Frequently Asked Questions.

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General. 

How is Tulsi Square different from other Medical Practices? 

We spend time with patients, offer more specialized labs and dig deeper into current symptoms, diagnoses and overall health. We specialize in the use of natural therapies, lifestyle and nutrition interventions to support your health goals. Naturopathic and functional medicine also integrate well with pharmaceutical medications and we are trained in pharmacology. 

Can Tulsi Square review my previous lab work? 

Yes, absolutely. We encourage patients to upload their prior lab work before their initial visit. This is true for all traditional labs/imaging, to genetic testing and everything in between. 

What do health plans look like? 

Recommendations may include lifestyle modification, lab testing, nutritional counseling, botanical medicine, homeopathy, nutraceuticals, health appliances, hydrotherapy, environmental medicine and more. We meet the patient where they are at, meaning, we won’t make any recommendations that are unrealistic for you. We do however, encourage individuals to challenge themselves and to take steps outside of their comfort zone. 

What is Naturopathic Medicine? 

Naturopathic medicine is a distinct primary health care profession, emphasizing prevention, treatment and optimal health through the use of therapeutic methods and substances which encourage the person's inherent self -healing process. The idea that our bodies can heal themselves when nurtured appropriately and when the obstacles to healing are removed is at the heart of naturopathic care. 

After receiving a bachelor's degree, Naturopathic doctors undergo a rigorous 4 year medical program which includes 1.5 years of clinical training. Both Dr. Pisacano and Dr. Shettell received their degrees from the state of Arizona, which has the largest scope of practice for Naturopathic Doctors. Therefore, within their education and clinical training, they both were trained to prescribe and manage pharmaceuticals, perform minor surgeries such as lipoma removals, act as primary care physicians, diagnose medical conditions, order lab work and imaging, and make referrals to other healthcare providers such as specialists, when appropriate. Having this medical training separates Naturopathic Doctors from many alternative practitioners since their education is not limited to their field, but overlaps the training of traditional Medical Doctor training. 

What is Functional Medicine?

Functional Medicine is a systems biology–based approach that focuses on identifying and addressing the root cause of disease. Each symptom or differential diagnosis may be one of many contributing to an individual’s illness.

For example, depression can be caused by many different factors, including inflammation. Likewise, a cause such as inflammation may lead to a number of different diagnoses, including depression. The precise manifestation of each cause depends on the individual’s genes, environment, and lifestyle, and only treatments that address the right cause will have lasting benefit beyond symptom suppression (IFM).

What are appointments like?

We invest a large block of time with each patient in order to find the root cause of their condition and offer individualized treatment plans. We may spend up to 2 hours for a new patient visit and up to 45 minutes during follow up appointments in order to better understand the patient's medical history and current health status. We also spend a significant amount of time outside the appointments researching up-to-date information on your specific condition. When you meet with your Naturopathic Doctor, they will review your health profile and possibly suggest lab work. After lab work has been reviewed and we have a confident health assessment, your health plan will be recommended. From there on out, future appointments will involve health coaching, tweaking of your health plan, lab comparison (ex: running a cholesterol panel to see if your lipids have improved), and symptom review. 

Scheduling and payment.

How do I schedule?

Appointments may be scheduled on our website, by phone or by email.

What if I cancel my appointment?

There is a 24-hour cancellation policy for all appointments with Kiwi Health. Canceling within 24-hours will result in a $100 charge to the credit card on file. However, we will not charge you for your first visit cancelled within 24 hours.

No-shows: If you do not show up to a phone, video/telemedicine or in person appointment without notifying the specific person you have an appointment with either via email or by changing the appointment by phone more than 24 hours prior to the appointment, you will be charged $50 to the credit card on file.

What are my payment options?

We accept credit/debit cards and cash. When you create a profile through Practice Better, you will be able to make payments online. We also accept HSA & FSA payments however, we cannot guarantee HSA and FSA will be accepted. If you are enrolled in a membership program however, a card must be on file to charge monthly. Otherwise, the membership must be paid-in-full upfront. 

*HSA = health savings account

**FSA = flexible savings account

Membership.

Why should I choose a membership instead of pay as you go?

When we started Tulsi Square, we decided we wanted to do a membership model to instill commitment. We recognize that it is human nature to procrastinate. With health goals, we want to limit procrastination. It is easy to want to put off getting labs drawn, or scheduling your next visit. With the membership model, the commitment is built into the program. We want to work with individuals who are willing to commit to their health for 4 months or a year. When patients delay scheduling, many times, when we see them for their second visit, they may have fallen off the bandwagon and sometimes, are feeling even worse. We want to work with you through your membership month-by-month to give you the best outcome possible. It holds both the healthcare providers and the patient accountable to commit to the patient’s health. 

What if I decide a membership is not right for me after enrolling?

No worries. We understand that life changes. We allow 30 days for the 4 month plan and 3 months for the 12 month plan to cancel your membership. When you cancel, you will be charged the full price difference for all appointments you have used. Further, you will be charged the difference in supplements, lab tests and services that were discounted at a membership price.

What membership discounts will I receive?

Members receive discounted visits, add-on visits (if you add appointments to your plan during the timeframe of your membership), 10% off of supplements and lab work (excluding blood work not covered by insurance or outside procedures), and additional savings on other Tulsi Square services. Further, you will have access to deals with local participating health partners. 

What does unlimited messaging entail?

Unlimited messaging is intended to keep you on track and are for check-ins or questions about supplement or health plan recommendations. Patients have unlimited messaging contact with our healthcare providers. We will answer within 48 business hours excluding holidays. However, if an email question or request is deemed by one of our doctors to be too complicated or involved for a response via email they may, at their discretion, require that the member schedule a phone, telemedicine or in person visit instead of responding via email. If you have questions about billing, appointment times, rescheduling, orders, or non-medical questions, please contain our management staff at hello@tulsisquare.com and they will assist you with your needs. 

What does the breast health assessment mean for me?

The breast health assessment informs us about your potential risk of breast cancer and what short term and long term strategies we can use to optimize your health and prevent disease. The breast health assessment is not meant to diagnose or treat breast cancer. It is a tool we use to help women be active in their breast health and understand their risks.

Insurance.

Do you accept insurance?

No, we are not in-network with any insurance plan. The cost of all Tulsi Square and Kiwi Health services will be billed to you directly. We do however, accept FSA and HSAs but as always, it is at the discretion of your savings account to approve charges from Tulsi Square and Kiwi Health. Further, general blood work is generally covered by insurance. This excludes specialty testing, which is not covered by insurance. You can, however, submit specialty testing to your insurance after paying for reimbursement.

Tulsi Square will not submit a medical claim to insurance on your behalf. We cannot assist you with claim resolution for our services.

We will provide you with a detailed billing summary upon request that you may submit to your insurance provider.

Supplements and labs.

How do I order supplements?

We recommend supplements that can be picked up in office or delivered to your door. In some cases we use a service called Fullscript. When a recommendation is made to you via Fullscript you will receive an email to create an account with Fullscript in order to place your order. Fullscript allows you to order prescribed nutraceuticals online to be delivered to your home. Prescription re-ordering and adjustments can also be made through FullScript. If you have a membership, your discount will apply to your Fullscript portal. 

Where do I complete my labs?

Each lab differs on whether it will be picked up at our office, delivered to your home, or drawn at a lab. Turn around time for labs can be anywhere from 1-4 weeks after the lab is completed. You will receive an email confirmation when your labs are received with a reminder to schedule an appointment to review the labs. For specialty lab testing not available in office we use a service called Rupa Health. Here, you will receive an email with all of your labs listed. They will ship your labs directly to you with instructions. If a lab through Rupa Health is suggested to you, please contact their help support at support@rupahealth.com and they will assist you on shipping, test  instructions, mailing, billing questions etc. 

What tests are offered?

We offer traditional screening labs and blood work as well as advance testing to look deeper at your current health status. Labs are ordered on a case-by-case basis, so it is best to schedule a 15 minute consultation to find out how labs may be arranged for you personally.

Health Information.

How do I fill out my patient paperwork?

When you book an appointment, you will be sent an email with a link to create a patient portal through Practice Better. This is a secure medical records system where you will be able to fill out your patient paperwork online. It is required you fill out your paperwork at least 24 hours prior to your new patient appointment.

How long will it take me to fill out my paperwork?

Our initial intake forms are very detailed and review every part of your health. Please allow 2 hours to fill out your paperwork. We appreciate your commitment in answering these questions. 

Medical Emergencies.

What if I have a medical emergency?

We do not have a 24-hour answering service and do not take calls on weekends. If you need to be seen urgently or have a medical emergency you would need to visit an ER, urgent care center, or call 911.