Welcome Letter

Welcome

It is a pleasure to welcome you to Better Health with Nicole. I strive to create the most open,

nourishing and effective healing relationship possible with my clients, while bringing you the best

in conventional and traditional medicine. While getting healthier does take commitment and

sometimes big changes are needed, my goal is to make this joyful and as smooth as possible

for you.

While I can’t guarantee every result of your dreams, I can guarantee you an honest partnership

and guidance. I have seen many amazing things happen for my clients.

I recognize you are making a commitment as well. Making changes can be daunting and

sometimes even more so if you’ve “tried everything”. I look forward to supporting you.

Please read this letter completely, it covers everything you need to know about working with me.

Thank you for taking the time to read the important details.

Practice basics

I’m located at 1175 Call Creek Place Suite 100 H, Pocatello Idaho 83201. My electronic medical

record is called Athena. You can review your plan after each visit in the portal within 48 hours of

your appointment, view your labs, and securely communicate with me. Your participation and

utilization of the portal fully is for your benefit and mine.

Set up your portal on your computer ASAP. This is the easiest way to sign off on all forms. Your

phone will not work for this task. Once these forms are signed, you may use your phone or

computer to message me through the portal. I ask that you upload a photo of yourself, this will

link with your chart. Once you are signed in, look on the left side of the screen. Click on My

Health, then forms and documents. There are 6 forms you need to complete; Welcome Letter,

HIPAA, Consent to use email, Release of Billing Information, Consent for Sale of Nutritional

Supplements and Informed Consent HRT. If you have other providers you would like your

information shared with, print and sign the release of information form as well. (Please bring

with you to your appointment.) If you have any questions, please contact me.

If you are seeing the practice for  If you are seeing the practice for a complex medical issue, I may ask you to complete additional forms. I ask that you have them sent to me at least 10 days prior to your first appointment. Please also have a copy of your medical records covering the last 12 months sent as well. You can utilize the release of information in the portal to obtain your records. These can be faxed to 833-471-4276. You are also able to upload the records via the portal under messages. All medical questions are to go through the portal so that they are safely stored in your medical record.

Practice Policies

I strive to make all communications and polices as clear as possible in order to be able to focus

our attention together on your healing and our relationship. I ask that you read all the enclosed

information carefully and complete all requested intake forms no less than 10 days prior to your

appointment.

In the event that a review of your medical records suggest your medical situation may not be

appropriate for Better Health with Nicole practice model, then Nicole CNM will call to speak with

you about other recommended providers.

Appointments

If your appointment is your annual exam, please get your records sent to my office. If we have

determined labs prior to your appointment please be sure to complete these 10 days in

advance. If you are coming for more complex health problems, I may ask you to complete additional forms in the portal. These will be our template in moving forward in your health plan. You can anticipate your first visit to last 45-60 minutes to discuss your symptoms, health concerns, medical, family and personal history, your nutrition, sleep and exercise as well as information that will help me understand the factors contributing to your health concerns. We will also review previous labs and medical records from your primary or specialty physicians. You may also have a focused physical exam as necessary.

At the end of the visit, I will recommend any further lab test, answer questions and suggest an

initial health plan to begin to move forward in your health plan. Your second appointment is

based on what concerns we are working with as well as having adequate time to make changes

and to see lab results as well as physical symptom improvement. This appointment is typically

in 6-8 weeks. These visits are typically 30-45 minutes.

Fees

I can bill insurance for you, or you can self pay. Wellness visits are once per year and are

typically covered completely by insurance. All other visits are applied to your deductible. If you

think you will meet your deductible then billing your insurance is probably your better choice. If

you don’t typically meet your deductible, your cost out of pocket if you self pay is discounted by about 25% from what it would be if I bill your insurance. Payment in full for self pay appointments is expected at the time of service unless otherwise agreed upon. Please understand that any outstanding balance left by your insurance is your responsibility.  Please pay the balance of your bill within 14 days of receipt of invoice or call the office and set up a payment plan. 

This is the same for labs. When bills go through your insurance other than your routine annual

labs they typically bill out at 4-6 times the amount of cash pay. Once it goes through your

insurance, there isn’t a way for me to change the cost to self-pay. Insurance only covers one set

of wellness labs a year. Anything other than a CBC, CMP, lipid panel and TSH all are billed

through your deductible.

I work with Ruppa, Ulta and Evexia for self pay pricing. Express labs has self-pay pricing on

their website that you can look up. Many of my hypothyroid clients utilize these services as it is

typically $70 versus $150. The same is true if we are doing larger lab panels to determine what

is causing problems. With typical larger lab panels ran through the hospital or Labcorp the price

is often several hundred dollars more when billed through insurance than if you self pay. There

is no guarantee what your insurance will cover. You can choose to have these same labs ran

through Ulta, Ruppa or Evexia for $300-$400. Please let me know what you prefer. Once

insurance has been billed I can’t change you to self pay to get the discounted price.

Appointment Cancellation/Rescheduling

I am a small independent private practice dedicated to your health. This makes it possible for us

all to work together to focus on your wellness. I don’t double book clients. Your spot is reserved

for you. If you need to reschedule your appointment, I would appreciate you letting us know as

soon as possible so we can potentially see another client during this time. If you cancel your appointment with less than 24 hours notice you will receive a bill for $75. If you no-show your appointment, you will be billed in full for your visit. This fee is required because another patent, who needs treatment, could have been scheduled and treated in this time slot. 

Late Arrivals

I am committed to being on time with your appointment. If you arrive late, the office visit for your

appointment will end at the scheduled time. If you have not submitted your medical records at

least 72 hours prior to your appointment then the first 20 minutes of your appointment may be

dedicated to reviewing your chart and records. An additional appointment may need to be

scheduled to complete your full intake.

Payment options

I take cash, check or credit cards. You can also use your HSA to pay for visits.

Medical records

Medical records can only be released by your authorization. It is your responsibility to obtain

previous medical records from other prior clinics and providers. You can download the form in

the portal for your convenience in obtaining these records. Your records can be faxed to

833-471-4276.

Insurance 

I take most insurances. You will want to check with your insurance to see if I am in your network. Insurance covers one annual wellness.  All other visits are applied to your deductible.  I strive to make costs reasonable.

Phone and messages

THIS OFFICE DOES NOT TAKE MEDICAL EMERGENCY CALLS

If you have a medical emergency, call 911 or go directly to the emergency room. I may not

always get through all of the patient portal requests by the end of the day and therefore cannot

guarantee immediate prescription refills or urgent answers.

Please be sure that all messages are to go through the patient portal and not to my email,

messenger or personal text. I really do love to help but I can fail to keep up with all the

messages I receive in these areas. The patient portal keeps your needs present till I have taken

care of them. I want to do a great job helping you in your health. Please keep messages and

refills sent to the portal.

I encourage you to use the patient portal to speak with me with questions or prescription refills.

This keeps track of our plan so either of us can refer back to what was said. It is the same for

prescription refills. The system doesn’t allow me to delete a message without handling it first.

Phone messages can sometimes be forgotten due to not having reminders and a busy day.

If you need to call the office, The Better Health phone number is (208) 261-4233. Please leave a

message with the following information:

● Your full name, spell your last name and date of birth.

● Reason for call.

● Best times to call you back and whether I may leave a message for you.

Everything going through the portal is in a secure system. I cannot guarantee a secure email

system or encryption through any other means of communication.

If you have questions that require a longer discussion, then consider making an appointment

instead.

I do not have an answering service, while I attempt to respond to calls regularly, please give me

up to 72 business hours to respond.

Prescription Refill request

It may take up to 10 days to get your prescription refilled . Several times a year I’m in the

back country and there is no access to me or a computer system. You will need to plan ahead to

avoid any interruption to your medications.

Supplements

Clients are able to purchase most recommended supplements through Fullscripts.com by using

the patient portal at 20% or more discount on retail price for any supplement purchased there.

There is no obligation to purchase supplements through the practice. I do my best to assist you

in sourcing supplements that are recommended but not carried by Fullscript. You don’t have to

use supplements. When available, I try to source food or other sources.

Emergencies and after-hours care

Please note I do not act as an urgent care provider . I recommend you have an alternative

primary care provider. If you incur a serious health problem that requires immediate attention,

then you should call your other provider or 911 or go to your nearest hospital emergency room.

If you notice an adverse effect from one of the components of your health plan, you should

discontinue and then contact me through the portal.

Recording Appointments

Electronic recording of appointments and/or conversations with me is prohibited. I understand at

times this is helpful for remembering what was discussed. If this is necessary for you, we can

discuss the matter and I will give you approval in writing. It is illegal and unethical to record a

medical appointment without the knowledge of the medical provider.

Differently-abled Access

While my office is wheelchair accessible, I do not own a table that can accommodate someone

who needs more accessibility. Upwards of 80 % of all medical diagnosis can accurately be done

without a physical exam. If you require a physical exam then it would be recommended to have

an additional provider who can provide those services.

I look forward to working with you.

To your best health,

Nicole Lamb MSN.,CNM