DR. SALT AND IBS & GUT MICROBIOME SOLUTIONS
POLICIES and PROCEDURES
WE DO NOT ACCEPT INSURANCE, INCLUDING MEDICARE
YOU (or someone with whom you live) MUST:
Be proficient with a computer. We will send an email to you with a Microsoft Word attachment, which you will need to open, type into, and return as an attachment to an email. You will need to be able to use your computer to enroll in ~ and use ~ your Patient Portal at PatientFusion.com. Your portal is HIPAA compliant; it will be used to communicate medical information to and from Dr. Salt.
Have an e-mail account and consent to the use of non-secure email to send and receive general office information and, occasionally, medical information.
Have a cellphone.
NEW PRICES EFFECTIVE SEPTEMBER 4, 2018
Effective September 4, our charge will be $600 per hour. Accordingly, the cost of your one hour Initial Consultation will be $600 and your 45 minute first Follow-Up Consultation will be $450. Since subsequent follow-up consultations vary in time, costs will be based on the hourly rate of $600 (i.e., the cost of a 30 minute consultation would be $300). In order to be able to spend more time with patients, we do not participate with insurance or Medicare. We will provide you with a "Superbill" after every consultation, which includes your diagnostic and visit codes (CPT Codes), which you can submit to your insurance provider with a request for reimbursement. You can expect your payment to count towards out-of-network deductible. The amount of reimbursement, if any, depends upon your specific policy. Insurance providers, including Medicare, consider Dr. Salt to be an out-of-network provider. But they also consider him to be an in-network prescriber, which means your insurance will kick in as it normally would for any tests, lab work, imaging, or procedures Dr. Salt may order. If you wish to check reimbursement rates for consultations, you can call your insurer and give them the following codes: new patient consultation CPT code (99245) and follow-up consultation CPT code (99215). Be sure to tell your insurer that Dr. Salt is a “non-participating/out-of-network provider.”
Payment for your consultation is accepted at the end of your visit in the form of credit card, debit card, check, or cash.
Established patients will be grandfathered under current prices through December 31, 2018. Afterwards, our September 4, 2018 prices will be applied.
DR SALT'S NEW E-LEARNING PROGRAM
You will be given free access to Dr. Salt's new e-learning course, a $599 value (which you can think of as "subtracting" from your initial fee!), so the consultation effectively only costs one dollar)! Click on the title below or button to learn more:
ADDITIIONAL IMPORTANT PRACTICE POLICY INFORMATION
Your health care professional can refer you by faxing our practice (877.883.5012).
"Schedule Consultation with Dr. Salt" is a link on PatientFusion.com's online scheduler. We request that only patients returning for Follow-Up Consultations use this scheduler.
We offer phone consultations. Phone consultations are available during evenings and weekends, depending on Dr. Salt’s availability. Let us know in the message section of the CONTACT FORM if that is what you prefer and we will call you to set it up. Be sure to include (in the message section) windows of times when you are available to take our call.
Appointments are Mondays, Tuesdays, and Wednesdays from 8:30 am to 3:30.
We maintain an active waitlist. If you would like a consultation sooner than your appointment, please let us know and we will put you on our cancellation list. If you know you cannot make your consultation, please give us as much notice as possible so we can offer the time to someone on our waitlist.
If you need to cancel your appointment, we ask that you do so at least one week prior to your appointment. (Dr. Salt reviews your medical records and Patient Intake Form one week prior to your appointment, taking quite a bit of time to do so.) After a late cancellation or “no-showing,” we will probably not reschedule you, unless we determine there is an impressive reason for doing so.
Please note that our office does not handle medical emergencies. If you are having a medical emergency, you should call 911, visit the nearest emergency department, or call your primary care physician.
PREPARATION FOR THE INITIAL CONSULTATION
Dr. Salt reviews your relevant medical records, your Patient Intake Form, and the MyGIHealth Mobile App report (see below) if you have an iPhone prior to your visit. Complete and send them one week before your scheduled visit.
You will arrange to have all relevant medical records either faxed (877.883.5012) or sent by mail at least 1 week prior to the consultation. If you are in possession of records, you can email them to us, as long as you understand that email is not secure:
Patient Intake Form
You will complete a comprehensive Patient Intake Form at least 1 week prior to the consultation, which is custom-designed by Dr. Salt. It includes questions based upon sophisticated research by the NIH (National Institutes of Health) intended to help patients express and health care professionals understand gastrointestinal symptoms (patient history). The Patient Intake Form will be emailed to you as a Word attachment. After completing the form, you can return it by email. This NIH research shows that there are 8 main groups of symptoms patients have who consult with gastroenterologists.
The MyGIHealth Mobile App
If you have an iPhone, visit MyGIHealth.io, read about the My GI Heath Mobile app, and down-load it from the Apple App store. This remarkable app will take your history accurately, such that recent research shows it to to be more accurate than the history obtained by many experienced gastroenterologists. You can send the report to us in an email to info@WilliamSaltMD.com. Please bring your phone (with the app) to your appointment.
Your appointment will last 1 hour.
Collaborative Shared Decision-Making
At the conclusion of the consultation, you and Dr. Salt will agree upon predominant symptoms, working diagnosis, differential diagnosis, and your Care Plan, which will be accessible to you through the Patient Portal within PatientFusion, some of which can and will be printed at the time of the consultation.
The eight symptom complexes or domains identified by the NIH research described above include belly pain, gas/bloating/flatulence, nausea/vomiting, diarrhea, constipation, bowel incontinence/soilage, heartburn/reflux, and disrupted swallowing. The MyGIHealth Mobile App available free in the Apple App store for the iPhone (and soon as a web-based app on the My GI Health website) helps patients to explain and health care professionals to understand symptoms.
This is the most likely explanation for your symptom. This can either be one or more diagnoses, each with an associated ICD-10 code, such as irritable bowel syndrome (IBS) (K58.0), or symptom-based, such as periumbilical abdominal pain (R10.33).
This includes the diseases and disorders that must be considered. For example, if the working diagnosis is IBS, the differential diagnoses may include celiac disease and Crohn's disease. See Printed materials below.
CARE PLAN (DIAGNOSTIC)
This is the mutually agreed-upon plan to arrive at a final diagnosis by testing if necessary and the patient educational assignments (see following discussion for details) and followup appointment, either in person or by phone.
CARE PLAN (THERAPEUTIC)
In some situations, treatment can be initiated. However, in most cases, a comprehensive treatment will not be initiated until the first follow up visit, after testing results have returned.
A printed copy of the latest version of Dr. Salt's Enteropathy Map (Refer to this on the Consultation Page) marked to show the causes and conditions to be considered in your case
Updated printed version of "Dr. Salt's Core Gut Health Recommendations"
Depending upon your evaluation, updated printed versions of Dr. Salt's pertinent diagnostic and treatment information.
- Diagnosis example: MCAS (Mast Cell Activation Syndrome)
- Treatment example: LDN (Low Dose Naltrexone)
- Treatment example: neuromodulation
FOLLOW-UP CONSULTATIONS (VISITS)
Your first Follow-Up Consultation will last 45 minutes. In most situations, you will require at least one Follow Up Consultation/visit. Subsequent Follow-Up Consultations if necessary will vary in time, depending on the complexity of your issues.
What happens during your first Follow-Up Consultation?
Test results will be reviewed and discussed
Your working diagnosis(s) will be reviewed, which is a description including ICD-10 diagnostic codes of Dr. Salt's impressions and opinion
Outstanding differential diagnosis(s), which includes the conditions and diagnosis or diagnoses that still need to be considered in your case (it is quite common for more than one to be present) will be reviewed
If you began treatment at your Initial Consultation, your response will be reviewed. Further treatment options will be described, if needed, and, together, you will decide on a comprehensive treatment plan with which you are comfortable.
Depending upon your evaluation, updated printed versions of pertinent diagnostic and treatment information will be provided
Your questions will be discussed and answered
What happens during Subsequent Follow-Up Consultations?
Treatment can be tricky. Due to individual complexity and uniqueness, many patients need changes to their treatment plans. If this includes you, Dr. Salt has many adjustments that can be employed. It would therefore be important for you to continue reporting back to him until you are completely satisfied
When you make the decision to become our patient, we immediately enter into a relationship with you. We make a promise and so do you. There are many components of our promise ~ from our policies and procedures to your patient experience. We promise to work hard to help you achieve your gut health solutions. We promise you unfailing personal time, friendliness, and attention to your health details. In return, we ask that you make a promise. There are components to your promise, too ~ from sending your Patient Intake Form and medical records no later than one week prior to your appointment to your consideration of our cancellation policy. To us, late cancellations and “no-showing” are a breach of trust. Your promise also includes consideration of Dr. Salt’s time when you send him messages through your Patient Portal.