or acute care. It is highly recommended that patients have available primary health care providers who can office those services.
The fee for office visits varies, depending on whether patients are seeking naturopathic medical treatment or weekly psychotherapy, or both. Naturopathic medical consultations for patients who are not receiving weekly psychotherapy are charged at a rate of $350.00 per 50-minute visit. The initial consultation for medical patients, which includes all those being treated for cognitive decline using the Bredesen protocol, is 100 minutes, and therefore $700. Prior to the initial meeting, Dr. Ducat will review the intake material and formulate an initial hypothesis about probable areas of imbalance. Of course, that hypothesis will be modified by the story the patient tells during the first appointment. Based on all this information, an initial battery of laboratory tests will be ordered.
At the time of the initial consultation, the lab kits and requisitions will be given to those patients seen in person. For patients meeting via telemedicine, they will be mailed out by the laboratories or our clinic prior to the appointment. During this first appointment, the recommended labs will be explained -- the rationale for each test in terms of the patient's history and symptoms, how the tests will guide treatment, how to collect the samples, and their costs. The laboratories are paid directly by the patient. We make no profit off of tests. The costs for lab tests will vary with the chronicity and complexity of a patient's symptoms and their insurance coverage. For patients with eligible insurance plans, a few of the laboratories will bill part of cost to the insurers. But most require full up-front payment. Once the laboratories receive the samples, it generally takes up to 2 weeks for results to become available. Depending on these variables, the cost of initial labs could range from around $2500.00 to $3500.00. For those patients who are being treated with the Bredesen protocol, the cost for initial labs can be as high as $5000.00 This is because of the large number of potential causal factors that must be assessed. In addition, patients on this protocol will require volumetric brain MRIs, the fees for which vary considerably for one imaging lab to another.
Once all the results come in, we will meet for a second 100-minute appointment to review the lab findings, and how they inform the treatment plan. The fee for this report-of-findings consultation will also be $700.00. Prior to that meeting, the raw lab data and the written treatment plan will be sent to the patient so that he or she can have it to refer to during our discussion. Because of the complexity of the information, it is recommended that patients take notes and/or record the session.
Generally, a follow-up appointment is made 8-12 weeks after the patient begins the treatment plan to evaluate the progress made, and whether the treatment needs to by modified. Occasionally, a few follow-up labs may need to be ordered. Usually, major comprehensive lab panels do not need to be reordered any sooner than 6-12 months, if at all. Over the course of a year patients can generally expect to require 3 to 6 50-minute visits. More complicated cases may involve a greater number of follow up appointments. The precise number over a year that may be required for successful treatment will, of course, vary depending on the progress being made and the changing needs of the patient.
As food and nutrition are foundational to any approach that seeks to prevent illness, and aims to treat its causes, Dr. Clifford provides nutritional consulting for her patients. Dr. Ducat will refer his patients to outside nutritional counselors when additional support is needed to help with complex condition-specific food plans, and enable patients to manage the profound pragmatic challenges, such as preparation, cooking and shopping, that come along with changing one's way of eating.
Nutritional Supplements, Botanical Medicines, Hormones, and Prescription Drugs
To the extent possible, medicinal substances recommended by the doctors at the Mind-Body Clinic will be available through one of the e-stores on the Virtual Dispensary page of this website. By using these sources patients are assured the highest quality medical-grade supplements and botanicals available. For bio-identical hormones and other prescription items, once Dr. Ducat calls in the initial prescription, they will be obtainable through the Koshland Pharmacy link (for California patients), or will be referred to another local compounding pharmacy. To order recommended items, patients need to click on the links to the supplement companies on our Virtual Dispensary page and set up an account. Thereafter, patients can order whatever is called for by their treatment plan, and have it delivered directly to them. The costs for these items are, of course, highly variable.
Psychotherapy is a treatment that requires continuity and some degree of frequency – at least once a week for the duration of care in order to be optimally effective. For those on insurance plans for which Dr. Ducat or Dr. Clifford are not providers, the fee is $210 per 50-minute appointment.
For patients who may want psychotherapy but are struggling with financial hardship, Drs. Ducat and Clifford are open to discussing a reduced fee. However only a small number of patients can be offered this financial accommodation.
Treatment by Phone or Telemedicine Video Conference
Patients who live in California, or those in Oregon who do not wish or are unable to come to our Bend office, can be treated remotely by phone or through a HIPAA-compliant and secure on-line video platform.
Out-of-State Health Education Consultations
Individuals who are not residents of Oregon or California and who cannot come to our Bend office cannot be patients or receive a diagnosis or treatment. However, they can have health education consultations whereby educational suggestions can be made. Such individuals must complete the bundle of forms pertinent to these out-of-state educational consultations, which can be found on the same page as the intake forms. The data from these forms are not used to make a diagnosis, but to inform Dr. Ducat about key aspects of an individuals history, and thereby optimize the educational value of the consultation.
Due to the unsustainably low rates paid by insurance companies, naturopathic medical services by Dr. Ducat are not directly billable to insurance. He will, however, provide patients who have PPO plans insurance-suitable invoices so that reimbursement for office visit fees can be facilitated. These invoices will be made available through the same secure online system that we use to manage payments.
In some cases, lab work will be paid for even when the fees for office visits are not reimbursed. Very few of the laboratories we utilize will bill insurance and wait for payment. Others, who have "pay-assured" programs may require a guaranteed minimum be paid at the time of sample submission, and pursue the insurer for the remainder. A few others are preferred providers, and will not charge covered patients. Most labs, however, will do courtesy billing to aid you in obtaining reimbursement but will require up-front payment.
Psychotherapy services by Dr. Ducat are covered by Regence Blue Cross/Blue Shield, Moda, Optum/United/Providence, Pacific Source, First Choice, and Medicare. For those on other plans, only out-pocket-payment can be accepted. However, invoices will be provided so those with PPOs can seek reimbursement.
Dr. Clifford is an in-network provider for Humana, Magellan, MHN, Regence Blue Cross/Blue Shield, Cigna, Pacific Source, Optum/United, Tri-Care, and Medicare.
If you are insured and want to set up an initial appointment, you are advised to first determine the exact nature and extent of your coverage, and then obtain authorization from your insurer. Our billing and insurance verification staff can do this for you, and answer any related questions.
Insured patients can contact Brooke Henry from Medical Billing Northwest to verify coverage. She can be reached at 503-592-9333. Her fax number is 503-592-9334.
Please note that health insurance providers do not always give our staff accurate information. Sometimes, unbeknownst to the patient, coverage promised or expected is withdrawn or does not come through. Be aware that patients, whether insured or not, are ultimately responsible for their bill. While it does not often happen, if for any reason your insurance company does not pay for services utilized, you will be billed at the rate the insurer would have paid.