Becoming a PatientPatient Guide
Welcome to Richmond Integrative & Functional Medicine!
Please read the following page carefully. It will serve as a guide to help us make your consultation and care here as efficient and productive as possible. It will also guide you through the necessary preparation prior to your initial evaluation. We value your time and the following will help to maximize your time here in our office.
1. Educating Yourself
Integrative Medicine & Functional Medicine differ from conventional medicine in many significant respects. It is important, therefore, to understand the unique goals and methods behind our approach to care at Richmond Integrative & Functional Medicine. Please review the following articles to prepare you for your experience here.
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2. Our Services
It’s hard to define all that Functional Medicine and Integrative Medicine encompass. Below are a few of the services that are offered at Richmond Integrative & Functional Medicine.
Comprehensive Systems Biology & Functional Medicine Intake Exam
This initial evaluation will last 90 minutes and include a Functional Matrix based evaluation. This includes an evaluation of environment influences on genetic expression, nutritional influences on genetic expression (nutrigenetics), nutritional influences on metabolic functions (nutrigenomics), metabolic derangements resulting is system failures (metabolomics), transgenerational influences on gene expression, psychological and mind body influences on systems biology functions and genetics, and if applicable a personalized genetic evaluation. Once this evaluation is complete, a personalized nutraceutical, dietary and if indicated an evidence based herbal regimen will be created for the patient. The above will be in accordance with principles outlined through the American Board of Integrative and Holistic Medicine, The American Board of Physician Specialties and The Institute for Functional Medicine.
This is performed during the initial intake of every patient and include but is not limited to Body Impedance Analysis, Biomarker Analysis and interpretation, peripheral circulatory evaluations utilizing vascular reactivity analysis and functional nutritional evaluations.
Metabolic and Organic Acid Analysis, Genetic, Toxicological and Functional Medicine Testing and lab analysis; as appropriate. This testing interpretation requires advanced medical training and at times lab interpretation can involve specialty consultations with other subspecialists in the field. These costs including time and resources are included in the program.
The initial intake appointment after joining RIFM will be 90 minutes. All follow up appointments will be scheduled for at least 30 minutes.
Executive Optimal Wellness Physical Exam & Advanced Laboratory Testing
RIFM through its participating physician will provide an advanced biological systems based analysis. This will include but not be limited to application of the Functional Medicine Matrix, Functional Nutritional Biomarkers and as appropriate additional functional testing evaluations.
Due to the intensive and time consuming nature of Functional & Integrative Medicine, RIFM agrees to limit the size of its panel for Integrative and Functional Medicine to no more than 300 patients per designated medical provider.
We are offering access to the Functional Medicine and Integrative Medicine services at RIFM through a membership program. Unfortunately, neither Integrative or Functional Medicine are presently recognized as a coverable service through most insurers or Medicare. We have chosen a membership model as the best way to provide access to these services. A full description of our reasoning for our policy can be found here.
Your insurance will still provide for the standard labs, x-rays, CT scans, standard evaluation and management procedures (typical office visits), etc. … that will be provided in addition to your comprehensive evaluation and treatment plan. The fee structure for the available memberships are as follows:
Initial membership induction fee of $730 then monthly maintenance fee of $135 per month during the next 12 months of membership. Annual re-induction fees will apply.
Couples & Families
Couples will get a 10% discount on the individual rate when joining. Children up to age 18 can be added on at a 15% discount from the individual rate.
Membership may be cancelled at any time but a written notice is required. The membership will be cancelled on the following monthly cycle. So if you cancel your membership after your initial evaluation you will be charged for only one month of membership after the induction fee. This allows us to do an appropriate follow up for all initial evaluations. Otherwise the membership contract will renew on an annual basis unless terminated by either party.
There are numerous ways to apply the concepts of Functional & Integrative Medicine to an individual patient. Below is a summary of how we typically approach a patient. Every individual will be different but the basic approach is consistent.
The first step in our process is to sign up as a patient and member. In addition to your basic contact information, you will be prompted to provide your insurance information as well as bank or credit card information. Your bank or credit card will not automatically be billed. All patients sign up using the same process. Actual charges will depend upon your specific membership plan or requested services.
2.1 Medical History
All new patients will receive an email from LivingMatrix — our digital intake application — containing a personalized link to your initial "paperwork." Click the link and choose a personal password (at least 8 characters in length). Click “Update Password” and begin entering all patient demographic information. After submitting your demographic information, you’ll be taken to the dashboard, which lists the forms you will need to complete before your appointment.
Intake Instructions (Text)
To begin entering information, click the small blue icon to the right labeled “View Form.” You should save your progress as you work through each section. (Please keep in mind that the forms may take as long as an hour to complete). If you do not remember the specific day or month of an occurrence you may enter “01/01/YEAR” as an estimate (the month and exact day are less important than the year.)
Once you have completed all of the sections, click “Submit.” (NOTE: Once you click submit, you will not be able to go back and edit information, as submitting forms locks in your information for your practitioner to review.)
In order for us to get a comprehensive idea of your health history, you will need to complete all sections of the forms you receive and be as specific as possible. Specific dates and occurrences will help us properly evaluate your medical situation and conditions.
For technical questions about the digital intake process, please contact our parter, LivingMatrix, by phone at 1-866-846-7888
Intake Instructions (Video Tutorial)
Our practice uses a system called LivingMatrix to assess your health and identify the root cause of your symptoms. One of the many benefits of using this application is that it saves our practice time on the intake process – meaning more time for us to paint a comprehensive picture of our patients’ health histories with them.
There are benefits for our patients, too. We are able to personalize your information in real time and provide you with a hard copy of your health assessment. You’ll not only gain useful insight into your health during your visit, but you’ll walk away from your appointment with an understandable, easy-to-read view of your current health, a list of health goals, and, if necessary, a functional medicine prescription.
We will review your intake documents to get a general feel for potential issues and areas for special concentration.
Once you have registered, we will request that you fill out all of your medical history forms through Living Matrix. We will need all this information prior to your initial visit. Your appointment will be scheduled at least two weeks out in order to give you time to fill these out and for us to adequately review your history prior to your consultation.
In order to schedule your initial visit we will need to collect a deposit of $345 to secure the appointment time. This will be credited toward the induction fee.
Call to Schedule Your Appointment
3.1 Administrative Paperwork
When you arrive for your visit you will need to fill out the usual and customary administrative paperwork for our practice. This will take around 30 minutes to complete. Please arrive at least 30 minute prior to your appointment to allow time for this and not distract from your medical appointment time.
At the time of your appointment, you will be brought back by one of our nurses to review your admin paperwork and collect the remainder of your membership induction fee. Please be sure to bring all your old medical records with you as well as old lab testing.
3.2 Vitals & Initial Testing
You will then have your vital signs taken as well as advanced biometric testing, vascular testing, body impedance testing and a body composition analysis prior to seeing the doctor. This testing is not covered by insurance but is included as part of your membership benefits.
3.3 Medical Review
You will have an extended visit with Dr. Hartman during which time he will review all the above information and evaluate you based on the Functional Medicine Matrix. This is used in combination with your Functional Time Line to begin unraveling the many layers involved with your biological systems.
Based on your evaluation, additional validated forms and intake questionnaires may be utilized to help us in our discovery process.
3.4 Physical Exam
Next, we conduct a detailed physical exam. This includes:
- A physical nutritional evaluation
- Skin/nails/hair exams
- Functional neurological exam
- Complete head to toe evaluation
This comprehensive physical exam is used to help discover physical manifestations of your underlying imbalances as well as determine how the treatment plan will be layered to address these.
3.5 Labs & Testing
You will have a panel of labs, procedures and testing done that will be billed under your insurance. These are standard procedures and covered by your insurance plan. Depending on your personal evaluation you may have multiple advance laboratory panels performed as well. These tests may take up to a month to return due to their specialized nature. Your total time in the clinic may be up to three hours depending on your health situation.
About Laboratory Testing
Some clinicians will order extensive testing from the beginning at great cost to the patient. Functional testing is already a significant expense and we see no reason to make it more so. Many times, basic imbalances will correct with simple interventions and lead into other areas that need addressing. We tailor testing to each patient at the time in their intervention as appropriate.
While not everyone needs extensive lab work, some will. At times a particular test may be repeated to look for changes. Other times one result will lead to more testing which leads to additional health interventions.
At this point your story is retold through the lens of the Functional Medicine Matrix. This will include an individual treatment plan as well as lab testing to discover further areas of system imbalance.
More complex patients will require close follow-up and reevaluations based on your response to therapy and results of testing. This could be monthly, bimonthly or trimonthly depending on your health condition.
Once your initial testing has returned, you will first receive an email with results and then a follow-up phone call to review them. After this, your follow-up will depend on your individualized care plan.
Chronic disease does not crop up overnight. It takes years to develop and requires time to address. Our program recognizes this and provides time to work on it. Some patients will see significant progress in 3–6 months; more complex cases may take over a year to return to a state of optimal health and performance. Our membership model addresses this reality in a way that makes you a member of your own health care team committed to your health and wellness.
You may at any time choose to make Dr. Hartman your primary care doctor or you may continue with your PCP and only use your membership services to continue your access to Integrative & Functional Medicine services. Your wellness program will be changing as your health status changes. Please be patient with us as we work together with you in your personalized wellness and health program.