Frequently Asked Questions:
Here is an FAQ of some of the most common questions we hear at Wise Woman Wellness De Pere. If you don’t see your question listed below, please give us a call at 920-339-5252. We’d be happy to answer your questions.
Will insurance pay for my visit?
Yes, our services are covered by many commercial insurance plans.
Please check with your insurance carrier for information about your coverage. Depending on your plan design, we may be considered an “Out of Network Provider” for you and your coverage may be at a lesser rate than if you were seeking care from an “In Plan” or “Participating Provider”. You may also have a separate deductible to meet when seeking care from an “Out of Network Provider”.
Do you accept any government sponsored insurance plans?
When do I pay for my visit?
You will be asked to pay for your visit upon scheduling your appointment.
How can I save money on the cost of my visit?
Who submits my charges to my insurance company?
What if I am having financial difficulty and cannot afford the cost of my visit?
Can I use my Health Savings Account dollars to pay for my visit?
Does my visit qualify for reimbursement under my Flex-Spend or Medical Reimbursement Account If I have one?
How many office visits will I need?
The North American Menopause Society recommends that women using female hormone medications be evaluated every 6 months. Occasionally other health conditions, increased stress, lifestyle changes and aging can cause further hormonal imbalances and the need for additional appointments.
If you are starting thyroid medication your dose may need to be titrated or adjusted upward gradually and this can take several visits. Once your symptoms are well managed you will need to be seen every 6-12 months for ongoing management. Thyroid lab tests are required annually or more often if needed.
Do you schedule telephone consultation appointments?
For new patient to our practice, your first appointment will be in person as you will receive a brief physical exam (above the waist only). Please plan on it taking 2.5-3 hours. All follow-up appointments may be in person or virtual depending on your preference and unique situation.
What type of hormones do you prescribe?
We are experts at prescribing bioidentical (some call these natural) hormones including estrogen, progesterone and testosterone. The term bioidentical hormone has come under fire in the past few years. It used to be considered a medical term but recently the FDA has called this a marketing term.
No matter what we call it, bioidentical hormones are simply hormones that are made in a laboratory out of soybeans or yams that exactly match the molecular structure of those produced in the human body. It is Randi’s experience (and many other practitioners who are experts at prescribing bioidentical hormone therapy) that many women may experience less side effects on these types of hormones, especially when the dosing is guided by dried blood spot hormone testing and severity of symptoms.
We are also experts at prescribing various types of thyroid medication for hypothyroidism at Green Bay. We have learned that “one size does not fit all” in terms of best thyroid treatment. We are willing to spend the time to help you get on the best medication (we prescribe many different forms of thyroid medication) and the right dose for you to help you “feel like yourself again”.
Can you prescribe compounded, low dose, bioidentical hormones that are made especially for me?
Special pharmacies called compounding pharmacies make up each prescription using USP ingredients at the time the medication is ordered. All compounding pharmacies are regulated through each state’s board of pharmacy. Your individually compounded hormone medication is mailed to you, usually within 1-3 business days after it is ordered.
What compounding pharmacy do you work with and why?
They were the first compounding pharmacy in Wisconsin to receive the prestigious seal of accreditation for the Pharmacy Compounding Accreditation Board®. This is important as it assures adherence to standards of quality and consistency in regards to your medication.
If you prefer to take your hormone therapy in standardized doses we work with all local and mail order pharmacies.
Are compounded hormones covered by insurance?
Compounded hormone therapy is covered by many prescription drug plans. It may be less expensive to pay for the hormones yourself than to pay your insurance co-payment amount for each hormone depending on your pharmacy plan benefits. Compounded hormone therapy may cost less than some standardized hormone medications.
How does Wise Woman Wellness care differ from care I might receive from my regular provider?
We stay up to date regarding the latest options available for PMS, peri-menopause or menopausal care along with adrenal and thyroid issues and offer the time necessary to really understand your unique needs. Your first visit at Wise Woman Wellness will last approximately 120 minutes. You and your hormonal imbalances are unique so a treatment program will be tailored specifically for you. We offer the best of both conventional and complimentary care and find many patients appreciate the additional integrative and functional medicine suggestions given regarding many of their symptoms.
Can you provide all my primary care?
Can you test my hormone levels?
We recommend dried blood spot testing to evaluate your estrogen, progesterone and testosterone levels and saliva testing to evaluate your DHEAS and cortisol levels (x4). Published research regarding this type of testing has validated its use and accuracy. We may order urine testing for iodine levels
We offer specialized thyroid testing as well and often order serum blood testing for TSH, FT4, FT3, RT3, TPO and TG antibodies. We may also evaluate your intracellular thyroid function by specialized reflex speed testing.
We may also order testing to evaluate your daily bone loss to help assess your ongoing risk for osteoporosis. At times we also may suggest other serum or radiologic testing depending on your unique needs.
How often will you retest my hormone levels?
Topical creams can cause accumulation of hormones over time. An initial dose that provides excellent symptom relief may eventually be too much. It is important to regularly monitor hormone levels and patient’s response to assure dosages are appropriate.
If symptoms require a dosage change a follow-up test is done 3 months later to assess how you are absorbing and responding to your hormone treatment. It is important to perform this follow-up test on time to avoid any over or under dosing of your hormone medications. Our patients tell us their customized treatments frequently help them “to feel like themselves again.” You will be charged for each appointment to review your results and revise your care plan.
How can I learn more about menopause, treatment options and hormone testing?
Women are strongly encouraged to attend the introductory “End Hormone Havoc- Stay Sane, Slim and Sexy” seminar to learn more about the menopausal transition, thyroid and adrenal issues, hormone testing and treatment options.
Our hormone seminar is offered several times each month. Seating is limited to 30. Please call 920-339-5252 for dates and times and to register. Prepayment is required to reserve your seat.
Education is a powerful ally when it comes to understanding our bodies and times of hormone change. We know from experience that patients who attend our seminar have better health outcomes and are better equipped to take care of themselves during times of hormone transition. For this reason, we require attendance prior to your initial appointment.
Can I purchase a hormone testing kit at the seminar?
Hormone test kits are available for purchase at the seminar.
Baseline – Estrogen, Progesterone, Testosterone, DHEAS and 4- point Cortisol (combination blood spot and saliva tests):
BASELINE testing includes estrogen, progesterone, testosterone, DHEAS & 4-point Cortisol levels (Note – this does NOT test thyroid function. We will discuss if you need thyroid testing at your first visit). Responsible hormone care requires regular retesting while taking hormones to assess your response and absorption. This may be ordered 3 to 4 months after starting hormones, after dose changes, yearly, or more often if needed. There are separate charges for each office visit to review your results and ALL follow-up hormone or thyroid testing. The cost of hormone testing may be covered by some commercial insurance plans after you submit your receipt. We recommend you contact your insurance company to verify your specific benefits. Cost: $458
Prompt Purchase Discount:
There is a $25 discount if you purchase by the end of next business day after the presentation. Cost: $433
Vitamin D – Blood Spot Test (Optional):
Additional optional test if you have not had your Vitamin D level tested within the last 3 months. Cost: $150
Through the seminar attendance you will become educated about hormone changes and the many available treatment options. This allows us to focus more on your individual needs at your first appointment and less on the basics of hormone treatment options.
If you take the hormone test prior to your first visit, we will be able review your results with you at your first appointment as well. This saves you the time and the cost of a second medical visit a few weeks apart if you choose to test directly after your first visit.
When do I learn about my test results?
Your results are usually available approximately 3-4 weeks after you test. You will schedule a medical appointment to discuss your results after you receive notification that your test results are ready. You will be charged for each medical appointment to discuss your results. It is important for your health and best treatment outcomes to fully assess your symptoms along with your test results before prescribing any hormone medication or make any dosage changes.
Can you adjust my hormone doses in between office visits?
It may take up to 12 weeks of hormone use to receive the full clinical effect. Prescribing hormone medication is done very carefully. These are powerful molecules and changes are made incrementally. We are unable to make hormone medication changes without properly assessing your health and symptoms during a visit. This includes asking you to complete a symptom severity inventory and review of your most recent testing results. This cannot be done in a brief informal telephone call. If you cannot make it to the office, we do offer 30 minute telephone appointments for follow up visits as requested. A telephone appointment may not be covered by your insurance.
When do I take the hormone test?
If you are still having your menses, you are asked to take the test on day 19-21 of your menstrual cycle. If you are no longer having regular menses then you may test any day that is convenient for you during the month. Please follow the instructions in the test kit very carefully and document the requested information as directed. This is very important! If you have any questions about the timing of when to test or how to test please call us!
If you are currently using any form of hormone (i.e. hormone therapy, birth control pill, Mirena IUD, Depo Provera injection) you must be on a steady dose of hormones for approx. 12 weeks or off any hormones for 8 weeks to assure the best test results. It is okay to test your levels if you are already taking hormone replacement medications. If you are taking birth control pills you may test on them or stop for 8 weeks and test off of them. Be sure to use an alternative birth control method if needed. Please be sure to record any hormone you are using on your lab test form.
How long will it take to feel better?
Each woman is unique in her physical and emotional make-up, symptom severity and response to hormone therapy and self care improvements. It often takes up to 3 months to receive the full benefit of your hormone therapy. Results are gradual. Hot flashes and vaginal dryness may improve in as little as 2-4 weeks. Other symptoms such as decreased libido may take up several months. If you have been taking higher doses of synthetic hormone therapy and you transition to lower dosed, bioidentical hormones you may experience an increase in symptoms temporarily while your body adjusts to the lower doses. Great self care during this time will help to ease menopausal symptoms no matter what doses of hormones you are taking.
Are there risks and side effects from taking bioidentical hormones?
There are risks in taking any medication. There can be side effects from any medications, including bioidentical hormones. You will receive a leaflet with your hormone medications that list the current known risks and side effects. The FDA advises that that all hormones in equivalent doses carry the same risks and side effects, no matter if bioidentical or not. If you are experiencing moderate to severe symptoms the benefits of hormone therapy will likely outweigh the risks. The severity of your symptoms and your personal and family medical history are an important part of your health assessment and will guide the discussion for appropriate treatments options. We will put a program together especially for you at your first visit.
Are there other options besides hormone therapy to help me feel better?
Definitely. Many women come to see us who are unable to or do not wish to take hormone therapy. We can help design a self care plan for you that may include use of supplements, diet changes, herbal products, stress management, exercise and other lifestyle change recommendations to help you feel your best!