Should I consider hormone testing?
Do you experience fatigue, headaches and/or weight gain? These qualify as potential hormone problems, as well as hot flashes, night sweats, mood swings, PMS/PMDD, low sex drive, vaginal dryness, insomnia, abnormal or irregular periods, menstrual headaches, cyclical migraines, breast tenderness and postpartum depression.
Do I have to come off birth control prior to hormone testing?
If you are on hormonal birth control (birth control pills, Depo Provera shot, birth control patch, birth control ring/Nuvaring, Implanon implant or Mirena IUD), it is recommended that you come off your hormonal birth control to properly assess your hormones.
What do I do if I’m not ready to come off birth control?
If you are not yet ready to come off of your hormonal birth control, then come in for the initial consultation and you & Dr. Poppy can decide together on the timing of your hormone test. If you are on birth control pills, the patch or ring you can stop those, have a period (a withdrawal bleed from the hormones), then wait to have your period on your own (usually 4 weeks).
If you are sexually active and you do not want to become pregnant, please take precautions and either use condoms or abstain while you are coming off of your hormonal birth control and having your hormones tested.
Dr. Poppy does not place IUDs or prescribe every form of hormonal birth control. Dr. Poppy does prescribe some contraception. Aimee Alviar does not prescribe contraception. Both Dr. Poppy and Aimee will remove IUDs and implants.
My periods are irregular, how do I know when I should try hormone testing? I’m over 50 with regular periods, but not on birth control. I have had a tubal or vasectomy or I am not sexually active. When should I take the saliva test? I’m over 50 and not having periods (or periods are irregular), when can I take the saliva test? I’ve had a hysterectomy, when can I take the saliva test? These questions and scenarios are common but the answer differs on an individual bases. Dr. Poppy will discuss your specific situation with you at your appointment and help you figure out when would be the best time to test your hormones through saliva.
How much is a saliva test? Pricing ranges from $175-$200. How long does it take to receive saliva test results? We will automatically receive your results approximately 2 weeks after you have mailed it off. A follow up appointment is required to review these results and they will not be released to the patient without an appointment. We ask that you schedule your follow up appointment at the time that you purchase your saliva hormone kit. In the event that you are unable to do so at that time please contact us to set up an appointment to review these results with Dr. Poppy once you send the kit off in the mail. How do I get my saliva test? I live locally in Springfield (or in the surrounding towns). Can I pick up my test? You can come to the office and pick up a saliva test. I don’t live locally, how can I get my saliva test? If you need your saliva test mailed, there is a $10 shipping and handling fee. We do not ship locally. Do you offer any other types of tests? Dr. Poppy offers routine, screening and targeted blood work testing, including comprehensive thyroid and vitamin testing, MTHFR/homocysteine, which can be drawn in our office.
Do I need a Pap or Pelvic Exam. Can we do that at the time of consultation?
We can do a pap and pelvic exam at the time of consultation. However, please let us know so we can include that in your appointment. If it has been more than three years since your last exam, Dr. Poppy will likely recommend one, although it does not have to occur at the same visit if you want to wait. If you are unsure if you need one, you can discuss this with Dr. Poppy at the time of your initial consultation.
I have had blood work done, can the results be sent to you? Yes! Any blood work you have had done within the last year. Do you have copies of it, or can the results be printed off the internet through a hospital portal? The results can be faxed or emailed to us ahead of time ,or brought in with you at the time of the visit for review. If you’ve had blood work done, but do not have access to it, you can call the office where your blood work was completed and ask for a copy (there is sometimes a fee for that). You can also sign a release with us to fax to the doctor’s office to obtain your blood work results (or pap or mammogram/bone density reports etc). If a medical release form is necessary for your results we ask that you wait until your appointment so that she can specify which results she would like to receive. I haven’t had any blood work done, but I do have insurance. What do I do? You can have your blood work drawn at our office through Quest Diagnostics and submit it through your insurance, or our office can send a lab order to a different location of your choice so that you can utilize your insurance if you wish. (Quest, note: some insurances specify Lab Corp for blood draws).DISCLAIMER: If you choose to submit blood work, or pap testing through your insurance, please know that we do not have the ability to know if it will be covered or not. Patients with insurance can call their insurance company ahead of time to check whether lab work/paps/biopsies will be covered, and if so, you need to ask if it needs to be drawn at a specific location. It is your responsibility to know your insurance coverage, not ours. If lab work will not be covered, or you have a high deductible and assume that it won’t, you have the option of paying out-of-pocket. Our office prefers that you wait to have your blood work ordered until after your appointment with her when submitting to insurance so that she can provide the most appropriate diagnosis codes. I haven’t had any blood work done, but I do NOT have insurance. What do I do? If you do not have insurance, or have a high deductible and wish to pay out-of-pocket for blood work, you can have blood work done at our office. We have very low prices, however we do charge a $10 blood draw fee.
Can you send my pap or biopsies through my insurance? Yes, we can. We just need a copy of your insurance card to do so. Can you order tests at outside facilities that I need done (like mammograms, DEXA scans, colonoscopies, etc)? Yes, we can order tests at other facilities where your insurance can cover. It is up to you to check with your insurance to find out where they want you to have tests done. You are responsible for any deductibles/co-pays that are required by your insurance for tests that you would like to have done. What happens if my insurance denies the blood work and I receive a large bill? It is the patients responsibility to be to be informed of their insurance coverage and choose where have their blood work drawn and submitted through. We can not make any adjustments or add any additional diagnosis codes to blood work submitted through your insurance outside of your office. However, if you have your blood work drawn in our office and submitted through insurance with Quest Diagnostics we might be able to help. In this instance if you receive a large bill from what your insurance would not cover and it is more expensive than the cash price we offer, we can cancel the labs through your insurance and you can pay this discounted rate in our office.
- Initial Consult for New Patients, 1 hour visit $300
- Follow up appointments for Saliva Results, 30 min, $150
- Follow up appointments for Saliva Results/Questions/Exams/IUD Removal/Diaphragm Fitting: 30 min, $150
- Annual appointments: 30 min $200 or 1 hour $250
- Initial Prenatal Appointment for New Patients 1 hour, $150
- Initial Prenatal Appointment for Existing Patients 30min-1 hour $150
- Prenatal/Postnatal Follow up Appointments: 30min, $75
- (Follow up appointments for existing patients can be done over the phone. All phone consults are $150. This excludes Annual Follow up appointments, these must be in person)
- Buddy Package- Dr. Poppy offers a Buddy package to any two patients who come together and schedule appointments at the same time following one another (A $50 discount per appointment for New Patients and $25 discount per appointment for Annual Follow ups with existing patients).
- Extras: Lab fees (blood work, pap smears, biopsies) are extra and can be billed to your insurance if you have it.
- Do you accept insurance? No, we do not accept insurance. We are a fee-for-service office. In other words, we charge a specific fee for a specific service.
- This seems like a lot of money to see Dr. Poppy. Why does she charge so much? Compared to most specialty clinics, and anti-aging doctors who specialize in Bioidential Hormones and Wellness, Dr. Poppy’s prices are very reasonable. We invite you to research and compare. Most people come to Dr. Poppy because they want an in-depth approach toward healing. They desire expert help problem solving their hormonal and medical issues. They also want someone who will take the time to listen and preform detailed testing and evaluation. In this age of managed care and Obamacare, doctors are under more and more pressure to see more and more patients, for less and less time. Many patients have complex issues that require time and effort to sort out. When Dr. Poppy took insurance she felt that same pressure to see more patients, because insurance companies would not reimburse her for her time. She chose to step away from the insurance model, because she wanted to spend more time with her patients, and help them get to the root causes of their issues. Many people are happy and willing to pay for someone to partner with them in their healthcare, and choose to make an investment in their health and wellbeing. How do I pay for my visit? We accept cash, checks, credit cards, debit cards, Health Savings Account Cards and Flex Spend Cards. Do you accept payment plans? Yes we do. We require at least $100 at the time of the appointment. Approval for an automatic recurring monthly payment (until your bill is paid) from your check, savings, credit or debit card must be set up at the time of your visit. A follow-up appointment can’t be made until the initial visit is paid off. Can I get reimbursed from my insurance or cost-sharing organization? We are happy to provide you with an itemized bill and receipt for your insurance or cost-sharing organization. Due to the increasing complexity and time required to navigate ICD-10, we are no longer providing HICFA insurance reimbursement forms. We will only provide diagnoses for cost-sharing organizations if requested.
Will Dr. Poppy tell me what supplements I should take? She will generally make supplement recommendations, after a full review of your history, as well as you saliva and blood work results. Does Dr. Poppy deal with thyroid problems? Yes. She is very comfortable treating most common thyroid conditions. She uses specialized iodine and thyroid testing, as well as a variety of thyroid medications.
We must revamp our approach to prenatal care. Testimony to that statement comes from the fact that the maternal mortality rate in the US is rising, not falling. There are many reasons for this change, which disproportionately affects Black, Native and Hispanic women. Obstetric patients are frequently only seen for 5-10 minutes by their provider, with a brief review of urinalysis, blood pressure, weight and fetal heart tones. Unfortunately, prenatal care has remained relatively unchanged in the last fifty years, with the exception of prenatal diagnostic testing. Often there is little time committed to education and support.
Functional Medicine is defined as a systems biology-based approach that focuses on identifying and addresses root cause of disease. Applying this functional model to the Obstetrics world is an area that has remained relatively unexplored. While there are many societal and cultural reasons why our maternal mortality rate is rising, Functional Obstetrics applies a Functional Medicine approach to get to the medical root of our poor OB/perinatal outcomes.
In spite of its widespread use, prenatal care in its current application has debatable cost-effectiveness and is often inadequate in reducing poor outcomes. Dr. Poppy’s offices uses a combination of medical, hormone and vitamin testing to optimize wellness in pregnant women. Prenatal, postnatal and breastfeeding support is encouraged. A plethora of birth options are explored in the context of a woman’s medical, social and obstetrical history. The Functional Obstetrics co-care that is provided at Dr. Poppy’s office helps to position women to be in a healthier and more informed position to advocate for themselves in whatever place they choose to birth. An individualized program of medical care, hormone support, pharmaceutical grade supplements and on-going monitoring are available to pregnant women interested in the Functional Obstetrics model. We are looking forward to offering group prenatal visits utilizing this model in the very near future!
We are experiencing a global epidemic of male and fertility hormone imbalance, infertility and sperm problems. This is primarily environmental although there can be some genetic factors that contribute to fertility issues, such as methylation. Unfortunately, it can hard to get help for fertility problems because many doctors no longer do much in-depth fertility work and simply issue a referral for IVF (in-vitro fertilization). For many couples, in-vitro is not an option or is a last resort. Many wonder if there is a more personalized evaluation/treatment plan for fertility or if there is a more natural-minded approach. We have coined the term Functional Fertility to describe our belief that fertility problems have causes and solutions that do not necessarily always require over-riding the physiological system of reproduction with IVF. Functional medicine is defined as applying a systems biology-based approach that focuses on addressing root causes of fertility conditions.
Our approach is to view the couple as a fertility unit and generally start with hormone testing and broad-based blood work. Charting of cycles is essential and can be very helpful to identify more subtle sub-fertility problems. High quality supplements and sometimes bioidentical hormones and ovulation induction agents can be used. Each patient is treated as an individual and a care plan is constructed based on that person’s or couple’s issues. Sometimes, there are multiple small issues that add up to a bigger problem. Some patients require more intensive medical therapy or a surgical evaluation/treatment. Our goal to help the patients understand what options they have so they can feel better armed to make decisions about how to grow their family. Most importantly, while our wholistic approach to fertility can require some financial investment, it is almost always less expensive than IVF or the traditional adoption process. We so enjoy helping a couple with their fertility journey. Let’s get started!
Does Dr. Poppy do phone consultations? Dr. Poppy can do phone consultations for patients that live at a distance, or in another state. If a patient lives in a state where Dr. Poppy does not have a medical license, the patient has to come to see her face-to-face for a consultation, the patient has to come see her in person for a face-to-face visit at least once a year. Dr. Poppy can do a phone consultation for a patient that lives out of state, however she can not prescribe medications unless the patient comes for a face-to-face visit. Dr. Poppy does have many patients that travel from out of state to see her. Can Dr. Poppy be my primary care doctor? Dr. Poppy is an Obstetrician/Gynecologist and a Hormone Specialist. We do not offer primary care options at this time. Can you refer me to another specialist if I need one? Of course! Does Dr. Poppy see men? Yes. She sees men for hormonal and fertility conditions, as long as they have a primary care provider for their other medical needs. Do Dr. Poppy and Aimee Alviar see kids? Not usually, unless they are having a gynecological or hormonal problem. They will provide care for adolescent girls who have started menstruating. How do I find out more about Dr. Poppy? You can follow Dr. Poppy on Facebook at Dr. Poppy and on Twitter, Instagram, Pinterest @drpoppybhrt.
Due to the recent Covid-19 pandemic, many states have lifted and softened their telemedicine rules in order to allow their residents to get medical care more easily. Please consult your state’s Board of Healing Arts/Telemedicine Rules in order to determine if you are allowed to access care at our office virtually. Out of state patients are always welcome to visit in person at least once a year in order to be prescribed medications.