Restore+ Bioidentical Hormone Replacement Therapy | BHRT Alberta

No. Issuing, modifying or renewing prescriptions cannot be completed without an assessment and appointment. Our health professionals are committed to providing safe and effective care, which requires a proper evaluation of your current health status before issuing, amending or renewing any medications. This policy aligns with regulatory standards and ensures that your treatment plan remains appropriate and effective.

BHRT prescriptions, in particular, require diligent oversight due to their personalized nature and potential for changes in your hormonal needs over time. Regular assessments allow us to monitor your progress, address any concerns, and make necessary adjustments to your treatment plan.

As a private fee-for-service (FFS) clinic, we prioritize maintaining affordability for the majority of our patients. To help keep costs low, we do encourage patients to explore alternative options for renewing their prescriptions. You can ask your MD or request the pharmacy to renew your prescription directly. If available to you, these options typically do not have associated fees and can save you both time and money.

Yes, we offer direct billing to many insurance providers as a value-added service, but no, we do not provide pre-authorizations for insurance claims.

Direct Billing Convenience

We provide web-based claims processing on your behalf, which ensures:

• Faster Claims Processing: Direct billing allows for quicker turnaround times on insurance claims.
• Improved Accuracy: By submitting claims directly, we reduce errors and ensure accurate claim submissions.

While this service streamlines the reimbursement process, please note:

1. Insurance Coverage Varies: Your insurance policy may differ in terms of patient and provider eligibility, as well as the percentage of fees covered.
2. Patient Responsibility: You are responsible for confirming your insurance coverage and paying for any fees or services not covered by your plan.
3. Denial of Claims: If your claim is denied, the remaining balance must be paid by you. Detailed receipts will be provided for reimbursement claims made directly by you.

Pre-Authorizations

We do not process or facilitate pre-authorizations with insurance companies. Pre-authorizations must be initiated directly by you with your insurer. Here’s what you need to know:

• What Are Pre-Authorizations? Some insurance plans require prior approval to confirm that specific services are eligible for coverage.
• Your Role: You are responsible for contacting your insurance provider to determine whether pre-authorization is needed and for completing this process, if applicable.

Your Responsibility

Whether for direct billing or pre-authorizations, we recommend the following:

• Confirm your insurance policy details, including eligibility, coverage percentages, and pre-authorization requirements, directly with your insurer.
• Be prepared to pay for any services or products not covered by your plan.
• If pre-authorization is required, complete the process with your insurer before your appointment.

We aim to make your experience as smooth as possible by offering direct billing and providing detailed receipts for claims. If you have additional questions about your insurance, feel free to reach out to your provider for clarification. Let us know if there’s anything else we can do to support you!

At Red Leaf Wellness, our goal is to optimize your hormone levels to support your overall health and well-being while adhering to safe, evidence-based practices. We carefully tailor your treatment to ensure that your hormone levels remain within an optimal and clinically appropriate range, avoiding the risks associated with excessively high dosing.

Hormone therapy, including BHRT, requires a precise balance. Ultra-high dosing can lead to significant health risks, including adverse effects on cardiovascular, metabolic, and endocrine health. Our clinicians use a comprehensive approach, incorporating regular assessments, lab testing, and your reported symptoms to ensure your treatment is both effective and safe.

We prioritize long-term health outcomes and are committed to achieving results that enhance your quality of life without compromising your safety.

Yes and no. Naturopathic Doctors (NDs) form a key part of our Hormone Health Program and play an essential role in natural remedies, lifestyle coaching, and, in certain jurisdictions, prescribing medications. Here’s how it works:

ND Role in Hormone Health by Jurisdiction

1. Alberta:
   NDs in Alberta currently have no prescribing authority. Their focus is on natural remedies, lifestyle adjustments, and coaching to support hormone balance. Patients in Alberta will work with both an ND for natural therapies and a Nurse Practitioner (NP) for prescription needs.
2. British Columbia and Ontario:
   NDs in these provinces have extensive, though not complete, prescribing authority. They can prescribe a range of medications, including bioidentical hormones (e.g., progesterone, thyroid medications) and some forms of hormone replacement therapy, but there are limitations. For example, NDs cannot prescribe testosterone or controlled substances in these provinces.
   • Example of Medications NDs Can Prescribe:
     • Bioidentical progesterone
     • Desiccated thyroid
     • Estriol and estradiol in some formulations
   • Example of Medications NDs Cannot Prescribe:
     • Testosterone
     • DHEA (in some jurisdictions)
     • Controlled substances (e.g., certain pain medications)

Using Naturopathic Medicine Coverage for Hormone Health

Many patients with Naturopathic Medicine insurance coverage can use it for ND-led services in the program, including lifestyle coaching, natural remedies, and, in some cases, prescriptions (where permitted by law). However, coverage varies significantly depending on your insurance provider’s guidelines, so we recommend confirming your policy details.

• What’s Covered: Appointments with our licensed NDs may be eligible for reimbursement under Naturopathic Medicine. You’ll receive a detailed receipt specifying the provider’s credentials to submit for insurance reimbursement.
• What’s Not Covered: If an ND cannot provide a required prescription due to scope limitations in your province, additional services from an NP will be required. These services will be billed separately and will fall under a different insurance category (Nurse Practitioner services).

Ensuring Efficient Care

If you prefer to have an ND lead your care but also require full BHRT prescriptions, we’ve streamlined the process to make it easy for you:

• NP Collaboration: Our NDs will collaborate with an NP for prescriptions outside the ND’s scope. This could involve an abbreviated NP prescribing appointment, depending on the complexity and whether the NP can complete the prescription in the background or requires a full clinical consult.
• Separate Receipts: You’ll receive a receipt for ND services and a separate receipt for any NP services provided, ensuring accurate documentation for insurance purposes.

Additional Insurance Details

• Appointments with NDs and NPs may be reimbursable under your insurance policy, but it’s important for you to verify eligibility and coverage percentages directly with your provider.
• If some services are not covered, you may be able to claim them under a Health Spending Account (HSA) for reimbursement.
• We strictly adhere to ethical and legal standards and cannot alter receipts to classify services differently for insurance purposes.

Due to the personalized nature of our Restore+ Hormone Health Program, all service appointments require a credit card on file and are non-refundable. However, appointments may be rescheduled if arranged more than 48 hours in advance in accordance with our cancellation policy.

If you purchased a package or arranged for a monthly subscription fee, the following policies apply:

Packages and Subscriptions:

• All service packages, including Bioidentical Hormone Replacement Therapy (BHRT), are non-refundable once payment has been made. This policy applies under all circumstances, including voluntary discontinuation, inability to complete the program, or dissatisfaction with treatment results.
• If you have concerns about your progress or results, we encourage you to discuss them with your designated Nurse Practitioner or Functional Medicine Practitioner, who will work with you to assess your situation and make adjustments to your treatment plan as needed.
• If you experience any adverse reaction to a supplement or medication related to your BHRT treatment, it is crucial that you immediately discontinue use of the product and seek appropriate medical attention. Please notify us in writing about the adverse event, providing relevant documentation. We take such incidents seriously, and our suppliers require this information to properly record and investigate the occurrence.
• For monthly subscriptions, by purchasing a subscription, you authorize us to charge your credit card monthly for the minimum number of months specified in your subscription plan. Subscriptions are non-refundable. This policy applies in all circumstances, including voluntary discontinuation prior to the end of the minimum commitment period. If you choose to discontinue your subscription early, you may be charged the remaining balance owing for the full term of your subscription plan.
• In rare cases where services or products were paid for but not provided due to extraordinary circumstances or errors on our part, we may issue a refund or provide compensation at our discretion. Any such exceptions will be considered on a case-by-case basis.

By adhering to these policies, we aim to provide a clear understanding of our commitment to your health and the integrity of our services. If you have any further questions or concerns, please feel free to contact us directly.