Medical Clinic FAQ

• What is the Medical Clinic at Thoughtful House Center for Children?
• How do I make an appointment with Dr. Bryan Jepson or Lucas Ramirez, NP?
• Do you bill insurance?
• What are your fees?
• What is your cancellation policy?
• How long is an appointment?
• When do I schedule a follow-up?
• May I email the doctor if I have questions between follow ups?
• What laboratory tests do you require?
• What are the average lab costs?
• What other costs may be involved?
• Do you see out-of-state patients?

What is the Medical Clinic at Thoughtful House Center for Children?
This clinic integrates traditional science and medicine with recently developed and recognized treatments and therapy for children on the autism spectrum. We apply the most advanced published research to our clinical care of children with developmental disorders.

We take the time needed to form an understanding of each child and their particular biomedical profile, accomplished with a comprehensive history and physical examination. Any available previous laboratory results are reviewed. Additional lab work can then be recommended in order to further delineate your child's medical status. We put together a treatment course specific to the child based on our clinical observations and findings, together with the lab results.
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How do I make an appointment with Dr. Bryan Jepson or Lucas Ramirez, NP?
Please see: Clinical Services

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Do you bill insurance?
No, due to the variability of insurance benefits we do not. We will, however, assist you by providing invoices with the appropriate coding and HCFA forms as needed to submit to your carrier for reimbursement. You are responsible for payment, which is due at the time of service.
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What are your fees?
Consultations and follow-ups are billed from $290 to $390 per hour. This is pro-rated - that is, only the time you spend in the appointment is billed.
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What is your cancellation policy?
We have a strict cancellation policy because so many children are urgently seeking our attention and care. Whether the consult is via phone or in office, all new patient appointments require seven business days notice for cancellation and all follow up appointments require 48 business hours notice for cancellation. If timely notice is not given, there will be a charge equal to 50% of the scheduled consultation fee.
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How long is an appointment?
Appointment times vary based on individual need. However, generally a first appointment will take between one and a half to two hours. The first follow-up, when we review any lab results and monitor the beginning of treatment, lasts about an hour. As a general rule, later follow-ups take 30-45 minutes.
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When do I schedule our follow-up?
Because of the busy nature of our practice, it's best to make a follow-up appointment at the end of each appointment with the doctor. Generally, follow-ups are available in 6-8 weeks.
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May I email the doctor if I have questions between follow-ups?
We are able to answer many simple email questions . Complex medical issues can only be addressed with an appointment. If there is a medical decision involved (for example, concerning prescription for medication), there will be a charge based on how much time the doctor spends discussing it with you. Please keep in mind that our office can receive hundreds of emails daily, and reading and answering takes considerable time for the physician and his medical staff, as well as the office staff, and while we want very much to answer all questions, we must sometimes bill you for our time.
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What laboratory tests do you require?
Usually none prior to the initial consult. This is because we take an individualized approach to treatment and can't know what background we'll need to inform that approach until we see your child. After meeting with the physician, certain laboratory investigations may be recommended. The charges for lab tests vary, and are not included in the consultation costs. Some tests are covered by most insurance companies, some not. Your physician will assist you in determining which tests are absolutely necessary.
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What are the average lab costs?
Some lab tests are covered by insurance plans, but plans vary greatly and we can't determine what will be covered. Generally, you can expect that the initial cost will be between $600 - $1,000 paid to the labs directly by you, or by your plan. Some children will need to be monitored with periodic lab tests.
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What other costs may be involved?
Some that you might expect the Medical Center at Thoughtful House to bill you for are:

• Blood Draw (Phlebotomy): $61
• Blood Processing: $10 to $60 depending on the number of specific tests.
• Letters: We are often asked to write letters on behalf of our families, such as requests for adjunct therapies, leave of absence for parents, and letters that clarify "medical necessity". We must bill for the time required for each of these, as sometimes a good deal of review is called for before the actual composition.
• Medication Refills: Have your pharmacy fax us with a medication refill request. Refills must be determined carefully, sometimes involving extensive review.

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Do you see out-of-state patients?
Yes, we currently have patients from 48 states and 31 countries. Many follow up appointments may be completed as phone consults, but keep in mind that we must see that patient at least once per year.
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Dr. Bryan Jepson | Kelly Barnhill, MBA, CN, CNN