Oregon Optimal Health

The initial visit usually lasts between 1 1/2 - 2 hours. It starts with measurements, like blood pressure, weight and height, and also test called a Body Impedance Analysis (BIA), which provides useful data, such as BMI, water weight, fat and muscle mass and a phase angle. Wear loose unrestrictive clothing in order to allow ease in movement. Hearing your concerns and discussing your priorities for health is the primary focus of the first visit. There will be a physical exam, customizing of a treatment plan, and instruction and counseling. Lab work or other testing may be ordered. You will receive a printed Plan of Care. It is common to also receive "homework", such as additional Questionnaires to help evaluate issues that came up during your appointment. You may also receive dietary and lifestyle suggestions and suggested reading.

Your expectations, and our requirements for follow-up care are as varied as our clients. Generally, at minimum, expect one follow-up visit after your initial evaluation to discuss lab results, effect of initial therapies suggested, and to formulate an individualized plan of care with your provider. A printed Plan of Care is provided at the end of your visit. It may contain suggestions for further testing, suggested reading, questionnaires to complete at home and return later, and actionable steps you may consider for future health. Many clients prefer or require multiple visits for complex issues or questions.

We like to have records of any medical care you have had from the last two years. This would included labs and any test results and chart notes. We also would like to see limited older records if you feel it is significant for your care. If you've had Functional Medicine labs, such as hormone or organics acids testing, specialty testing, then the last 5 years of that is helpful.

We can bill most commercial insurance plans. As a courtesy, and to avoid surprises, we prefer to check insurance benefits in advance of your appointment and will do our best to let you know of potential coverage issues. Keep in mind that our benefit-check is an estimate and not a guarantee of coverage. Your insurance is a contract between you and your insurer, and you are responsible for payment of services regardless of the amount your insurance pays.

You will pay your copay or estimated portion of your insurance copayment at check-out. You will receive a statement if there is a balance remaining after insurance processing. If you do not have insurance coverage for visits, you will pay the discounted "self-pay" charge at check-out.

Participation status can change. As of 11/1/2024 we are in-network with many (but not all) of the plans associated with these commercial insurances: Aetna Blue Cross Blue Shield (Regence) First Choice Health Network Moda Pacific Source Providence Regence Group Administrator Insurance plans change annually, along with rules of coverage. If you are curious about your coverage for services with our provider, Jeanette Welker FNP, we suggest using your plans "Find a Provider" option online for the most accurate and up-to-date information.

We can bill most commercial insurances, even if they are out of network. Some plans have fairly good coverage, even if out of network. You should check with your plan to determine what your coverage may be. We also will courtesy check this for you if you provide your billing information prior to the visit. The estimate is not a guarantee of coverage. If your coverage is poor, we offer discounted self pay rates. Most testing (labs, imaging) can be obtained at in-network labs. Some out of network commercial insurance plans that we can bill include: CAS (Coastal Administrative Services) Cigna EBMS GEHA HMA (Health Management Administrators) Health Net Imagine 360 Meritain Shasta Administrative Services Surest-BIND United Healthcare UMR (United Medical Resources) WEB-TPA

No, not in most cases. Our provider has opted out of all Medicare and Medicare Advantage plans. What this means for you: Your visit will not be covered by Medicare or your Medicare Advantage plan. We cannot bill your charges. Your expense for the visit will not go towards your deductibles. You cannot bill Medicare or your Advantage Plan in lieu of our office not billing. Our office will require you to sign an Opt-Out Contract which acknowledges these facts (these are Medicare's rules, not ours). Some patients have a Medicare plan, but also have valid commercial insurance - typically via employment, or a spouse who has a commercial insurance plan. There may be benefits in these cases. Most Medicare patients are self pay and qualify for discounted pricing. Please see our Charges and Fees sections for the most current rates. There typically is/can be very good coverage for Labs and Diagnostic Imaging for our Medicare patients. Please see that FAQ section for more details.

Medicare and unrestricted Medicare Advantage plans typically cover diagnostic testing ordered by our practitioner. (Please read to the bottom for known issues) Jeanette Welker NP is a Nurse Practitioner, able to evaluate patients, diagnose, order and interpret diagnostics tests, initiate and manage treatment - including prescribing medications and controlled substances - under the exclusive authority of the Oregon Board of Nursing. There is no difference in treatment of her orders versus a MD, for example. If you have a straight Medicare plan (usually with a supplement), orders will be covered to the limits of what Medicare allows, which may included considerations of medical necessity or non-covered labs or services. If you have a Medicare Advantage plan, coverage depends on the rules of the plan you've chosen. Many Advantage plans cover ordered testing well. Some Medicare Advantage plans (HMO's, or HMO-POS) restrict who can order labs or diagnostics and will not pay for items not managed by your PCP. Confirm with your insurance if your specific plan has these restrictions. We also prefer to obtain a copy of your insurance card in order to spot those issues in advance of ordering labs. We have access to deeply discounted labs through our partners and offer affordable options for our HMO or HMO-POS patients.

We don't participate with or bill Medicaid plans. We offer discounted self-pay rates (please see the Charges and Fees FAQ). What you can expect: Your visit will be self-pay, at discounted rates. Any diagnostics will also be self-pay. We have access to deeply discounted labs for regular blood draws as an option. Prescriptions will not be covered. They must be authorized by a network provider.

The following is our fee schedule as of 11/1/2024, subject to change without notice. Charges are based on time and includes preparation, face to face visit and coordinating care, such as ordering labs. Initial Consultation - $356 First Follow-up Visit - $250, one hour, typically Most visits require 30-60 minutes time, depending on complexity and quantity of items to review. 40-60 minute visit - $250 30 minute visit - $187 20 minute visit - $124 10 minute visit - $80 minimal visit/nurse visit - $40 Labs: We offer affordable lab testing via our lab clearinghouse partner, RUPA Health.

The following is our fee schedule as of 11/1/2024, subject to change without notice. Charges are based on time and includes preparation, face to face visit and coordinating care, such as ordering labs. Initial Consultation - $356 First Follow-up Visit - $250, one hour, typically Most visits require 30-60 minutes time, depending on complexity and quantity of items to review. 40-60 minute visit - $250 30 minute visit - $187 20 minute visit - $124 10 minute visit - $80 minimal visit/nurse visit - $40 Labs: We offer affordable lab testing via our lab clearinghouse partner, RUPA Health.

Yes - many people are sensitive to scents and chemicals. Please refrain from wearing perfumes or colognes or heavily scented products during scheduled visits.

Yes, as a Nurse Practitioner, our provider can prescribe medications without restriction.

Functional Medicine is a personalized, patient-centered approach to healthcare that focuses on identifying and addressing the root cause of disease rather than just treating symptoms.