Policies and Procedures

Cancellation Policy:
New Patients: must cancel at least 7 days ahead of your appointment or you will be charged the full amount of the appointment.

Existing Patients: must cancel at least 48 business hours ahead of your appointment or you will be charged $75 the first time and the full appointment time thereafter.

Cancellations are only received if you have received verbal or email confirmation from us via the MD-HQ portal. Regular email will not suffice for noting confirmation of cancellation.

Appointment Types:
New Patient

*** Appointments are charged at the rate of $400 per hour.

In case of emergency, please dial 911

Very Important:

You are REQUIRED to have a separate primary care doctor.
Dr. Tamyra Comeaux offers functional medicine consultation only.

We do not offer after-hours or urgent care – you must have a primary care doctor for this purpose. This also means, she is unable to respond to urgent requests of any sort, including messages and phone calls.

Expectations for Initial Investment

Functional medicine works to identify root cause of particular symptoms and then uses a personalized approach to helping your body restore balance. This process involves an initial intake appointment to review your medical history, health goals, current lifestyle habits and symptoms and to identify the type of testing that is needed to further identify the root cause. At the end of the initial visit, you will leave with lab orders that may include blood testing, salivary testing, urine testing and stool testing. Whenever possible, Dr. Comeaux does her best to order testing that is available within your insurance coverage plan. For PPO based insurances, most blood testing is covered at an in-network lab such as Quest or LabCorp.

We do work with specialty lab companies, with blood panels that are lower than retail for patients who do not have adequate insurance coverage. The second visit is the first follow-up appointment. For the second visit, we recommend a minimum of 60 minutes, but some patient needs less time if we are discussing only one type of lab result at a time. For example, if the first follow-up is after getting a blood test, saliva test and stool test, you are likely to require 60 minutes to review all results, get the protocol discussed and written up and have your questions answered. Thereafter, follow-up is recommended in the acute intervention phase every 2-8 weeks for the first 3-6 months.

The number of visits and time in between visits is dependent on the complexity of your case, how quickly you want results and whether or not there are medications being used that require titrating to the optimal dose, as is the case with hormone replacement or thyroid disease. We can give you an idea how often you’ll need to follow-up in the acute phase at your first or second appointment when the case is better understood. Generally speaking, the how effective the protocol is and how quickly results will be achieved is often reflective of the amount of time, attention and commitment you put in to the process.

Functional medicine is just as much about removing hindrances to imbalance as it is about implementing personalized dietary changes, lifestyle changes, micronutrient replacement or hormone balancing and we are in partnership together on this process. Please expect at least a 3 month commitment to achieve lasting change and set your expectations and budget in line with that commitment.

We are very much invested in you achieving the goals you desire and want to have every opportunity to help make the difference. In the ideal situation, we have an intake and testing phase (1 appointment) where we assess the issues, an initial intervention phase (1-3 appointments) to implement a personalized protocol, a monitoring phase, when minor adjustments if necessary can be made (0-2 appointments) and a reassessment phase (1 appointment), where we see how well the first layer of intervention did in achieving your health goals. For the vast majority of cases, you can expect a 50-100% improvement after this process. Diving back in for round 2 will be required and necessary if your goals weren’t fully met or you have new goals you want to work on, in which case we usually proceed with more testing and implementation of a new protocol.

Medical Records and Forms Requested

The cost of having Medical Records sent to you or your doctor is $100

A release form must be signed.

Please allow 7-10 business after you have signed the release form to receive your records.

If you have a form that needs to be filled out by Dr. Comeaux outside of an appointment time, this will be billed at her usual hourly rate of $400/hour. Uncomplicated forms will seldom exceed $100.

Payment
Payment is due at the time of service. Our office accepts cash, checks, Visa, MasterCard, American Express or Discover. We also accept payment from Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA). We do not bill insurance companies directly, but upon your request, we can provide you with a copy of your completed invoice (Super Bill) so that you may submit it directly to your insurance company for reimbursement.

If you have an HSA (Health Savings Account), functional medicine consultations and prescribed supplements are allowable, tax-free expenditures. Health Savings Accounts are a new option for health insurance and they have two parts. The first part is a health insurance policy that covers large hospital bills. The second part of the Health Savings Account is an investment account or retirement account from which you can withdraw money tax-free for medical care. Unused money accumulates with tax-free interest until retirement, when you can withdraw for any purpose and pay normal income taxes. We strongly urge you to look into an HSA as an alternative insurance choice. To find out more, please go to http://www.hsainsider.com.

We recommend that everyone ask their insurance providers what type of out-of-network coverage they offer prior to using our services.

Insurance
Tamyra Comeaux, MD does not accept insurance. We do provide a Superbill, which you can submit to your insurance company for reimbursement if you have an insurance that provides an out-of-network benefit. If you are unsure, call the member services number on the back of your card and inquire about your plan. You can let them know you are planning an appointment with an out-of-network physician and want to know what percentage of your visit will be eligible for reimbursement.

Again, HSA and FSA accounts are accepted.

Phone Consultations
Phone consultations are available for patients who live in or out of the area after scheduling your initial appointment in person. Phone appointments will follow the same fee schedule with a 15-minute increment option for quicker check-ins or questions that can’t be answered by email. We recommend having at least one in-person visit annually at a minimum, with the remaining appointments available to do by phone, email, or in-person. Some services that can be done in person can be done via phone consultation. Lab tests can be ordered that can be performed in your area. And, we may also order medication from a pharmacy or that can be shipped to you.

Out of State Patients
If you are out of state and have not had an initial in person consult, Dr. Comeaux can still work with you on a consultative basis. This means she can take a look at your history, lab reports and current treatments and advise you on how she would approach your case if you were her patient. She can make suggestions for further testing you may need, and offer suggestions for interventions and changes to your regimen that could further support you in finding optimal health. She cannot, however, order labs or prescribe medications. Many Out of State patients have been able to achieve the optimal wellness they are seeking by working with Dr. Comeaux in conjunction with their own doctors who can follow the recommendations offered to them.

Email Policy
Email communication with you will be limited to answering questions regarding side effects or clarification of therapy. Any communication that requires clinical decision-making will best be addressed in an office visit or by a scheduled phone consultation. The best determinant is: does your question require a “yes” or “no” answer. If so, email communication is welcomed and your inquiry will be addressed within 48 hours. If not, we will request that you call the office to schedule either a brief phone consultation or to schedule an office visit. Dr. Comeaux receives many emails and won’t always be able to respond to your updates or to emails that are not related to your current regimen. When time allows, she will do her best to answer quick questions, but this is not guaranteed. All email correspondence should be done via our secure Patient Portal messaging system once you are an established patient. If you are expecting a response and do not get one within 48 hours, please call the office if you need to reach us. 832-237-4200. If your inquiry seems to require a change in your protocol or you are experiencing new onset of different symptoms, this usually indicates it is time to make a follow-up appointment. You may also opt to have an email response to a clinical inquiry, but this will be billed at her standard $400/hour rate. If this is your expectation, please indicate so in the body of your message. You must have a valid credit card on file for this option.

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