Policies and Procedures
WELCOME TO THE PATH – CENTER FOR INTEGRATIVE AND FUNCTIONAL MEDICINE WITH DR.CHRISTY KRAIL-JAVIER, DNP, FNP-C, ND, PhD
We are so happy you found us and look forward to supporting you on your journey to better health and wellness. Here you will find answers to frequently asked questions and information to help optimize your time with us so we can focus on what’s most important – YOUR HEALTH!
PATIENT PORTAL
The Path uses the Cerbo secure patient portal.
INTEGRATIVE AND FUNCTIONAL MEDICINE APPOINTMENTS
Prior to Your Initial Consultation:
You may request a free Discovery Call and/or Initial Consultation on our website OR by calling our office at (504) 427-8365. The first time Discovery Call is free and is designed to answer any questions you may have and to discuss our new patient onboarding process. Should You decide to move forward with the Practice, you will be scheduled for Your Onboarding Appointments with Dr. Krail-Javier, DNP. Appointments include an 1) Initial Consultation and complete evaluation of your full health history to inform your plan of care, and your 2) Onboarding Follow – Up Consultation where you will receive a detailed review of your full personized, targeted plan of care. These Onboarding Appointments will be schedule approximately one week apart to give Dr. Krail-Javier enough time to finalize your plan of care. You may book Your Onboarding Appointments immediately following your Discovery Call and will be offered our earliest available day and time.
When You schedule your Onboarding Appointments, You will be asked to place a credit card on file. While a first-time Discovery Call is free of charge, to schedule Your Onboarding Appointments with Dr. Krail-Javier, DNP, you will be charged half of the Onboarding fee to secure Your appointment times. This fee is a non-refundable deposit to hold your place on our calendar and will be applied toward the total Onboarding fee collected at your Initial Consultation. If you choose to use a credit card to make your payment, you will be charged a 3% credit card service fee. However, we offer alternative forms of payment if you wish to avoid the credit card fee. Please see the explanation and details below.
Once Your Initial Consultation is scheduled, you will receive an email with a LINK TO REGISTER FOR OUR PATIENT PORTAL. You will then need to complete a few New Patient forms which you can find under the “Forms & Questionnaires” tab of the portal.
Please only fill out the forms in the section titled, “REQUIRED New Patient Onboarding Documents”.
All required forms must be submitted THREE WEEKS prior to your Initial Consultation via the secure patient portal. Required documents include:
- Signed Patient Contract Fee for Service Agreement
- Signed Office Policies and Procedures (This Form)
- Signed Notice of Privacy Practices
- Signed General Informed Consent
- Signed Consent to Participate in Telemedicine Consultation
- Completed New Patient – Medical Intake Form
- Completed New Patient – Family History Form
- Completed New Patient – Social History Form
- Completed Symptom Review Questionnaire
- Completed Environmental Exposure Questionnaire
- Completed Sleep Questionnaire (PIRS 20)
- Completed Insomnia Questionnaire
- Completed Women’s or Men’s Questionnaire
- Completed New Patient – Readiness Assessment
- 7-day Food Diary
- Upload Any Recent Lab Work (within the last 6-12 months)
- Upload Any Pertinent Medical Records or Diagnostic Test Results
If you have had extensive testing done by another provider prior to your Onboarding Appointments that you would like Dr. Krail-Javier to review, this may result in additional Onboarding fees. Fees will depend on the number and complexity of tests. The review of functional lab tests beyond a single report may incur a cost of $50.00 – $100.00 for each test submitted.
Depending on your situation, you may be asked to complete additional forms or documents. Early submission of documents is required to allow Dr. Krail-Javier, DNP sufficient time to thoroughly review your medical history and efficiently and effectively prepare for your Initial Consultation. The integrative /functional medicine model utilizes an in-depth and lengthy patient intake process that involves significant time on the part of the provider both prior to and during your Initial Consultation to ensure you receive the highest quality of care. If the required forms are not received at least THREE WEEKS prior to your initial consultation, your onboarding appointments will need to be rescheduled. If your appointments must be rescheduled more than once, you may forfeit your deposit as well as future appointments.
Initial Consultation:
During your Initial Consultation, Dr. Krail-Javier, DNP will meet with you for about 1.5 hours to review your medical history and in-office assessments. She may also perform a physical exam and discuss any necessary diagnostic tests. Based on her findings, she will then make individualized recommendations to address your specific medical needs. Recommendations made during the Initial Consultation are not fully comprehensive and are intended to get you started on your first steps while awaiting results of diagnostic tests and/or further evaluation of assessments made during your Initial Consultation. Your FULL plan of care will be provided and reviewed during your Onboarding Follow-up Appointment that was scheduled as part of your Onboarding Process. During Your Initial Consultation, You may also meet with other office staff who will explain any recommended testing, lab kit instructions, blood work, supplement schedules, costs, and follow-up appointments. Please allow approximately 3 hours for Your Initial Consultation.
No Refunds:
The practice does NOT offer refunds for Onboarding Appointments to include the Initial Consultation and First Follow – Up Appointment.
Follow-Up Appointments:
Based on Your recommended diagnostic tests and/or assessment procedures, a Follow – Up Appointment will be scheduled approximately 3-6 weeks after your Onboarding Follow – Up Consultation. Follow – Up Appointments are scheduled to review and discuss Your test results, Your progress, Your response to treatment and address any questions you may have regarding your integrative plan of care. Dr. Krail-Javier, DNP will attempt to address all related lab results in one visit. However, if multiple tests are required, the number of follow up appointments may be determined by the number and type of tests ordered to thoroughly evaluate Your medical needs. The total number of recommended Follow – Up Appointments within a designated time frame is based upon Your unique condition and requirements. Follow – Up Appointments generally last ONE HOUR and are designed to address necessary accommodations to Your plan based on test results as well as Your response to treatment. Unless Your Follow – Up Appointments have been pre-paid, we ask you pay a $50 deposit to hold Your appointment time on our calendar which will be applied toward the total appointment fee at the time of service. Follow – Up Appointments are subject to the cancellation policy below. Although You may receive a courtesy reminder call or text from our office, You are responsible for remembering your appointment date and time.
Existing Patient Consultation:
If you acquire a new condition unrelated to the primary concerns being addressed from Your Initial Consultation that requires a new evaluation, it would not be considered a Follow-up appointment and is associated with slightly higher costs. See Appendix A in the Policy and Procedures document in your patient portal for more information.
Telemedicine:
Telemedicine visits are available to patients in the state of Louisiana and Florida. Providers licensed in the state of Louisiana and Florida can provide Telemedicine to patients who are present in the state of Louisiana and Florida, respectively at the time of the Telemedicine appointment. Dr. Krail-Javier, DNP may do Telemedicine visits via a video platform within the secure patient portal or by telephone. These Telemedicine visits will be charged the same rate as in-person office visits. Please refer to the fee schedule under Attachment A in the Policies and Procedures document that was emailed to you after scheduling your Initial Consultation.
Cancellation Policy:
We have a waiting list, so if you must cancel an appointment, we ask that you notify the office in writing (email or secure messaging though patient portal) as soon as possible so we may offer the allotted time to another patient. We have a 48-hour cancellation policy for ALL appointments, whether with Dr. Krail-Javier, DNP or any other provider, including our MFR provider Dr. Cheryl Jeane, PT, DPT. Without sufficient notice, another patient could lose the opportunity to receive help and we will lose the cost of an appointment. If appropriate notice is not given within the requested time period, your credit card on file will be charged for the full cost of the cancelled appointment and a 3% credit card service fee will be applied. In the case of an emergency, we may waive the charge for missing an appointment without sufficient notice. However, we will (reasonably) determine what constitutes an emergency, for example: a death in the family, your hospitalization, or an Act of God. If an appointment must be rescheduled more than twice, you may forfeit your Appointment and your card on file will be charged the FULL COST of the cancelled appointment. If your appointment is forfeited, The Practice will determine whether to offer you the option to move forward with the practice at a later date.
Late Arrival Appointments:
We schedule our appointments to prevent wait time and make it a priority to stay on schedule. We value and respect your time and ask for your mutual consideration for us as well as the other patients who are scheduled the same day. If you arrive late for your scheduled appointment, the appointment or consultation will not exceed the time it was originally scheduled to end, and you will be charged for the full appointment as originally scheduled. If you are more than 15 minutes late for your appointment, you may need to be rescheduled. We understand things happen but must remain respectful of other patients and can not run your appointment over into another patient’s time slot.
If you do not show up for your appointment or if you show up too late for your appointment to be completed, you will be charged for the full appointment due to the loss of time. Those who are late to their appointment or do not show up more than once will only be allowed to schedule future appointments by prepaying in advance for the visit and this pre-payment is non-refundable. Failure to show up to an appointment for a second time may run the risk of not being seen in the future. The 3% credit card fee will be applied to all charges including late arrival and no show charges.
Integrative and Functional Medicine Appointment Fees:
Unlike conventional medicine visits, much of the provider’s work is done up-front prior to your face-to-face visit. Due to the nature of integrative care, Dr. Krail-Javier, DNP spends extensive time reviewing your medical history, test results, preparing for your consultation, and formulating your individualized wholistic plan of care PRIOR to your appointment. Some of this time may even be spent in consultation with other practitioners and specialists to ensure the best, most comprehensive treatment plan, and appropriate recommendations. Extensive preparation, planning, and follow-up is necessary to optimize your care and ensure efficiency of clinical time. Dr. Krail-Javier is not a salaried provider, and our clinic is NOT affiliated with a large organization or hospital which receives subsidies and insurance reimbursements. Consultation fees are reflective of our time, experience, unique services, expertise in our field, and the quality of care we provide to our patients.
Dr. Krail-Javier’s integrative and functional medicine Appointments include two Onboarding Appointments (Initial Consultation + Onboarding Follow – Up Consultation) for $975.00. And subsequent Follow – Up Appointments which are $325.00 per visit. These Appointment fees EXCLUDE any recommended testing, therapies, procedures, or supplements that may be recommended. If You choose to purchase your Onboarding Appointments along with your first Follow – Up Appointment which is recommended, you can receive all three for a single discounted rate of $1175.00. It is typical for everyone to require at least one Follow – Up Appointment. You may also receive discounted rates with advanced payment for multiple Follow – Up Appointments. Please see Attachment A for package plan discounts, concierge options, and other pricing for additional services. You may also find a detailed list of services included in your Onboarding package in Attachment A.
**Appointment fees are subject to change without notice.
The Initial Consultation is generally about a 90-minute session with Dr Krail-Javier, DNP but another 60-90 minutes may be spent with office staff to review your welcome packet, conduct personalized assessments, and review the details of your integrative plan. Follow-up appointments are generally 1 hour.
INTEGRATIVE AND FUNCTIONAL MEDICINE BILLING AND INSURANCE POLICY:
At this time, we do NOT participate in any private or government funded health insurance, PPO or HMO plans or panels and have opted-out of Medicare. We do not submit bills to any private insurer or federal or state health care program (including Medicare, Medicaid, Tri-Care, Veterans Affairs, Federal Employee Health Benefits, etc.) for services even if deemed to be a covered service under such third-party insurance plan.
As providers of high quality integrative and functional medicine, our billing and insurance policies must align with the cost of offering truly preventative medicine and natural healthcare services based on the highest standards of care. Therefore, our billing policies are unique to our field and clearly distinct from that of mainstream medical practices who bill insurance companies. We understand that our inability to accept or bill insurance at this time may present a financial and practical challenge, so we would like to explain the reasoning behind this policy. We want you to understand that this policy is in place for sound reasons that serve to benefit you and ensure that we may provide you with the quality care you seek and deserve. Below provides further explanation as to why billing insurance directly can compromise the care you receive and answers to commonly asked questions regarding our billing policy.
We do not directly bill private, or government funded insurance like many other healthcare providers. This is because providers who participate in health insurance plans must sign a contract that allows the insurance company (not the doctor) to determine which services you can receive via coverage and the associated billable fees for services provided. Most services that insurance companies approve are not focused on disease prevention, wellness, holistic care, or resolving the underlying cause of disease, but rather concentrate on pharmaceutical drugs and invasive procedures that mostly address symptom management. Furthermore, insurance coverage tends toward a one-size fits all, rather than patient-centered approach to treatment.
Our integrative and functional medicine model focuses on health promotion through personally recommended nutrition and lifestyle modification, natural and holistic therapies, and root cause resolution of disease. These practices require intervention typically deemed unnecessary, thus non-coverable by insurance companies. We do not subscribe to the sick care model or the disease management approach. Additionally, insurance companies determine the fees that can be charged for services rendered. These fees are often insufficient to cover the cost of quality integrative care and are usually not applicable to the services we provide. Furthermore, participating providers are prohibited from billing for the difference between the allowable insurance fee and the actual cost for the services. Hence, our clinic would have to forego the difference in revenue while incurring further expense from additional staff and specialized software and equipment needed to process and track the insurance claims. This would prove to be an unsustainable business model under which we would not be able to exist. By agreeing to the forced terms and conditions of this restrictive third-party landscape, we believe your care may be limited and quality of service sacrificed and/or minimized as a consequence of predetermined medical intervention, necessary time constraints, and unreasonable fees set forth by insurance companies. In other words, we would be forced to provide low quality care and brief appointment periods to accommodate discounted rates set by non-medical professionals.
Many conventional medicine providers and primary care clinics have joined other medical institutions and hospitals, which rely upon expensive invasive surgeries and diagnostic tests to financially compensate for low insurance reimbursements. Other providers increase the number of patients treated to make up for the financial loss. Neither of these are realistic options for integrative and functional medical providers who provide time intensive, research-based holistic and wellness centric care. Therefore, in order to provide such quality care that supersedes conventional standards, we DO NOT accept insurance and you will remain fully and completely responsible for payment to The Path CIFM. However, you, at your discretion, may independently submit your service invoice, or superbill to your insurance company with the exclusion of Medicare or Medicaid. At your appointment, you may request an itemized invoice including diagnosis codes necessary to file for insurance reimbursement. Please retain and provide a copy of any lab kit requisition forms which contain procedure codes for your insurance provider.
We, The Path CIFM, do not make any assertions, representations, claims, warranties, or guarantees whatsoever that your (or any) insurance provider will reimburse You for any fees paid under this Agreement. However, we advise you, to either obtain or keep in full force such health insurance policy(ies) or plan(s) that will cover your general health care costs. We do not cover hospital services, or any services not personally provided by The Path CIFM, Dr. Krail-Javier, DNP, or other office providers.
Same-Day Scheduled Consultations:
We offer patients the option to book a self-deemed “urgent” integrative medical or nutritional consult with Dr. Krail-Javier, DNP after hours on our clinic days if you do not wish to wait for the next available appointment time. The cost for Same-Day Appointments is $200.00 and these appointments are held to a 30-minute time frame. The Patient may request the appointment be held in-person or virtually through the secure patient portal and the appointment fee is due at the time of Service booking. Same-day appointments are only to address integrative and nutritional healthcare needs and DO NOT take the place of emergency care. If you believe you are experiencing a medical emergency call 911 or report to your local emergency department immediately
Moving Forward with The Path CIFM:
We are a program-based Integrative Functional Medicine Practice. After your Initial Consultation, Dr. Krail-Javier, DNP or another Practice provider may decide, based on your case, to offer you the opportunity to join a wellness program through the scheduling of follow-up appointment(s) for continued care as a patient. You will have sixty (60) days to accept the offer to move forward with a program or membership. On or about the thirtieth (30th) day after the Initial Consultation, if you have not yet decided to move forward, we will call and email you as a reminder of this policy. If, after sixty days, you have not decided to move forward with the program or membership, you will need to come in for another Initial Consultation if you wish to join the The Path CIFM as a Patient.
COMMUNICATIONS
Post-Initial Consult Communications:
We will not provide continued care in terms of portal messaging support, phone calls, or visits after the Initial Consultation unless you enter into a program through the scheduling of Follow-up Appointment(s) or membership agreement to continue care with us and our providers. However, our providers or staff will substantively respond and answer inquiries seeking to clarify the recommendations made during the Initial Consultation or to answer supplement usage or dosage questions. If your questions exceed the scope of this limited exception, you will be encouraged to come in for an appointment, and thus begin a program or membership with us or to seek counsel from your primary care physician.
General Communications:
E-mail communications (outside of the secure patient portal), facsimile, video chat, instant messaging, and mobile phones are not guaranteed to be encrypted, secure, or confidential methods of communications. Any communications made outside of the patient portal are made at the Patient’s risk with respect to all e-mail communications. The use of electronic communication outside of the secure patient portal has inherent limitations, including possible breach of privacy or confidentiality, difficulty in validating the identity of the parties, and possible delays in response.
We will not respond to e-mails or other messages that contain sensitive medical information. If a response is requested, we will respond through the secure patient portal. Though it is our policy only to respond through the patient portal, by you initiating correspondence through an unsecure and/or unencrypted channel, we are not obligated to guarantee confidentiality with respect to correspondence using such means of communication. We may retain any communications between The Path CIFM, our providers or staff and the patient and may include such communications in the patient’s medical record.
Portal messaging or e-mail are not appropriate means of communication regarding emergency or other time-sensitive issues or for inquiries regarding sensitive information. We will do our best to get back to you as soon as possible but a prompt reply is not required on behalf of our staff and should not be expected. Please do do not deal with emergencies or time sensitive issues through portal messaging, In the event of an emergency, or a situation which you or anyone else reasonably believes could develop into an emergency, please call 911 immediately or proceed to the nearest emergency room and follow the directions of emergency personnel.
We check our telephone and portal messages during business hours and will respond to them on a regular basis throughout the week. Portal messages are to be used for non-urgent messages only, and a response to your inquiry or message will generally be sent within 1-2 business days. Office staff will respond and answer inquiries such as those seeking to clarify the recommendations made during your appointment, supplement usage questions, or questions regarding testing instructions. When leaving a message, please briefly state your full name and date of birth followed by the reason for your call. If there is more than one question or concern requiring a response, please list them succinctly.
We understand that beginning your integrative medicine Journey can be overwhelming and often invoke many questions along the way. We wish to and will address each of your concerns as timely and effectively as possible but please be advised that our staff and Dr. Krail-Javier, DNP can only answer a few brief questions outside of your appointment times. If, in the sole discretion of the practice, your questions exceed the scope of this limited exception or require an in-depth or detailed response, you will be encouraged to schedule an Appointment OR Portal Message Consultation charged at the same rate as an appointment. You may also be given the option to schedule a Same-Day Appointment at a higher rate to have your extended list of questions or in-depth questions answered or to address your immediate needs. This ensures you receive the best and most appropriate care while honoring the practice’s time and busy schedule. Questions surrounding in-depth treatment details, lab or test results, condition pathology, or issues other than those addressed during your appointment(s) will require a SEPARATE CONSULTATION / APPOINTMENT and fall outside the scope of office staff responsibility. Therefore, **Please keep all messages as concise as possible. Sending extremely long or multiple messages that require more than a few minutes to read may result in a consult fee.** A 3% credit card service fee will apply to all charges including charges for portal messaging.
Medical Records:
Your written authorization is required to release your medical records to another provider. You must provide your medical records from other providers if you wish Dr. Krail-Javier, DNP to review them. These records must be received by our office 3 days prior to your scheduled appointment. Extensive medical records requiring a lot of time to review may be subject to additional fees.
TESTS, SUPPLEMENTS & PAYMENTS
Diagnostic Tests:
Dr. Krail-Javier, DNP may order conventional blood work and diagnostic tests such as ultrasounds and x-rays as well as advanced functional medicine diagnostics to evaluate your condition and/or determine the need for a referral. Functional Medicine Tests are often necessary for an in-depth assessment of nutritional status, toxic chemical exposure, underlying biochemical imbalance, and how the body is functioning as a whole. They typically involve the collection of blood, urine, and stool, and less often, hair. Some can be done in the comfort of your home, and others may require you visit a blood drawing facility. Dr. Krail-Javier uses these advanced diagnostics to help complete the clinical picture and precisely guide your plan of care while eliminating most of the guesswork. Functional testing has not been acknowledged or adopted by mainstream medicine. Your conventional provider(s) may be unfamiliar with these tests or disagree with their use or interpretation. However, our goal is to restore health and prevent further illness or new problems from developing in the future rather than diagnose disease. Be advised that NO test is perfect and will never substitute for a robust history taking and physical examination. After a comprehensive interview that reviews your full health history and a thorough evaluation, Dr. Krail-Javier will decide which lab tests, if any, are needed to properly inform interventions moving forward and which align best with your personal needs. Dr. Krail-Javier is happy to discuss any questions or concerns you may have regarding diagnostic testing.
If you need to have any testing, during your appointments, you will be provided with pre-test instructions and/or in-home test kits for functional tests. Some kits are available at the office, and some my be mailed to you directly. Either way, it is Your responsibility to complete the tests, and mail any collected in-home test samples via USPS, UPS, or FedEx to the appropriate laboratory. A prepaid shipping label and envelope are typically provided in the test kit. Please notify our office once You have mailed your kit to the appropriate laboratory so that you may receive a timely follow-up appointment.
You will receive reminders to have tests completed. If not completed in a timely manner, you may require another appointment for reevaluation. Test results will be discussed during follow-up appointments and made available in your secure patient portal upon request. You will be given a copy of your results at each visit to maintain for your records. With each additional copy requested there is a $25.00 fee. Fees for laboratory and diagnostic testing may not be billed through our office. If we do not collect payment for your diagnostic testing, you will need to pay these fees directly to the associated testing facility or laboratory when you submit your samples. The costs for labs or other diagnostics are in addition to your appointment fees.
Always make a copy of your lab requisition form included in your testing kit which contains codes needed to file with your private insurance, if applicable. We are not responsible for any charges or bills you receive from any laboratory.
Supplements:
It is likely you will be prescribed nutritional, herbal, and/or homeopathic supplements. This is common practice in integrative medicine and based on scientific research. While we are happy to answer any questions you may have or address any concerns, you are encouraged to read “Why Your Doctor Offers Nutritional Supplements” which can be found in your welcome packet received upon arrival to your Initial Consultation. We offer only the highest quality pharmaceutical-grade vitamins and supplements to our patients. All vitamins and supplements have been thoroughly vetted by Dr. Krail-Javier, DNP and selected specifically based on their quality, purity, consistency, proper dosing, and third-party testing standards. Each has been verified to contain the exact ingredients listed on the label and the therapeutic strength necessary to achieve effectiveness. Verification is often done by independent third-party testing labs along with purity studies.
As a complementary service and convenience to our patients, many of our recommended products which are not available through retail chains are sold on-site at our specialty Holistic Health and Wellness Store, The Path Naturals, or through our online dispensary available on our website. You may purchase products directly from our store in-person or place orders for pickup by phone or through the patient portal via secure messaging. When your order is ready to be picked up, we will message you. Supplements and other necessities can be picked up during business hours and will usually be ready the same day or the next day if placed after business hours. You may also elect to have your products shipped to you. Shipping charges will be added.
Returns and Refunds:
Products and supplements (except those requiring refrigeration) may be returned for a refund or exchange if in original condition and unopened/unused within 14 days of purchase.
Payment Options:
Our office accepts credit cards (Mastercard, Visa, Discover, and American Express) and cash for payment of services and products. We do NOT except checks. We will ask that a credit card be placed on file to hold your scheduled appointments, but your card will not be charged unless the parameters for cancellation are violated. Telemedicine consultations are automatically charged to your credit card on file on the day of service unless another payment option is provided prior to your scheduled appointment.
Collection Policy:
In the event of nonpayment, The Practice reserves the right to turn your account over to a collection agency or attorney in order to obtain payment of fees owed, expenses, and attorneys’ fees.
Office Hours:
Our office hours are Monday-Thursday, 8:30 AM-5:00 PM. If You need to visit the office to pick up supplements, test kits, or other necessities, please call (504) 427-8365 or message through the patient portal ahead of time so we can have your things ready.
Mobile phone and device policy:
We ask as a courtesy to our staff and other patients that you turn off your mobile phone and / or other hand-held wireless devices while visiting the office or while on a video call with Dr. Krail-Javier, DNP or any of our staff. If you have to take an emergency or urgent call, we ask that you step outside the building. Some patients are sensitive to electro-smog emissions from wireless phones and devices and we stive to make our environment here at the path as ancestral as possible with minimal harmful emissions. We thank you for your understanding and cooperation with our policy.
Thank you for taking the time to read through our policies. If you have any questions or concerns, please do not hesitate to contact us. Now let’s get started on The Path to health and wellness!