Office Policy

Confidentiality of Medical Records

With the exception of lab reports, I do not release medical records (office progress notes) except under the following conditions:

  1. A signed release request from patient to release records to another physician
  2. A patient directly requesting copies of records for legal purposes or for their own personal examination in the waiting room.
  3. A patient may request a copy of their own records and determine whatever part they designate necessary to their insurance company for "reimbursement review." Unfortunately, a request for records from insurance companies is almost always a "detour tactic" to withhold payment. Rarely does it produce reimbursement for the medical service rendered. Legally, a CPT code and proof of the visit is all that is necessary to receive contractual payment. Payers, too often, place themselves between the patient and the physician- using personal office records unfairly to rule against appropriate diagnosis and treatment and thus avoid legitimate payment.

DIAGNOSTIC TESTING POLICY:

We ask that patients do not call the office for diagnostic test results. The results can only be interpreted by Dr. Raxlen and Carolyn Welcome; therefore, we ask that you please wait until your next appointment for discussion of these results and treatment plan. Should you wish for a copy of these results they will be sent to you prior to your visit without any interpretaton.

Please understand that we have a large patient population also waiting for results and it disrupts the smooth flow of the office to give all patients their results.

Payment Policy & Information

We do not take insurance assignments.

We are an out of network provider. Your payments may include Dr. Raxlen’s consultation visits, PICC line insertions, dressing changes, nutritional IV infusion therapy, IM injections, phlebotomy, and medical supplies.

Full payment is "due at the time of your visit."

We accept Amex, M/C, Visa, and Discover Card

Your financial obligation is to Dr. Raxlen directly. Your health care contract is with your insurance carrier for reimbursement. Your reimbursement will vary depending on your health insurance policy.

Unfortunately, we are not a Medicare provider due to the complex bureaucratic paperwork. Medical prescriptions must be sent to the office 48 hours before refills are due.

All balances must be paid prior to the next visit (visit are scheduled 8-12 weeks apart). No prescriptions will be re-filled or paperwork completed (i.e. record request, disability papers, etc.) until accounts are settled.

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FEE SCHEDULE

  Fee Hours
Initial appointment with
Dr. Raxlen		 900.00 1—1 1/12 hr(s)
Initial appointment
Carolyn B. Welcome, PA		 750.00 1—1 1/12 hr(s)
2nd appointment with
Dr. Raxlen		 550.00 1 hr
2nd appointment with
Carolyn B. Welcome, PA		 450.00 1 hr
Regular office visit with
Dr. Raxlen		 450.00 45 min
Regular office visit with
Carolyn B. Welcome, PA		 350.00 45 min
Phone consult with
Dr. Raxlen		 300.00  
Phone consult with
Carolyn B. Welcome, PA		 225.00  
PICC line insertion
(with 1st dose supervision and teaching of procedures)		 750.00
Nutritional IV 150.00
BW drawing fee 25.00
Shipping 25.00  

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TOTAL COSTS

Specialty lab fees for diagnostic purposes are separate expenses at the time of the visit. Fees are paid directly, at the time of the visit, to the specific laboratory performing the tests. They will accept credit cards. The following specialty labs (FDA and Medicare approved) are utilized for testing:

  • IGeneX (California)
  • Fry Labs (Arizona)
  • Medical Diagnostic Labs – MDL (New Jersey)
  • LabCorp (North Carolina)
  • Metametrix (Georgia)
  • Quest (Nationwide)
  • Genova Diagnostics (North Carolina)
  1. The cost of your testing and the method of payment will depend on the laboratory which is selected for diagnostic purposes. Some laboratories will bill your insurance company directly. Other laboratories will not process your serum specimen until your payment is received (credit card or check). The diagnostic assessment can vary from $500 - $2,500, depending on the complexity of your case. The cost will be discussed with you prior to phlebotomy.
  2. Each patient’s tick-borne illness is unique and always complicated. You should expect your cost (as a non-intravenous patient) to be approximately $2,500 - $3,500 for the first year. The second year is $1,500 - $2,500. The third year is $1,000 - $1,500. This estimate includes the costs of the office visits to Dr. Raxlen, immune support nutriceuticals, out of pocket prescriptions from compounding pharmacies and off-list medications represented as "medically unnecessary" or "experimental" by your insurance carrier.
  3. Other diagnostic services which could be important might include:
    • Neurology or ophthalmology consultation
    • SPECT Scan
    • MRI
    • Neuropsychological Evaluation
    • Physical therapy
    • Sleep study
    • Cardiology consultation
    * Your insurance provider may require prior authorization before any of these procedures can be undertaken.
  4. Most medication prescriptions are filled at your local pharmacy. However, your insurance company may have what is called a "preferred" list of "cheaper or generic" medications, which they will require you to use. On other occasions, the insurance company will deny the necessity of the prescribed medication for your treatment (i.e. Babesiosis), in which case you will be required to pay "out of pocket" for your preferred treatment prescription.
  5. A compounding pharmacy may also be recommended for special transdermal formulations and hard to get medications (i.e. pain gels, Tinidazole). These are not usually covered by insurance and, unfortunately, are an out of pocket expense.
  6. The following are the compounding pharmacies and nutriceutical distributors which are recommended for specialty pharmaceuticals and generalized nutritional and immune system support:
    • Wellness Pharmacy (Alabama)
    • Compounding Solutions (Connecticut)
    • Emerson Ecologics (New Hampshire)
    • Natural-Immunogenics
  7. This office does not specify that you purchase medications or nutriceuticals from any of the above recommended sources. These names are listed for your convenience. Our office has found their products and service to be excellent.

For those out-of- state patients (Maine, New Hampshire, Rhode Island, Vermont, Virginia, Pennsylvania, Rhode Island, etc.), it is highly desirable that the patient have a local family physician to act as a liaison doctor with Dr. Raxlen.

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MISSED APPOINTMENTS

Our office contacts you a day or two before your appointment to remind you of your scheduled visit. Our office must be notified of a cancellation at least 48 hours prior to your scheduled appointment date. This gives our office enough time to fill your place with another patient from a long waiting list. We are filled more than three months in advance and we do not double book patients. You will be charged a regular office visit fee if the appointment has been missed without notifying the office.

Dr. Raxlen understands that tick-borne illness can cause financial hardship. If you have been ill for an extended period of time, you have already had significant medical expenses prior to your visit with us. Dr. Raxlen will make every effort to render his diagnosis and your treatment in the most cost-effective manner possible.

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Location

123 W. 79th Street, 1st Floor
New York, NY 10024

Office Hours

Mon. - Fri.
9am - 5pm
T. (212) 799 - 1121
F. (212) 799 - 2377

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