GENERAL QUESTIONS

+ Your role in partnership with CIH

Our practice requires a partnership between practitioner and patient. We promise to do our best in delivering quality healthcare to each and every patient. In return we ask that you understand the role you play in your healthcare. By taking responsibility for your individual health and wellbeing, you empower yourself to be healthy from the inside out.

Your Role in the Partnership:

  • Schedule and follow through on recommended appointments and lab tests
  • Ensure you understand your health protocols designed by your practitioner and take steps to implement your protocols
  • Purchase and refill your supplements as needed
  • Call your pharmacy at least 7 business days prior to your need for a refill of your medication
  • Contact your health insurance if you have insurance related questions
  • Provide prompt and timely payment of invoices for services provided

+ What does it mean to be an Integrative practice?

The term 'Integrative' has become very popular in medicine and can mean different things. When we use the term "Integrative" at Capital Integrative Health, we refer to our unique ability to collaborate on treatment planning and diagnosis with our in-house multidisciplinary team of experts.

+ How do I obtain a copy of my medical records?

Please email membership@cihealth.org and type “Medical Records” in the subject line to inform us of your request. Please note, it may take up to 4 weeks during this transition time to obtain a copy of your records, so let us know as soon as you have decided to leave the medical practice. We will send your records through your patient portal whenever possible, and use your email address on file as the second option. We will send your records through the postal service only when necessary, and there will be a small charge.

+ What is your cancellation policy?

This office has a strict 2 business day notice for cancellations. If you do not cancel your appointment at least 2 business days in advance (by 10am Thursday for a 10am Monday appointment), you will be charged the cancellation fee. If you arrive more than 15 minutes late to your appointment, your appointment will be rescheduled and you will be charged the cancellation fee as well. Excessive no shows may cause you to be dismissed from the practice. Insurance-based patients will be charged $100 for a late cancel or no-show. Non insurance-based patients will pay the full amount of their treatment.

+ What is your privacy policy?

Website Privacy Policy: Capital Integrative Health, LLC is committed to ensuring that your privacy is protected. Should we ask you to provide certain information by which you can be identified when using this website, then you can be assured that it will only be used in accordance with this privacy statement.

Capital Integrative Health may change this policy from time to time by updating this page. This policy is effective from January 1, 2016.

What we collect

We may collect the following information:

  • name
  • contact information including email address
  • demographic information, such as family size, household income, names of family members
  • credit card information via a secure site

What we do with the information we gather We require this information to understand your needs and provide you with a better service, and in particular for the following reasons:

  • Internal record keeping
  • To improve our products and services.
  • To assess qualification for financial assistance
  • To periodically send promotional emails about new services, special offers or other information which we think you may find interesting using the email address which you have provided.

Security We are committed to ensuring that your information is secure. In order to prevent unauthorized access or disclosure we have put in place suitable physical, electronic and managerial procedures to safeguard and secure the information we collect online.

Our website allows for online booking and access to medical information via a patient portal. This portal is HIPAA compliant.

Links to other websites

Our website may contain links to other websites of interest. However, once you have used these links to leave our site, you should note that we do not have any control over that other website. Therefore, we cannot be responsible for the protection and privacy of any information which you provide whilst visiting such sites and such sites are not governed by this privacy statement. You should exercise caution and look at the privacy statement applicable to the website in question.

Controlling your personal information

We will not sell, distribute or lease your personal information to third parties unless we required by law to do so. We may use your personal information to send you our newsletter or to communicate changes or promotions regarding our practice.

You may request details of personal information which we hold about you under the Data Protection Act 1998. A small fee will be payable. If you would like a copy of your personal information please write to Capital Integrative Health, 4701 Sangamore Rd. Suite N270, Bethesda MD 20816.

If you believe that any information we are holding on you is incorrect or incomplete, please write to or email us as soon as possible, at the above address. We will promptly correct any information found to be incorrect.

Click here to view our Patient Care Privacy Policy

+ What is Functional Medicine?

Functional Medicine is a modern approach to healing illness that is more reflective of the advances in science and the needs of the 21st century patient. It is a highly patient-centered approach which relies on a deep partnership between patient and provider, while utilizing the best of advanced research, labs and holisitic healing modalities to better understand why we get sick and how we revive optimal wellness. This progressive model of medicine is evidence-based and systems-oriented: We focus on treating the body as a whole system, addressing the causes of illness -- not only their symptoms-- and viewing the body as a whole organism, rather than simply a collection of organs.

Functional medicine is a specialty which is not formally recognized by insurance as it goes beyond the usual standards of care.

Functional Medicine incorporates the latest in genetic science, systems biology, and understanding of how environmental and lifestyle factors influence the emergence and progression of disease. - See more at: [https://www.functionalmedicine.org/What_is_Functional_Medicine/AboutFM][1]

+ How is Functional Medicine different than Primary Care?

Functional Medicine and traditional Primary Care are different in their approach to wellness. While many Functional Medicine providers also practice primary care, they do so with a mind toward building wellness through an in-depth focus on how to uncover and transform what is out of balance in our body. Both Primary Care and Functional Medicine may focus on prevention, however, Functional Medicine delves more deeply into the biochemical, genetic, emotional, structural and energetic requirements for each individual to feel his or her best.

+ How do I purchase high quality supplements through your practice?

We have a limited number of frequently-used supplements available for purchase in-office. We also partner with Fullscript, a leading supplement site based in Canada that offers top-notch professional supplements and fast shipping. You can order directly from Fullscript by clicking on the button below:

Purchase products through our Fullscript virtual dispensary.

+ How do I refill my prescriptions?

If you are in need of a refill of your prescription, please send a message through your patient portal directly to your practitioners’ medical assistant requesting the medication. Provide your M.A. 7 days notice before you run out of your medication refilled at your retail pharmacy, and 14 days notice for a mail order pharmacy. Be sure to include the medication name, dosage, and frequency you take it, in addition to your pharmacy's information.

For your safety, we reserve the right to deny your prescription refill until you have an appointment to monitor how you are doing. You will be required to return every 3 months for medications for chronic illnesses such as high blood pressure, diabetes, thyroid disease, bio-identical hormones, etc. This is subject to the medication you are on and the discretion of your practitioner. If you are taking medications for any mood disorder or ADD/ADHD including but not limited to long term use of stimulants, benzodiazepines, anti-anxiety or antidepressants, you will be required to have a psychiatrist to provide and monitor your medications. To find a psychiatrist that participates with your insurance plan, you can call the number on the back of your insurance card.

Note: If you have not been seen physically in our office for more than 1 year, we cannot refill your medication and you will have to be seen by one of our practitioners.

+ Web browser for patient portal access

Only Firefox and Google Chrome can be used to access the patient portal at this time. You can log in here: https://phr.charmtracker.com/login.sas


ABOUT THE ANNUAL FEE

+ Why an annual fee?

This annual fee supports our ability to provide the functional medicine approach to patient care.

Functional medicine is a specialty which is not formally recognized by insurance (it goes beyond the usual standards of care). Functional medicine incorporates the latest in genetic science, systems biology, and understanding of how environmental and lifestyle factors influence the emergence and progression of disease. - See more at: https://www.functionalmedicine.org/What_is_Functional_Medicine/AboutFM

Many of the therapies advocated by functional medicine, such as specialized, cutting-edge experimental biochemical and molecular testing, botanicals, acupuncture, manual medicine, and mind-body techniques are explicitly NOT covered by insurance.

+ Does every patient pay an annual fee?

Only patients of Dr. Wong, Dr. Delistathis, and Marna Regehr, FNP, are responsible for the annual membership fee. If you are seeing other practitioners (ie, PT, acupuncture, myofascial release, etc) and are not a patient of Dr. Wong, Dr. Delistathis, or Marna Regehr, you will not be charged the fee.

+ How and when is the annual fee charged?

You will pay your CIH fee online at www.cihealth.org/memberpayment on an annual or monthly basis. If you select the monthly payment option, it is a 12 month committment with automatic payments.
We will send you a reminder before the annual fee is due.

+ What happens if I don’t want to pay it, which practices can you refer me to?

You must pay the annual fee in order to receive care from Dr. Andrew Wong, Dr. Sandra Delistathis, and Marna Regehr, FNP. If you decide you do not want to pay the fee and therefore move on from our practice, we are happy to refer you to the following providers.

  • Kelly Goodman, NP : Comprehensive primary and women's care, convenient hours, and caring for the whole family. Click here for more information.
  • JHCP/Bethesda : Primary care under the Johns Hopkins system, with enhanced access to specialists from this system. Click here for more information.
  • GW Center for Integrative Medicine : Innovative, holistic care using principles of integrative and functional medicine. They do not take insurance. Click here for more information.

+ What if I just want primary care?

Our approach with every patient goes beyond primary care to include functional medicine. If you only want primary care, we can refer you to another practice.

+ If I do not pay the annual fee can I continue to see my other CIH practitioners?

Of course. You are encouraged to continue to see all other practitioners at CIH to stay on your path toward health and well-being.

+ What if I want to stay with the practice but my spouse/partner or child does not?

You would pay the individual annual fee, and your family members will no longer be patients of the medical practice. If your family members decide to return to the medical practice at a later date, we will adjust your billing option to reflect the family fee.

+ Who is eligible for the “family” discount?

The family discounted rates are only for immediate family members who are either spouses/partners and children under the age of 26.

+ Why do families have a reduced individual annual fee?

We have many families of 3+ who visit us at CIH and it is important to make our practice an affordable option for them. We have observed that if family members are working toward health and wellness together, they have greater success in achieving their goals.

+ Do I still have to pay the annual fee if I have health insurance?

Yes. The annaul fee is not covered by insurance. It exists to help support the functional medicine care we provide our patients which insurance does not reimburse.

+ Can I pay the annual fee with my FSA or HSA?

Unfortunately, Health Savings Accounts and Flexible Spending Accounts will not cover the annual fee as it is not considered to be a medical service.

+ Can the annual fee be prorated or refunded?

Our annual fee covers the basic costs of the functional medicine care we provide. Because of this, we do not provide refunds or prorate the annual fee. If you select monthly billing, the fee is still a twelve month commitment.

+ How do I get a copy of my medical records if I want to leave the practice?

Please email mycihplan@cihealth.org and type “Medical Records” in the subject line to inform us of your request. Please note, it may take up to 4 weeks during this transition time to obtain a copy of your record, so let us know as soon as you have decided to leave the medical practice. We will send your records through your patient portal whenever possible, and use your email address on file as the second option. We will send through the postal service only when necessary, and there will be an associated charge.

+ Do people on Dr. Wong’s waiting list still have to pay the annual fee?

Yes, people who are not yet patients of the medical practice will pay the new patient annual fee. This fee will help support our ability to offer functional medicine. If you do not wish to stay on the waiting list, please email mycihplan@cihealth.org as soon as possible.

+ When will you open Dr. Wong’s practice to people on his waiting list?

Dr. Wong's practice is currently full. We are not sure when we will open up his practice to new patients. We strongly recommend seeing Dr. Delistathis, who is currently accepting new patients.

Please visit "make an appointment" page for registration steps.


UNDERSTANDING  INSURANCE

+ What insurance plans do your physician and nurse practitioner accept?

We are in-network for many health plans, including:

  • Aetna
  • Blue Cross/Blue Shield
  • Cigna
  • United
  • Medicare (For those with private insurance HMO plans, you must select one of our doctors as a PCP before receiving primary care. If we are not selected as a PCP, we can see you as a patient for the HMO's "out of network" fees.)

+ Do your physician and nurse practitioner accept Medicare and Medicaid?

We do accept Medicare for our medical practice, but we do not participate with Medicaid. We selectively provide pro bono care to patients in need, and are happy to receive donations to our patient fund to help support the pro bono care provided.

+ Are all your services covered by insurance?

Our medical doctors (Dr. Wong and Dr. Delistathis) and Nurse Practitioner (Marna Regehr) accept the plans noted above, though occasionally there will be a procedure or treatment that may not be covered by insurance. We will always alert you to this beforehand. Please check with your insurance company to verify coverage for certain lab kits covered by insurance.

Our acupuncturists also accept several insurance plans. For acupuncture benefit verification please click here. Our other practitioners do NOT accept insurance.

+ How does insurance billing work?

  • CIH will bill your insurance provider for you at each visit.
  • You are responsible for the co-payment at the time of service, which depends on your insurance plan.
  • You are also responsibilty for your deductible (if you have one).
  • If certain procedures or treatments are not covered by your plan, you will be responsible to pay at the time of service for them.
  • If you have questions regarding your health coverage, please call your insurance company. The support number can be found on the back of your card.
  • Our office will send you an invoice to your Patient Portal for services/deductibles not paid for at the time of your visit.

Please note, that insurance companies often have major delays in sending your bills out or responding to requests from lab companies about your reimbursement for tests. The 2015 change from ICD 9 to ICD10 codes has increased this timing and unpredictability as well.

Additionally, you will receive an EOB (Explanation of Benefits) from your insurance company prior to being billed by our office. This EOB explains what your insurance paid and did not pay based on your coverage. It is NOT A BILL.

+ Are labs and lab test kits covered by insurance?

Coverage depends on several factors. Some labs are more routine and are more likely to be covered by insurance, while some are more specialized and often not covered by insurance. The following will impact your level of coverage for all laboratory tests:

  • Whether you are responsible for a co-payment, deductible, or coinsurance.
  • Which clinical labs are in-network (these are the labs that have agreed to accept your insurance company’s contracted rate). Your plan may require higher co-pays, deductibles, and co-insurance for out-of-network labs.
  • Specific specialty lab tests may not be covered even if the lab is in-network.

+ What is a deductible?

Your health insurance deductible is the amount you are required to pay before your insurance will cover any portion of your health care costs. All providers (including Lab companies) who are IN NETWORK are required by law to bill patients their deductible. Until you reach your deductible, the insurance company will not pay for your visit.

+ What is a copay?

A health insurance copay is a flat fee that you pay each time you visit the clinic after you reach your deductible. In most cases, if you have a copay you will not have co-insurance, and vice-versa.

+ What is co-insurance?

Co-insurance is the percentage of an office visit fee that you must pay after you reach your deductible. When a claim is submitted, your health plan will determine if it pays all or a portion of the allowed amount of the claim. The remaining portion of the allowed amount is called the co-insurance and is the patient's responsibility.

+ What does "allowed amount" mean?

The term allowed amount refers to the amount that insurance is willing to pay for any procedure or office visit. Co-insurance is a percentage of the allowed amount of a claim that a patient is responsible for.

+ What is an EOB?

EOB means Explanation of Benefits and is the document you receive from your insurance company that explains the amount it has covered for an office visit or procedure. EOBs also explain what is wrong with a claim if it is denied.


LABS/SPECIALTY TESTS

+ Do you have a laboratory on-site?

Yes, we do. Our lab is open between 8:30am and 3:30pm, Monday through Friday.

+ What are specialty labs?

Specialty labs/test kits refer to progressive assessments of body functioning that are not typically offered in primary care settings. There are many different types of lab tests, such as blood, urine, saliva, breath, and stool tests. Specialized testing is frequently done to assess nutritional status including amino acids, fatty acids, oxidative stress, vitamin levels, mitochondrial function, food allergies, and heavy metals.

These tests may or may not be covered by your insurance.

+ What labs and test kits are available at the clinic?

We provide many specialty lab tests, including nutritional assays, hormonal testing, digestive function testing, adrenal functioning testing, comprehensive Lyme disease panels, food allergy/intolerance testing, and neurotransmitter testing.

Some of these labs, such as bloodwork, can be drawn in-house, while others are kits that you would need to take home and then ship via FedEx or UPS to a specialized lab.

+ Do I have to do lab testing?

Lab testing is not a requirement but may be very helpful. Your provider will review the recommended testing plan with you and will discuss potential costs so you may determine what testing you want to complete.

While the testing gives a more complete picture of your status, effective care can often be implemented without it, or testing can be done over time. You should not let this prevent you from seeing one of the practitioners.

+ Should I fast before coming in for labs?

Many of our tests require a 10-hour fast. You can, and should, drink water during this fast and take all prescription medication. Do not take any thyroid medication the morning of your appointment until after your blood is drawn. Please bring a snack to eat after your blood is drawn. The following blood tests are more accurate when done fasting:

  • Cholesterol tests
  • Blood sugar tests
  • Hormone tests, including adrenal and thyroid tests

If you are coming in for morning physical, we recommend fasting prior to your appointment.

+ Are labs and lab test kits covered by insurance?

Coverage depends on several factors. Some labs are more routine and are more likely to be covered by insurance, while some are more specialized and often not covered by insurance. The following will impact your level of coverage for all laboratory tests:

  • Whether you are responsible for a co-payment, deductible, or coinsurance.
  • Which clinical labs are in-network (these are the labs that have agreed to accept your insurance company’s contracted rate). Your plan may require higher co-pays, deductibles, and co-insurance for out-of- network labs.
  • Specific specialty lab tests may not be covered even if the lab is in-network.

+ Why won't insurance cover certain lab tests?

Functional lab testing tends to get to the root cause of your health issues, but is often considered by the insurance companies to be investigational or experimental. We order both routine and functional testing depending on your health situation, and will discuss costs with you as well, to the best of our knowledge. Unfortunately, insurance coverage of labs is not predictable, and per our membership policy the cost of any lab test ordered remains the patient’s responsibility should the insurance company decide not to cover it.

+ How does lab test billing work?

In most cases, a lab will bill your insurance for you the day it receives your sample. For some tests, we have special pricing from the lab and you will pay that amount plus a small handling fee in our office as you check out.

In the weeks or months after your test, you will recieve an EOB (Explanation of Benefits)from your insurance company and Lab detailing for you what could potentially be billed. Labs are required by law to collect deductible, co-insurance and co-pays per their contract with your insurance carrier.

+ Is the EOB (Explanation of Benefits) a bill?

When you receive anything from a lab, please first look to see if it is an EOB or an actual Bill. You are not responsible to pay anything on an EOB until you receive an actual bill. If you have questions about this process, please contact Customer Service at the lab or specialty test company specifically about your responsibility.

+ How long does it take to get my labs back?

General laboratory tests are returned usually within 1-2 weeks; however many specialty labs/functional testing can take three to five weeks. You will receive a notice via the patient portal when those results have been reviewed by your practitioner and are ready for you to view.

+ Will you contact me to review my labs?

In cases where you ship your specialty test to the lab, please message our Medical Assistants to inform them, so that we can track your test results. Due to the complex nature of these tests and the time it takes to interpret them, we require follow-up by either an in-office appointment (billed to insurance) or a phone consultation (fee for service) for review. Follow-ups are to be scheduled within 4-6 weeks of taking the tests.

In the event that a lab result indicates the need for accelerated follow-up, either your practitioner or their assistant will contact you.