Frequently Asked Questions
1. Will my insurance cover the cost of your services?
That would depend on your insurance plan and coverage. Generally, clinical nutrition services are not defined as "medically necessary services" unless you have a written referral from your physician and then it still depends on your policy. However, a written referral may help you get re-imbursed for your consultation and lab testing. With your physician's referral, you may submit your receipt for consideration by your insurance company. We do not accept insurance assignment. However, keep in mind that Clinical Nutritionists are not permitted to make medical diagnoses. If you need a medical diagnosis, please consult with a health care provider who is legally licensed to do so.
2. Can you bill my Insurance Company for my visit?
No, fees are payable prior to initial consultation, and at the conclusion of follow-up consultations. We accept VISA, MasterCard,and AMEX. At some point in the future, we should have e-check payment available.
3. Do I have to pay for the phone charges for my consultations?
No. We will call you on the phone number you provide, via our VoIP phone system at no cost to you. The video service via Skype or webinar is a free service and does not add to the appointment fee.
4. Is the Video format necessary for the Initial Consultation?
Yes. For professional, legal and ethical reasons, we need to see who we are speaking with. It is also helpful in building a better relationship when people see each other.
5. Is Skype the only format available to conduct the video consultation?
No, but Skype is easy to use and is a free software download at www.skype.com. There are PC and MAC versions. If your computer does not have a built-in camera, you will need to purchase one. If you don't wish to use Skype, we can set up a video one-on-one webinar using your current web camera. Very simply, we provide you with a meeting number and password and when I call you for your appointment, you would go to: www.webex.com and click on "Attend a Meeting". Enter the meeting number provided and let the system load up. There is no software to set up (but an automatic system pre-check is recommended). The audio conversation can be conducted over the telephone or through your computer. If you have a slow internet connection, we recommend conducting the audio portion over the phone, which allows all of your internet speed to be used for the video portion. Both options are easy to do. It probably sounds a bit complicated if you have never used either technology or suffer from a bit of "techno-phobia". The good news is: everyone finds it far simpler than they thought once they go through it for the first time!
6. I don't know much about web cameras. What do you recommend?
We are not computer geeks either, but we found the Logitech 9000 Pro HD camera to provide a very clear image and is quite easy to install and use. It is available in most computer stores and from Amazon.com.
7. I would like my whole family to see Dr. Sullender. Can we make a group appointment?
Clinical nutrition assessments and programs are based on the biochemical individuality of all people, even those living in the same home. Even a husband and wife who have lived together for 50 years, have not "merged" their genes. And while there are many principles that may apply to everyone in a given home, consultations are designed for one client at a time. If you want very general, non-specific advice based on "typical" human nutrition averages (i.e. the RDA) you may want to see a Registered Dietitian at your local hospital.
8. Can I schedule an hour appointment time and discuss myself, and one or more of my children, all in the same hour?
No. An appointment is for ONE person and the time alottment is an "up to" limit in order to deal with the practical aspects of scheduling. It also helps avoid the "blurring" of critical health information about multiple people into a confusing mess. If you are scheduled for a "Follow-up / Regular" appointment for yourself (which allows up to 45 minutes) and the consult is concluded in 35 minutes, there is no "extra time" to use or transfer. Discussing another member of the family, is another separate appointment.
9. Can I send in my lab tests and history and have Dr. Sullender look it over to see if he might be able to help me?
Unfortunately, pre-screening clients is neither practical nor feasible. Whether an individual can be helped depends on so many variables, many of which are not measurable by lab tests and diagnoses. The Initial Consultation is where we discuss these and other aspects of health and healing. I will not accept a case if I believe I cannot be of benefit.
10. If specific nutritional supplements are recommended, where can I get them?
As a client, you will be provided with special access codes to order high quality, professional nutritional formulations that are normally restricted to professional use only. You will receive these links with your written Nutritional Program. We are a professional practice, not a store, and as such we are prohibited from providing access to non-clients and to the general public.
11. Do I have to purchase my nutritional supplements through your sources?
You are free to purchase what you wish, where you wish. However, discerning high quality products and formulations from the "junk" on the market is no easy task. If you do decide to source your nutritional products and formulations on your own, you owe it to yourself to become educated on what questions to ask the company or supplier. Is the company certified in any way, such as NNFA cGMP or TGA? Does the company make their own supplements, or are they "private labeled" for them, buy a different manufacturer? And questions as to third-party independent testing for purity, bacterial contamination, heavy metals, pesticide residues, rancidity in the case of oils, are just some of the concerns. Testing should be done on "raw materials" and "post-production". That is, the better companies will pull bottles off the production line and test for how the tablets dissolve, compression, bio-availability, potency, heat damage, and with oils, rancidity, etc. It has been our experience that people who try to cut the corners to save a few dollars on supplements, frequently end up with poor clinical outcomes. Saving 10% on a formula that does not work, is no bargain.
12. How are returns handled, for nutritional products I purchase through your web-links?
That is fairly easy to do. You would make any returns directly to the company or distributor from whom you made the purchase, in accordance with their specific return policies.
13. What is the criteria by which you select the nutritional formulations you recommend?
Our primary concerns are quality, purity and bioavailability. We do consider cost as well, but not at the expense of quality, purity and bioavailability. We prefer, where possible, to select products and formulations that have original clinical trials or published literature behind them, rather than "copy-cat" products that quote their research as if it where their own. The more uncertainty we can remove from the equation, the better the clinical outcomes tend to be. Of course, safety is always our primary concern!
14. Will lab tests be recommended during my consultation and if so, how do I get them done?
Specific lab tests are often recommended at the initial consultation or thereafter. For those lab markers that can be performed through your physician via conventional diagnostic labs, we will provide you with a Lab Request letter to take to your physician or nurse practitioner. This is a request, not a lab order. Your primary care provider will have the ultimate say as to ordering the test requested, but most PCPs today are open and welcome reasonable requests from other professionals. In the case of specialzed testing, we can have the appropriate test kits shipped directly to you from the appropriate lab. You perform the test, we get the results a few weeks later.
15. How will I get my test results?
If your tests were performed through your PCP, you will need to get copies of the results and fax or email them to us. Please note that we need the numbers and reference ranges for the tests ordered. The letter that says that your kidneys, liver, and glucose were "normal" is not helpful. For specialty tests performed through CNER, we will be able to access your test results in a couple of weeks and can FAX or email them to you, as you prefer.
16. When do I pay for lab tests performed through CNER?
Payment for any tests performed through CNER must be made prior to the test kit being shipped to you. Please bear in mind that there are NO refunds for tests and test kits once they are ordered, and the test kit must be used within 30 days of receipt from the lab.
17. What if I have questions between appointments? How do you handle this?
We expect questions to come up. It is, afterall, a learning curve for most people, and learning involves questions. If you have simple questions of clarification, such as, "Do I take the Resveratrol with or without food", or "Is this blood test fasting or not?" please email those questions directly. Questions that are education based, such as "How do I balance protein and carbohydrates?" or "What is a protein?", are best grouped together and answered through an interim appointment to make sure the questions and answers are clear and that you understand things. Such answers are often a book-length email, which is neither feasible nor pracitcal.
18. Are you available for Emergency calls?
In a word, No. We are not licensed or trained to provide Emergency medical care. Please contact your primary care provider in the case of all emergencies or call 911. We can provide what we call "urgent care" support. That means, appropriate natural suggestions and recommendations that can help support your physiology during self-limited conditions, such as colds, coughs, scrapes, injuries, viruses, etc. In these cases, please consult the on-line appointment calendar for the soonest available appointment. If none is available, please email and put "URGENT CARE REQUEST" in the subject line. We can generally fit such request into the schedule within 24 - 36 hours, during our regular office hours.
19. Is a Clinical Nutritionist consultation appropriate for everyone?
Good question. We would like to say "yes" but that would be a bit idealistic. There are those who turn to natural remedies and clinical nutrition in response to a strong desire to identify and address underlying causes and imbalances which created the symptoms. They realize that symptoms such as elevated cholesterol or high blood pressure, while problems, are created at a deeper level. People who are motivated toward "conscious living" and taking an active role in their health, typically do well with a natural therapies approach. However, there are those who simply want to find the rare herb or special vitamin that will successfully and quite simply replace their prescription drug for their cholesterol or migraines or joint pain or asthma or ...... Without any further exploration as to why they are experiencing those symptoms, natural healing becomes just another band-aid approach, that may or may not have fewer side-effects. While natural methods can be manipulated to just treat symptoms, we believe that this is an unfortunate distortion of the goal. So, the critical question may be: is the goal to simply get rid of the symptom or to become healthy, resilient and in balance and thus eliminate the need for any symptom at all?
Can I follow you on Facebook or Twitter?
No. We are a professional healthcare practice. We don't chirp, tweet, crow, bark and we will not plead with you to become "our friend". We value our time, and respect yours.