How Do I Begin? What is Involved? . . .
STEP 1: Contact Us Tribeca Wellness Collective is both a concierge membership and fee-for-service medical practice (we do not accept insurance for our services). We design a tailored made approach to concierge medicine where we believe no patient is the same and not every patient requires the same level of care. We serve to provide you with PREVENTIVE. PROACTIVE. PERSONALIZED. service to suit your wellness needs.
STEP 2: Blood Tests You are required to get some blood tests before your visit. We will send you a lab requisition that you can take to any Empire City (in-home concierge blood draws) by clicking here, Quest or Labcorp draw site. You can find the location of the nearest Quest Lab by clicking here, and Labcorp draw sites can be found here. No appointment is necessary at Quest or Labcorp sites. You must be fasting for 8-12 hours before the test is performed: nothing to eat or drink except water. If you are taking any medications (including hormones), please use them as you normally would on the day of the test (pills may be swallowed with water even if it is a fasting blood draw). Most labs open before 8AM. The results will be sent to our office 7-10 days later.
STEP 3: Initial Consultation & Biomarker Testing Our practitioners will conduct biomarker testing on you here in our office to establish a baseline of your physical condition. Then Dr. Trutt will spend 2 hours assessing your symptoms, discussing your labo work and results, answering your concerns and questions, review the principles of bioidentical hormones, and take a detailed medical history and a physical exam with you.
STEP 4: Treatment At the end of your initial consultation, you and your practitioner will determine the course of treatment. Treatment may include diet and exercise recommendations, supplements, hormone replacement therapy, intravenous therapies (vitamins, glutathione, phospholipids), and more. Both commercial-brand and custom-compounded medications may be used as appropriate. Compounded medications will be shipped to you within a couple of days.
STEP 5: Follow-Up
After 5 weeks of treatment, you will need to get a follow-up blood test to assess hormone levels and other progress. You will then have your first follow-up consultation with your physician. (Concierge patients will speak with Dr Trutt about every two weeks.) Dr. Trutt will discuss the effects of the program and adjust your dosages accordingly. You will repeat this process after 2-3 months and again thereafter, depending on the situation.
Will my insurance cover the cost of lab tests? . . .
For uninsured patients, Initial lab tests cost approximately $1,000. Follow-up lab tests range from $300 (male patients) to $500 (female patients). Rates may be higher for tests performed at Labcorp. New patients will typically need 2-3 follow-up lab tests in the first year.
For insured patients, we will provide the laboratory with your insurance information so they can bill for these services accordingly. You will be responsible for any test not covered by your plan.
Do I have to come into to the office? . . .
Dr. Trutt has patients all over the world as well as around the continental United States — so distance need not be an issue. Follow-up consultations may be conducted over the telephone, FaceTime or by Skype if needed. However, for your initial consultation, you will be required to come to our office in person for a full physical examination.
Will my insurance cover the cost of perscriptions? . . .
Dr. Trutt is happy to use bioidentical hormones that are covered by insurance whenever possible– and contrary to what you may have heard, there are many FDA-approved bioidentical options. There is no commercially available testosterone product for women, so that must be compounded. Progesterone comes in an oral commercially available FDA-approved bioidentical form, but not all women tolerate it, and so sometimes compounded progesterone cream must be used. Most insurance companies do not cover the cost of compounded medications. For this reason, our pharmacy partner does not accept insurance for direct payment. However, we can arrange to provide you with properly coded invoices that you may submit to your insurance carrier for reimbursement. Please note: although there are 7500 compounding pharmacies in the United States, only about 115 are PCAB-certified. For compounded medications, Dr. Trutt will only work with PCAB-certified pharmacies. You may view a list of PCAB-certified pharmacies here.
Will my FSA cover your treatment? . . .
Many employers offer a Flexible Spending Account (FSA) to their employees. These arrangements permit the employee to stow a portion of their pre-tax earnings in a special account for use on health-related expenses NOT covered by primary health insurance. Depending on the type of FSA, these arrangements may cover the portion of your treatment not covered by your primary health insurance, including medications, office visits, co-pays, program fees, vitamins & supplements. Ask your employer or visit the IRS FSA site.
Can I use my own pharmacy? . . .
We are better able to manage your hormone levels with precise accuracy if all medications come from the same pharmacy. Bioidentical hormone modulation is very different from prescribing “one-size-fits-all” drugs like Premarin. Every treatment regimen is custom-tailored to the individual based on the results of blood tests, medical history, physical exam, and symptoms. With compounded medications, hormone powders are mixed with a cream or gel base or loaded into capsules. There are many variables such as the absorption level of the cream base and the size of hormone particles. By standardizing with one pharmacy, we are better able to predict a patient’s response to a certain dosage and properly adjust the dosage in response to symptoms. Please note: although there are 7500 compounding pharmacies in the United States, only about 115 are PCAB-certified. For compounded medications, Dr. Trutt will only work with PCAB-certified pharmacies.