Frequently
Asked
Questions

Do I need to have Long COVID (suspected or confirmed) to receive care from RTHM Clinic?

No. We are currently accepting patients with confirmed or suspected Long COVID (triggered by infection or vaccination), ME/CFS, dysautonomia (including POTS & orthostatic hypotension), mast cell activation, Hashimotos, hypothyroidism, SIBO, and/or IBS. The new patient application is now open to patients with the illnesses listed above!

Are you accepting patients under the age of 18?

Not at this time. We are currently only accepting patients age 18 and up. We are looking to expand access to ages 6 through 17 soon.

Can I become a RTHM patient if I developed Long COVID symptoms after a COVID-19 vaccination rather than from COVID-19?

Yes, we accept patients who developed Long COVID symptoms after vaccination as well as after infection! We are interested in the mechanisms behind “vaccine long haul” and how they are similar and different from “infection-induced long haul.” At RTHM, we feel it’s our duty to help the people who got the vaccine to help protect themselves and those around them and then suffered ill effects.

Does RTHM have a minimum membership duration?

Yes. Treatment of Long COVID, ME/CFS and other related chronic conditions is a journey, there is no magic treatment that works for everyone (yet). Due to the thoroughness of the evaluation, the complexity of the illness and the time it may take to get certain testing or outside referrals completed, we ask for patients to commit to an absolute minimum of three months with us.

What should I expect from my provider visits?

During the consultation, your RTHM Care Navigator will review your medications and supplements at the beginning of the visit, then the provider will join the visit and review your medical history & symptoms, vitals, current treatments, and determine what labs, imaging and testing are needed, and either set up or modify your treatment plan.

From our experience so far, having more frequent visits allows your team to more quickly and thoroughly assess and manage over 300 aspects of your health that could be contributing to your symptoms.

For the first 2-3 months at RTHM you will be having visits with your RTHM provider every 3-4 weeks and labs drawn every 1-2 weeks.

You will track your symptoms using a provided symptom tracking form, vitals (via your preferred wearable device), and any medications you start, stop or change each day. This is a critical part of letting your RTHM provider see which treatments are working well for you and which can be stopped.

Visits during months 4-6 are generally every 4-6 weeks to update your treatment plan based on how you have responded to each therapy tried since the last visit, as well as doing any follow-up testing that is required.

Visits during months 7-12 are generally every 8-12 weeks to adjust treatments according to your responses to them, manage refills and prior authorizations for effective treatments, and order any additional workup that may be required.

Any prescriptions or supplements that are recommended will be sent to your pharmacy or through Fullscript or another reputable supplement distributor.

If a pharmacy prescription is very expensive, or not covered by your insurance, please check GoodRX.com for a coupon for your medication (there are many excellent discounts you can get on prescription medications). If the medication costs >$50 despite the coupon & it is helping your symptoms, we will submit an insurance prior authorization to try and get the medication covered for the following month, however, prior authorizations for off label use of medications may often be denied – we cannot guarantee insurance coverage, just work with you to try to reduce medication costs and find any alternatives as best we can.

Will RTHM Clinic replace my primary care physician?

No, RTHM does not replace your primary care physician. You are required to have a primary care physician while you work with RTHM.

RTHM focuses on complex illness medicine rather than primary care and will do our best to coordinate WITH your primary care physician to care for your Long COVID symptoms and conditions.

We recommend seeing your primary care physician for age-appropriate cancer & disease screenings and management, as well as for acute issues (e.g. urinary tract infection, strep throat, etc.). We do not have providers on call after hours to handle acute care problems. For acute care issues, please see your local primary care, urgent care, or ER.

Will I be required to complete any in-person visits?

All appointments with your RTHM team are virtual/telehealth visits. You may need to go to a nearby lab to have blood (and possibly urine or saliva) tests done, go to an imaging center, or visit certain specialists as recommended by your RTHM provider. Your RTHM team will work with you to locate a specialist, imaging center, lab draw location, or arrange for a mobile phlebotomist to come draw your labs at your home for a fee.

Can I get as much testing done as possible to figure out answers in the shortest possible time?

You can, but it is A LOT of blood to have drawn at one time, so we generally order it in segments and have patients get a smaller volume of blood drawn every 1-2 weeks, especially if you have post exertional malaise (PEM or PESE), tend to get lightheaded easily, or know that you tend to become more symptomatic after blood draws.

If you are anemic, iron deficient, or get very ill with blood draws, please let your RTHM provider know at your first visit. There are some lab companies that can run more labs on less tubes of blood, but they do not accept insurance. Using such a lab may be a better option for you.

What data will I have access to and can I share my data with non-RTHM providers?

You will have access to our patient portal, your health plan summary from each provider visit, your health history summary, health metrics, vital signs, lab and imaging results. Research data used for diagnostics development is not available for download until we have published it. You will have the ability to download your clinical data and/or share it with your providers outside of RTHM (we encourage this!).

What kind of medication can RTHM provider prescribe for me?

We cannot prescribe any controlled substances or any medication that requires an in-person exam prior to prescribing. You will need to have any controlled substances prescribed by one of your local medical providers.

In which US states can RTHM see patients?

We currently can see patients in California, Colorado, Washington, Oregon, New York, Florida, Massachusetts and Texas with additional states coming soon. We cannot provide care for patients outside the US.

Does RTHM follow the Sunshine Act?

The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public. The information can be accessed here.

Can I join RTHM Clinic if I don't have health insurance?

No, not at this time.

We are also unable to accept patients with Kaiser Permanente, VA or TriCare, or Medicaid (MediCal in CA) health plans because such plans do not legally allow patients to pay cash for parts of their care, and others generally do not cover labs, procedures, imaging, referrals and treatments ordered by clinicians who are not within their respective organizations.

We are not contracted or in network with any health insurance provider at this time, but are actively working on becoming in network! It turns out every clinician has to be registered for every insurance plan in every state…separately. There are multiple hundreds of insurance plans across the US, so this effort has been taking longer than we’d hoped. We appreciate your patience!

Does RTHM accept my health insurance?

Lab tests run through Quest Diagnostics are generally covered by most PPO health insurance plans, with some exceptions. For RTHM membership costs, we are not currently in-network with any health insurance carriers and are not able to bill insurers at this time.

Can I use my HSA or FSA?

Your Flexible Spending Account (FSA) or Health Spending Account (HSA) can be used to pay for many of the costs associated with your care through RTHM, including the RTHM membership costs. Please see the details of your health plan’s HSA or FSA for more information.

Does RTHM provide superbills so I can use my out-of-network insurance benefits?

Yes! RTHM can provide you with superbills for your visits if you wish to try to get some of the costs reimbursed on your own through your out-of-network insurance benefits.

Will lab tests ordered by my RTHM provider be covered by my insurance?

This answer depends on your individual insurance plan, as each has different laboratory testing coverage policies & rates. Our providers order labs through Quest Diagnostics because Quest is contracted with most major PPO insurance plans. If Quest is a contracted lab for your insurance plan, most of the labs ordered by your RTHM provider through Quest should be covered, but please check your individual insurance plan (since Quest is the one that bills your insurance for the labs, not RTHM). Your deductible and co-pays may still apply to lab costs.

If you wish to have more of the costs covered by your insurance provider, you are going to have to address this matter yourself with your insurer.

What if I have an insurance plan that does not cover labs done at outside labs like Quest Diagnostics?

Then, unfortunately we will not be able to have you join RTHM as a patient.

The labs we order can be quite expensive and are generally not affordable without insurance coverage.