DOVITAL
Health & Wellness, LLC
820 West First Street
Monticello, Iowa 52310
319.480.4623
Fax: 541.229.1239
www.dovital.org
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PATIENT INFORMATION
Please fill out the forms and return
for Functional Medicine appointment OR
Bioindentification Hormone Replacement
forms
ABOUT YOUR VISIT
Payments & Insurance
Functional Medicine is a direct pay practice insurance companies will not pay for this type of health care. Since Functional Medicine is aimed at personalized care there is no set rule of the tests that will need to run, but the goal will always be to provide the most effective and be cost-efficient as possible. Payment is expected in full for the appointment at the time of service.
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Bio-identical hormone replacement is a unique practice and is considered a form of alternative medicine. Insurance companies do not recognize it as necessary medicine. It is considered similar to Plastic Surgery (esthetic medicine) and therefore is not covered by health insurance in most cases.
As such the insurers do not provide coverage for, nor reimbursement of expenses associated with Bio-Identical Hormonal therapies. This includes consultative fees, laboratory fees, medical procedures such as pellet insertions, and medication expense for the hormonal pellets.
Payment is required at the time of service and upon request, a receipt showing the amount paid and the nature of the procedure will be provided. This receipt will serve as evidence of your medical expense. We will not call, write, attempt any pre-certification, or contact your insurer regarding this therapy. If an inquiry from your insurer is received this office will not respond. Should this office receive any funds from your insurer we will return those funds to the sender.
'Patients who have access to a Health Savings Account may pay for treatment-related charges with that credit or debit card.
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