Appointment Information (for Dr. Arlene Nichols)

An initial evaluation is generally done in 2 separate appointments, as outlined below:

First appointment: This appointment is done with the parents and the child.  Since a large portion of the appointment is history-taking, parents need to have someone who can be with the child if he/she needs to be in a separate room while history is taken or if he/she needs a break.  The appointment lasts approximately 2 hours.  A comprehensive detailed history is taken addressing birth history, past and current medical issues, diet and nutrition, current and past medications and/or supplements, developmental milestones, behavioral symptoms, education and therapies, and family history.  A detailed general physical examination and neurological examination, including attention to nutritional clues (in skin, hair, nails, etc.) is done. (Please see developmental history form in the “Forms” section.)

Second appointment:  This appointment is done with the parents only and lasts approximately 1 ½ to 2  hours.  This appointment includes an in-depth discussion of your child’s diagnoses and treatment recommendations.  Both traditional medical and functional medicine (e.g., diet and nutrition) approaches will be discussed.  Recommendations may include laboratory testing, additional therapy or educational recommendations, dietary changes, nutritional supplements, or medications.  An initial treatment and follow-up plan will be formulated.

Lab testing:

If laboratory testing is done, a follow-up appointment will need to be scheduled when all tests results are back.  This may be done on the phone (see phone appointment policy in “Policy and Procedures” section) or in the office.  Depending on the number and complexity of tests done, this appointment generally lasts 30-45 minutes.  Lab results and revisions/updates to the treatment plan will be discussed.  Cost of this appointment is prorated based on the practitioner’s hourly rate.

Labs may or may not be covered by your insurance plan.

Blood testing done at traditional labs such as Quest Diagnostics or LabCorp is generally covered.

Prior to your first appointment, please check with your insurance company to determine which local lab is covered by your insurance company.  In addition, please ask whether your reimbursement rate is different depending on whether an in-network or out-of-network physician orders your tests.  HeartLight practitioners do not participate with insurance plans.  If reimbursement is better for labs ordered by an in-plan physician, labs can be ordered by your primary care physician if he/she is willing to order labs we recommend.

Other labs done at specialty labs (such as Great Plains, Genova Diagnostics, or Metametrix, for example) may not be covered by your insurance.  It is your responsibility to discuss this with your insurance plan.  HeartLight continually researches different labs to determine the most accurate and cost-effective options for testing.

Follow-up in-office appointments:

The frequency of these appointments varies depending on your child’s diagnosis and treatment plan.  Follow-up appointments generally occur every 3-4 months.  Follow-up appointments range from 30 minutes (simple medication follow-ups) to 1 ½ hours, again depending on the reason for follow-up and the complexity of the issues.  Follow-up appointment charges are pro-rated based on the practitioner’s hourly rate.

Costs:

Initial appointments: $350 per appointment for a total of $700.

Follow-up lab appointment: Prorated at the practitioner’s hourly rate.  Appointment is generally 30-45 minutes, depending on the complexity of the labs and other issues requiring follow-up discussion.

Subsequent in-office follow-up appointments: These appointments range from 30 minutes for simple medication follow-ups to 1 or 1 ½ hours for more complex issues.  The cost is prorated based on the practitioner’s hourly rate.

Dr. Nichol’s hourly rate for follow-up and phone appointments: $200/hour.