FAQ’s

Functional medicine and naturopathic medicine take a whole-person approach to healthcare, looking beyond symptoms to understand the underlying factors that may be contributing to your health concerns.  Rather that focusing only on treating a diagnosis, these approaches consider your genetics, nutrition, lifestyle, environment, stress, hormones, and other aspects of your health to create a personalized plan.

At Peninsula Integrative Medicine, our doctors use evidence-informed functional and naturopathic medicine alongside conventional medical knowledge to help identify root causes, support the body’s natural healing processes, and create individualized strategies for better long-term health.

Naturopathic doctors receive similar training to medical doctors in the biomedical and clinical sciences but are also trained in evidence-based natural therapies such as clinical nutrition, herbs, supplements, and the use of alternative diagnostic tools.

In general, NDs spend more time with their patients, allowing them to conduct a deeper investigation into the underlying cause of their illness. In treatment, the goal of NDs is to use the least invasive therapies possible, with an emphasis on prevention and reversal of chronic disease. Naturopathic doctors spend the majority of their clinical hours in outpatient clinics and generally do not do hospital rounds.

At Peninsula Integrative Medicine we care for patients with a wide range of health concerns. We commonly support patients with:

• Women’s health: fertility, pregnancy care, postpartum support, perimenopause, menopause, PMOS (formerly PCOS), PMS, menstrual concerns, endometriosis, and other hormone related symptoms
• Men’s Health: testosterone levels and other hormone concerns, thyroid function, cardiovascular wellness, fertility and sexual health
• Metabolic Health: insulin resistance, blood sugar concerns, and weight management
• Digestive Health: IBS and IBD, bloating, constipation, diarrhea, acid reflux and GERD, food sensitivities, gas, indigestion, SIBO, intestinal permeability aka “leaky gut”, H. pylori, Candida overgrowth, Celiac disease, parasitic infections, gut related skin conditions
• Fatigue, Energy & Mental Wellness: persistent, fatigue, low energy, difficulty feeling restored, brain fog, difficulty, concentrating stress, and mood concerns
• Autoimmune & Inflammatory Conditions: Hashimoto’s thyroiditis, Graves’ disease, Rheumatoid arthritis, Psoriatic arthritis, Lupus (Systemic Lupus Erythematosus), Sjögren’s syndrome, Multiple sclerosis (MS), Crohn’s disease and ulcerative colitis, Celiac disease, Psoriasis, Ankylosing spondylitis
• Chronic, Complex Conditions: Chronic Fatigue Syndrome (ME/CFS), Long COVID and post-viral illness, Fibromyalgia, Mast Cell Activation Syndrome (MCAS), Dysautonomia and POTS support, Complex digestive disorders, Persistent infections, PANS/PANDAS, Ehlers-Danlos syndrome (EDS), and other connective tissue disorders
• Healthy Aging and Prevention: personalized strategies for longevity, resilience, and long-term health
• Cancer support: risk reduction planning, genetic testing, integrative support alongside conventional cancer treatment and survivorship care
• Skin Conditions: Acne, Hormonal acne, Eczema, Psoriasis, Rosacea, Chronic hives, Chronic rashes, Skin inflammation, Hair loss and thinning, Autoimmune-related skin conditions, Skin concerns associated with hormone imbalance or gut dysfunction
• Environmental Medicine: Lyme disease, Tick-borne illnesses, Mold illness, Mycotoxin exposure, Chronic inflammatory response, Environmental toxin exposure, Persistent unexplained symptoms

If you don’t see your specific condition listed that does not necessarily mean we can’t help. Call our office or send us a message to learn whether your concerns may be appropriate for care at PIM.

Functional medicine may be a good fit if you want to understand why you are experiencing symptoms, not simply manage them. At Peninsula Integrative Medicine, functional medicine is a personalized collaborative approach that looks at the connections between your symptoms health history, nutrition, lifestyle, environment, hormones, lab findings, and other factors that may influence your health.

This approach may be right for you if you:

• want to explore underlying or root causes of ongoing health concerns
• prefer personalized care rather than one-size-fits-all treatment plan
• are open to nutrition, lifestyle and other supportive strategies alongside conventional medical care
• value, collaboration, and shared decision-making
• are willing to take an active role in your health and make changes overtime

Functional medicine may be less suited to someone looking for a quick fix, single intervention, or fixed treatment protocol. Because your health can change overtime, your care plan may evolve based on your symptoms, goals response to treatment and lab results

At PIM we believe meaningful progress does not require perfection. Our goal is to work with you to create a thoughtful evidence informed plan that feels realistic, sustainable, and aligned with your priorities. Your care should adapt to you not the other way around.

The cost of a new patient appointment at Peninsula Integrative Medicine varies depending on the type and length of your appointment and the doctor you see. New Patient Appointments typically range from $695 to $850.

For more information, please see the FAQ section at the bottom of the bio of the provider with whom you are interested in working or call our office at (650) 485-2758 so our Patient Care Coordinators can explain our various fee schedules.

We also offer several wellness packages and programs that can help reduce the overall cost of care for patient who are ready to take a more comprehensive approach to their health. During your complementary consultation or first appointment, your doctor can discuss the options that may be most appropriate for your needs and goals.

Our goal is to provide personalized, comprehensive, integrative, naturopathic care while being thoughtful about the cost of that care.

The cost of a follow up appointment at Peninsula Integrative Medicine depends on the doctor you see, the length of the visit, and the type of care you need. Follow-up visits are generally shorter, and therefore cost less than an initial consultation. For more information, please see the FAQ section at the bottom of the bio of the provider with whom you are interested in working or call our office at (650) 485-2758 so our Patient Care Coordinators can explain our various fee schedules.

Your doctor will recommend the appropriate follow-up schedule based on your health concerns, treatment, plan, and goals. We also offer wellness packages and programs that may help reduce the overall cost of ongoing care for patients who are looking for more comprehensive support.

Because every patient’s needs are different, we will always discuss the recommended frequency, type of visits, and associated cost with you as part of your care plan.

Peninsula Integrative Medicine is out-of-network with insurance plans, so we do not bill insurance companies directly. Payment for your visit is due at the time of service.  After your visit, we can provide a superbill which is a detailed receipt that includes information such as the services provided, diagnosis codes, and CPT (procedure) codes. You can submit the superbill to your insurance company to request reimbursement for eligible out-of-network services.

Insurance coverage varies by plan. Before your appointment, we recommend contacting your insurance company to ask whether your plan provides out-of-network benefits for naturopathic, functional medicine, or acupuncture services. We can provide the appropriate CPT codes to help you ask your insurance company about potential coverage and reimbursement. Email our office to request the CPT code information.

Please keep in mind that providing a superbill does not guarantee that your insurance company will reimburse you. Our experience is that most PPO plans reimburse a portion of the visit cost, however, any reimbursement is determined by your individual insurance plan.

Insurance coverage for laboratory testing depends on your insurance plan, the type of test being ordered, and where the testing is performed. Because coverage varies, we recommend checking with your insurance company before having labs drawn whenever possible.

For routine bloodwork, many PPO plans provide coverage when testing is performed through an in-network laboratory. If you have an HMO plan, such as Kaiser, you may need to have certain labs ordered and processed through your primary care physician or your plan’s designated laboratory. We can help you understand what testing we recommend but your insurance company ultimately determines coverage.

Some specialty and functional medicine tests, including saliva, stool, urine, and other advanced laboratory testing may be covered by insurance in some circumstances, while others may not be. We recommend contacting your insurance company in advance to ask about coverage for a specific test.

If you have a high-deductible health plan or limited laboratory coverage, we may be able to offer a lower cost options through a discount laboratory provider. This can make routine blood testing available at a fraction of typical retail pricing, particularly when insurance coverage is limited.

We have found that Medicare generally does not cover laboratory tests and services ordered by our doctors. However, we can offer you the same lower cost options through a discount laboratory provider that we offer to our patients with high-deductible health plans or HMOs.

Our team can provide information about the type of testing recommended so you can contact your insurance company and ask about specific coverage before proceeding. If you know you do not have coverage and want an estimate of out-of-pocket costs for ordered tests, we are happy to provide the estimate prior to sample collection. Please message PIM Front Desk through the Charm Patient Portal to request an estimate

Yes! FSA and HSA funds can generally be used for eligible medical expenses, including certain appointments, laboratory testing, and supplements when they qualify as medical care under IRS rules. However, eligibility can vary by expense and by your specific plan so we recommend confirming with your FSA or HSA administrator before using your FSA or HSA funds to pay for products or services.

• Appointments: Visits with our doctors for the evaluation diagnosis and treatment of a health concern may qualify as eligible medical expenses.
• Laboratory & Diagnostic Testing: Lab testing recommended as part of a evaluating or treating a medical condition may be eligible for FSA or HSA reimbursement coverage and documentation requirements can vary depending on the type of testing.
• Supplements: Supplements are not automatically eligible simply because they are recommended by a doctor certain supplements may qualify when they are specifically recommended to treat or prevent a diagnosed medical condition and meet your plans requirements your FSA or HSA administrator can confirm with a particular supplement is eligible.

If your FSA or HSA administrator requires additional documentation, we may be able to provide a Letter of Medical Necessity (LOMN), when appropriate. An LOMN documents that a specific service, test, or product is recommended as part of medically necessary care. It does not guarantee reimbursement, as the final determination is made by your plan administrator.

To help with reimbursement, we recommend:

• Check with your FSA or HSA administrator about eligibility before purchasing
• Keep your receipt and documentation for all eligible expenses
• Ask us if you need a superbill or other documentation for an appointment or laboratory testing
• If required, contact our office, via email or through the Charm Patient Portal, about providing a Letter of Medical Necessity

Because FSA and HSA rules can vary, your plan administrator is the best source for confirming whether a particular expense qualifies.

You can request a new patient appointment with the provider of your choosing in 3 different ways:

• Call our office at (650) 485-2758 and speak directly with one of our Patient Care Coordinators
• Send us a message or email about your health concerns so we can help you find the right provider
• Request an appointment through our online booking system if you already know who you want to see

Please note, if you request a new patient appointment online, that request will not be officially scheduled until confirmed by one of our Patient Care Coordinators after connecting with you to go over rates, office procedures, and new patient intake paperwork.  If you have questions for the doctor prior to committing to a new patient appointment, please consider requesting a complimentary consultation first.

A little preparation before your first appointment helps your doctor make the most of your time together. Please complete all required intake forms through our patient portal at least four business days before your appointment. If your forms are not completed by this deadline, your appointment will need to be rescheduled.

Before your visit, we also recommend:

• Complete your intake forms ASAP:
  • Complete your intake forms as soon as possible so that your doctor can request any additional information she/he may need in advance of your new patient appointment, including records from other doctors or clinics that can take 2-6 weeks to receive.
  • If you are on a doctor’s waitlist for a sooner new patient appointment, our Patient Care Coordinators will check to see if your intake forms are complete prior to offering to move your appointment to a sooner date should one become available
• Upload relevant medical records:
  • If available, upload recent lab results, imaging report, and pertinent medical records or specialist notes to the patient portal. Here are instructions on how to upload records to the “Documents” section of your patient portal.
  • If unavailable, complete Release of Records forms for each doctor or clinic from which you would like your PIM provider to request your records.
• Think about your goals:
  • Consider what you would most like to address and what you hope to accomplish through care at PIM.
  • Make a list of questions for your doctor and upload these to your portal in advance of your appointment or bring them with you.

The initial office visit is a comprehensive one-on-one consultation during which your provider will work to obtain a complete picture of your, or your child’s, present condition as well as review your medical history, past and current health concerns, nutrition, and lifestyle. After assessing your health needs, your provider may recommend dietary modifications, nutritional supplements, or additional testing which may be done through a conventional lab or a lab specializing in functional medicine testing.

Your doctor will also discuss next steps and follow up care based on your individual needs. Follow up timing varies, depending on your concerns, treatment plan, and whether additional testing is recommended. In general, the first follow-up is scheduled for 3-6 weeks after the initial visit to review any lab work received and your initial treatment plan; these first follow-up range in length from 45-75 minutes depending on your provider, tests ordered, and various other factors. Subsequent follow-ups will be determined by your provider.

Please note: completing your intake forms by the 4-business-day deadline is required so your doctor has adequate time to review your information and prepare for your initial visit.

Many Peninsula Integrative Medicine providers, offer phone and secure video appointments, allowing you to receive personalized care from the comfort of your home. Your provider will let you know whether a phone or a video visit is appropriate for your appointment. Video visits are conducted through a secure platform, and you will receive instructions for connecting before your appointment.

During a virtual visit, your provider can review your health history, current symptoms, medication and supplements, nutrition, lifestyle, and health goals, just as they were during an in person consultation. Depending on your individual needs your provider, may recommend laboratory testing, nutritional or lifestyle changes, supplements, or other personalized strategies.

Many lab tests that PIM providers order can be done at home. The types of tests that can be done at home include stool, saliva, urine, and dried blood samples.  Test requiring a blood draw may be completed at our office in Palo Alto, CA, by our phlebotomist, Suzy. Alternatively, some orders for blood tests may be completed at Quest, LabCorp, or other labs associated with medical organizations like Sutter, PAMF, Stanford, OneMedical etc.

Once your results are available, your provider can review them with you during a follow up phone or video appointment and explain what they may mean in the context of of your overall health. Your care plan may then be adjusted based on your progress, symptoms, and test results.

Virtual care at PIM is designed to be convenient without sacrificing personalized care. Your provider will work with you to determine which appointments can be conducted virtually and when an in person visit or examination may be recommended.

Please note, if you have out-of-network coverage for naturopathic care, and submit your superbill to insurance for reimbursement, there may be differences in the reimbursement percentage for phone or video appointments as compared to in-person appointments; it is always best to confirm the details of your policy and coverage with your insurance company.

Many of our Peninsula, Integrative Medicine providers have a hybrid work schedule where they see patients in-person in Palo Alto, CA on certain days of the week, and virtually other days.  Please check the FAQ section for your individual provider for details on their availability to see patients in person or virtually.

If your PIM provider sees patients exclusively through telemedicine, and you need to be seen in-person for any reason, your PIM provider may refer you to another PIM provider with in-person availability, to your primary care physician (PCP), or to Urgent Care, depending on the circumstances.

In order to ensure that we have room in our schedule for all of our patients, we have a 3-business-day cancellation or rescheduling policy. If you need to cancel or reschedule an upcoming appointment, we ask that you call our office or send a message through the patient portal to PIM Front Desk at least 3-business-days in advance of your appointment so that we can accommodate your cancellation or rescheduling request at no charge.

If you request to cancel or reschedule your appointment with less than 3-business-days, notice, you will be charged a percentage of the visit rate as a late cancellation or late rescheduling fee. The first late cancellation or late reschedule is charged at 25% of the visit fee. The second late cancellation or late reschedule is charged at 50% of the visit fee. Any subsequent cancellations or late reschedules are charged at 100% of the visit fee. Of course, exceptions can be made for unique circumstances.

There is no standard number of lab test recommended for every patient. The number and type of labs we recommend are highly individualized and depend on your symptoms, health, history, goals, existing test results, and the complexity and duration of your health concerns.

Some patients may need only a few targeted tests, while others with chronic or complex health concerns may benefit from a more comprehensive evaluation. Doctors who frequently work with complex, chronic illness, including Dr. Thalia Hale and Dr. Michael McKee, may recommend a broader range of laboratory testing when clinically appropriate.

We also understand that testing takes time, can require different types of sample collection, and can add to the cost of care. Your doctor will work with you to prioritize testing based on what is most important to your treatment plan, the difficulty or inconvenience of collecting the sample, and your financial considerations.

Rather than ordering every possible test at once, we aim to take a thoughtful, step-by-step approach and focus on the information most likely to help guide your care. As your health and treatment plan, evolve, additional testing may be recommended when it can provide meaningful information.

When several lab test are recommended, we generally encourage completing them early in your care whenever possible. Having a more complete picture of your health from the beginning, can help your doctor identify factors that may be contributing to your symptoms and develop a more targeted treatment plan.

Comprehensive testing may help uncover issues that could otherwise be overlooked, such as an underlying infection, nutritional deficiency, hormonal, imbalance, metabolic issue, or environmental exposure. Identifying these factors early can help avoid spending months treating symptoms without understanding what may be contributing to them.

That said, we understand that lab testing can be a significant financial investment, and some test may require more time or effort to collect than others. If completing all recommended testing at once is not practical, your doctor can work with you to prioritize the most important test first, based on your symptoms, treatment plan, the information each test is expected to provide, and your budget.

You do not have to choose between comprehensive care and what is financially manageable. Our goal is to create a thoughtful testing strategy that provides useful information while respecting your priorities and resources.

It depends on the type of testing and laboratory performing the analysis. Different labs and different tests have different processing and turnaround times. Some routine lab results may be available relatively quickly, while specialty and functional medicine testing can take several weeks.

Because we want to make sure your doctor has received all of the recommended results before reviewing them with you, follow up appointments are generally scheduled 3-6 weeks after your visit or after the time of collection; this allows time for testing to be completed, specimens to be processed, and results to be returned to PIM.

If you have questions about the estimated turnaround time for a specific lab test, our Patient Care Coordinators may be able to provide more information based on the laboratory and the test being ordered.

When we receive your lab results, you will be notified through the patient portal, and we will attach a copy of the results to the notification message. We only automatically notify patients of final results, not of partial, preliminary, or interim results.  If you are in need of partial, preliminary, or interim results, please message PIM Front Desk through the patient portal and request them.

In most cases, specialty lab tests need to be ordered through a licensed healthcare provider. Many of the specialty labs used by Peninsula Integrative Medicine work exclusively with registered healthcare practitioners and do not sell or provide test kits directly to patient.

Your Primary Care Physician (PCP) may be able to order some specialized testing, but many PCPs do not routinely order functional medicine or specialty lab test. These specialty tests often require a different approach to selecting, interpreting, and applying the results to an individual patient health concern concerns.

There are also direct-to-consumer services that offer broad, standardized testing panels. While these can provide useful health information for some people, a standardized panel is not the same as personalized testing. A large panel may include tests that are not relevant to your particular symptoms or health goals while leaving out other tests that could be more clinically useful.

At PIM, our doctors select lab tests based on your individual health, history, symptoms, goals, and treatment plan. Rather than ordering every available test, we focus on obtaining the information most likely to help us understand your health and guide your care.

If you already have lab results from your PCP or another doctor, we encourage you to share them with your PIM provider. Existing results can help your doctor determine what additional testing, if any, may be appropriate.

Based on a thorough history of your health concerns, physical examination, and appropriate laboratory testing, your provider will determine a customized therapeutic plan for you, which may include nutritional supplements, herbal medicines, therapeutic diets, lifestyle modification, and prescription medication when appropriate. Nutritional supplements are often an important part of your treatment plan and are customized to the individual needs of each patient.

A Peninsula Integrative Medicine, our doctors recommend high-quality supplements from reputable manufactures that meet specific standards for ingredients, sourcing, potency, dosing, accuracy, and quality control. Many of the products we recommend are available through practitioner-only dispensaries, which can help ensure product quality and consistency.

Because supplement recommendations are individualized to your health needs, your doctor may recommend a specific product, formulation, dose, and duration based on the ingredients and concentration in that particular product. Your “After Visit Summary” will contain information on where to purchase the recommended supplements, or your doctor may advise you to purchase the supplements from PIM’s in-office supplies.

Most PIM providers recommend supplements that can be ordered through our Fullscript dispensary or Doctors’ Supplement Store.  If it is difficult for you to order supplements online, our Patient Care Coordinators can order your supplements and have them drop-shipped to you. Please submit your order over the phone or via email. Be sure to include the following information:

• Manufacturer
• Exact name of supplement
• Strength
• Whether it comes in liquid, powder, or capsule
• The size of the bottle, number of capsules, or amount of liquid or powder
• Quantity needed

Please confirm your shipping address and billing information (ie. last four of your CC). In general, orders will ship out the following business day and take two to four business days to arrive.

You are always welcome to purchase supplements from another source besides PIM, if you prefer. However, supplements can vary significantly in quality, formulation, and potency, even when they appear to contain the same ingredients. For this reason, our doctors can only verify and provide guidance on products and manufacturers, they know and trust. We recommend being especially cautious when purchasing supplements through large online marketplace, mislabeling, quality, concerns, and counterfeit products can occur.

Supplement recommendations are never mandatory, and your care is not dependent on purchasing supplements through PIM or from a specific manufacturer. Our goal is to help you make informed choices and ensure that supplements you choose are appropriate for your individual care plan.