Thank you for your interest in our clinic. We look forward to serving your health needs. If you have not already done so, you may learn more about our clinic from our website: www.drhirani.com. We require all new patients to read and understand the information on this form to avoid any misconception or confusion about the services we offer.
1. Dr. Hirani has been conventionally trained at USC Medical School (where she is also a former Assistant Clinical Professor of Family Medicine); and at UCLA where she received a Master of Science degree with specialization in Nutrition from the School of Public Health. She is Board Certified in Family Medicine.
2. However, we are a Holistic clinic that offers complementary and alternative medicine (CAM) treatments, otherwise known as Integrative Medicine or Functional Medicine. Depending on your condition, recommendations may include specific nutritional diet modifications (no sugar, gluten, alchohol, etc), lifestyle and nutritional counseling, dietary supplements, IV therapies or injections, oxygen therapy, sometimes prescription drugs, specialty lab work and possibly other treatments not listed here. When there is a quick fix, both doctor and patient are pleased, but many treatments may require serious effort on the part of the patient (or parent) and may not be simple. Please visit the website (drhirani.com) for examples. We highly recommend that parents should watch the videos posted on our website. Parents should also realize that they will need to coax dietary supplements into their child.
3. Some leading edge treatments at this clinic are not considered the "standard of care" offered by conventional medicine. Therefore conventional providers who are not trained or familiar with CAM therapies may disagree and disparage the medical plan or testing offered by Dr. Hirani. For example: biomedical interventions for autism, homeopathy, acupuncture, neural therapy, stool testing or Lyme testing, and other treatments.
4. Fee structure: Our office does not accept any insurance assignment. We are not a Medicare provider. Professional fees for Dr. Hirani's consultation time, and ancillary services performed by our office are due and paid on the day of service. Initial consultation fees are $800 for adults (60 minutes) during which time Dr. Hirani will take a detailed medical history, perform a full physical exam, a body composition analysis, and make an initial treatment plans including recommendations for lab work. Fees for lab work, follow up consultations, specimen collection and handling, dietary supplements, and other treatments are not included in this initial fee. A follow up appointment is necessarily required to review progress and lab results. Lab results are not automatically communicated to patients because most specialty lab results require further explanation by the doctor. We provide patients with a superbill only for office visits. Please contact your insurance company to determine reimbursement for an out of network provider. Additional insurance information is available on the website. It is difficult to provide an estimate for what your total out of pocket expense would be for the course of treatment since it is dependent on many variables. Processing of insurance paperwork and documentation requests will incur a nominal handling fee.
5. Insurance for Lab Fees: Generally, Dr. Hirani will recommend lab testing. Our clinic is not staffed to draw your blood on site therefore you will receive instructions on Labcorp draw station and outside mobile phlebotomy service for specialty labs not included in your consultation fee. Depending on your condition, separate labs may be required and sent to various facilities nationwide or internationally. Our primary labs are contracted with most insurance companies and require no patient copay for most carriers and Medicare. Some other labs may be contracted within your insurance network and you will be responsible for network deductibles and copays. Labs may offer cash pricing schemes to limit the maximum out of pocket expense. Some labs do not accept insurance. It is impossible to determine the nature of the labs you may require in advance of your visit. The nurse will explain applicable out of pocket lab fees at your visit.
6. Communication: Patients primarily communicate with our office and Dr. Hirani through the secure online portal messaging system. Outside of your scheduled consultation Dr. Hirani is only available to answer brief questions for a fee and this service does not replace a proper consultation for complex medical questions. Direct voice communication with the doctor is not available except for scheduled phone or Skype consultations. Lab results and patient education material are also communicated electronically. Although phone communication with our office is available, it can be delayed.
7. Cancellation: We require 5 days notice to cancel or change an initial consultation. We may be able to accommodate (at our option) last minute cancellations or rescheduling by drawing from our waitlist, but you will still be charged $100 for our effort to fill your cancelled appointment. Otherwise, your credit card will be billed up to $800 for any time that goes unused since we do not double book appointment slots. You will receive an email confirmation when your appointment is cancelled. You must save this email.
8. Credit Card Info: A credit card authorization is required to hold your appointment. This is not a charge. This card will be kept on file and used to enforce our cancellation policy described above and future charges. All boxes must be completed. If you provide a debit card, your funds will be put on hold, therefore it is not recommended if you also have a credit card.
9. You will require a G6PD blood test to determine if you are able to metabolize intravenous doses of Vitamin C. The cost of this test is approximately $75 and is not covered in the cost of the consultation.
Generally, most therapeutic vitamin therapies are considered not medically necessary and will not be covered by your insurance.
End of Addendum
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Upon receipt of this information, the next business day, a staff member will create a secure portal account to communicate with you in a secure manner. You must then login and follow further instructions on a few additional forms to complete and return via the portal. Finally, a staff member will call you to finalize a consultation date and time. Please be advised that sometimes there may be a two month wait for a NEW PATIENT appointment. If you do not receive a call back within 24 hours after submitting your additional forms, please call the office 310-559-6634. Thank you. We look forward to meeting you soon.
