HORMONE IMBALANCES AND INSURANCE
Bio-identical hormone replacement therapy (BHRT) is a unique practice and is considered a form of integrative medicine. Insurance companies do not recognize BHRT as medically necessary. BHRT is considered elective, like aesthetic procedures or plastic surgery. All providers at engaged with BHRT are Hormone Certified Physicians and Nurse Practitioners.
We offer affordable self-pay lab testing through LabCorp for BHRT. While lab testing can be costly, even with insurance, NSFM only charges $50 for hormone blood panels. This is the price you pay each time you come in for lab work. NSFM will NOT submit lab costs to your insurance company or LabCorp on your behalf. We will not contract with LabCorp to submit through your insurance company. You, as the patient, may submit a request directly to your insurance company, but we cannot guarantee reimbursement.
PAYMENT AND REIMBURSEMENT
We require payment in full at the time of service. We will provide a receipt showing that you paid out of pocket upon request. Receipts are your responsibility and alone serve as evidence of your treatment. NSFM WILL NOT submit for reimbursement directly with your insurance company or provide a letter with diagnosis codes from our office to your insurance provider for BHRT or lab work associated with BHRT. For patients who have access to a Health Savings Account, you may pay for your treatment and lab work with that credit or debit card.
IS THE HORMONE PROGRAM A PART OF THE DPC PRACTICE?
Our concierge BHRT program is a separate service from the direct primary care practice at New South Family Medicine and MedSpa. Rates are not adjusted for patients who are currently receiving hormone therapy elsewhere or through the DPC membership practice at NSFM. If you choose to begin treatment with our BHRT provider, this is a completely separate service from the primary care membership service at NSFMMS and fees are paid on the day of your visit.
APPOINTMENTS AND PRICING
If you are interested in Bioidentical Hormone Replacement Therapy, we will need to see you for lab work first. This helps Shannon make an informed decision so together you can map out your best course of action. Please fill out the BHRT New Patient Forms that have been emailed to you before your initial lab appointment. It takes just a few minutes and helps us to set up your account.
NEW PATIENT TREATMENT PLAN/PRESCRIBE (one-time appointment)
Fee: $175 *Price does not include the pellet insertion fee.
This appointment is for our new hormone patients ONLY. During this appointment (review labs), Shannon will discuss and address the results from your lab work and answer all your questions. Your treatment plan will be custom-tailored to fit your unique needs and your lifestyle. Medications are prescribed based on your custom treatment plan and any additional supplements and/or injections to allow for a healthier lifestyle. Pellet insertion will also be available to you at this time for an additional fee.
We will repeat lab work for ALL new hormone patients six weeks after you begin hormone replacement therapy. This includes both men and women to determine your hormone levels and to make adjustments if necessary. Moving forward, female patients will return for follow-up lab work every 3-4 months and male patients will return every 5-6 months.
SIX-WEEK FOLLOW-UP/NEW PATIENTS ONLY (one-time appointment)
Fee: $100+ $50 per pellet to boost hormone levels (usually 1-3 pellets)
We will discuss your new hormone levels and will make any adjustments for non-pellet patients and possibly add an additional hormone pellet at this time for patients who are receiving pellets. A $50 charge for each additional pellet (usually 1-3 pellets). The pellet insertion fee is waived during this appointment.
FEMALE PELLET INSERTION
Female hormone patients will return (3-4 months) to repeat lab work and to continue receiving hormones through pellet insertion.
MALE PELLET INSERTION
Male hormone patients will return (5-6 months) to repeat lab work and to continue receiving hormones through pellet insertion.
RETURN NON-PELLET HORMONE PATIENT
Fee: $50 -$100
Prescription-only hormone patients will need to repeat labs and schedule a Return Non-Pellet Hormone Patient appointment for prescription refills. (Female 3-4 months and Male 5-6 months)