Frequently Asked Questions
Why do you only accept clients from California, Idaho and Nevada?
RN and ARNP licensing requirements only allow me to provide counsel to clients in my state of license, which is currently California, Idaho and Nevada. Howlett Integrative Cancer Care will soon be expanding to other states. For more information on which states, please contact us for more information.
Why do you require all clients to have a primary care provider?
I practice as a consultant in functional and integrative medicine, nurse coaching, and education. I do not provide any primary care services, and require that all clients maintain a relationship with their own primary care provider and oncologist, and that they have had a physical exam within the past 12 months. If I suspect a disorder or condition that is not appropriately treated with functional or integrative medicine interventions or virtual visits, the client will be directed to promptly consult their primary care provider, oncologist or emergency services (if indicated) about any suspected and concerning problems, when appropriate. If you ever have concerns of an urgent nature, you should consult your primary care provider, oncologist or emergency services, as appropriate.
How are your methods different from other practitioners?
I use my extensive training and experience to help clients minimize side effects of traditional cancer treatment and improve immune system function through functional and integrative medicine approaches.
How much time do I have to move or cancel my appointment?
In order to reserve your time with me, all appointments are prepaid at the time of booking either a monthly, three or six month membership. If for any reason you cannot make your appointment, please let me know at least 48 hours before your scheduled time, so we can reschedule accordingly. New client paperwork requires at least 48 hours to complete and review, and my returning clients typically schedule weeks in advance. Therefore, I am not able to reschedule with short notice in most instances.
What if I am late to my appointment?
I will wait 15 minutes on the platform for our scheduled appointment. If you arrive in that time, we will get started, but our end time remains as scheduled. For example, if we are scheduled to meet from 1pm-2pm, and you log in to our meeting at 1:10pm, we will have 50 minutes to meet. No partial refunds will be provided, as I will be present the entire scheduled time.
Can I write you with questions between visits?
If you have a question that requires a yes or no answer, or is clarifying directions from a previous visit and I did not send you instructions via email, please email me for clarification. If you have new concerns, ongoing conditions, or questions that require a detailed response, an appointment will be necessary. This can often be arranged within several days, depending on schedule availability. I answer messages during business hours, and strive to reply promptly. If I am unavailable for any extended reason such as vacation, you will receive an automated reply.
Do you accept payments from FSA (flexible spending account) and HSA (health savings account) cards?
This varies with your insurance company. Many health insurance companies do allow consulting and coaching by an RN or ARNP such as myself to be paid for through FSA and HSA accounts. I am able to run those cards through my payment system. I encourage all clients using these accounts as payments to confirm that their insurer permits coaching by an RN or ARNP. Some insurers may require a letter of medical necessity (LMN) from your primary care provider to be submitted to them prior to approval. More often than not, your insurance will allow you to use FSA and HSA funds to receiving consulting/coaching from me, but be sure to confirm this prior to scheduling.
Why don't you accept health insurance?
When clinics bill health insurance companies directly, the providers are required to become participating providers. The provider must sign a contract that allows the insurance company to determine which services they will and will not provide and how much they can charge for those services. A participating provider must agree to accept the fees the insurance company establishes, regardless of whether the fees are reasonable or applicable to that practice. In general, these established fees cover the actual cost of the briefest (and I believe the lowest quality) care. Providers who are participating providers are required to accept discounted fees for their services, and they cannot bill the client for the difference between their fee and what the insurance company will pay. Most providers and clinics cope with the requirements of being participating providers by keeping their office visits very brief, so that they can see many clients within a given time frame. Unfortunately, I have found that I cannot be a participating provider in the insurance networks and provide the time-intensive, well-researched care that I offer.
Can your office provide documentation that can help with getting insurance reimbursements for consultations and/or test kits?
Our practice does not process insurance claims. Howlett Integrative Cancer Care is a fee-for-service practice, which means payment is due at the time of service. We accept all major credit/debit cards (including health savings accounts). As a courtesy we can provide patients with an itemized receipt called a superbill, which patients may submit to their insurance carrier for possible reimbursement. The amount of reimbursement received will be dependent on your specific plan. If insurance reimbursement is a concern, we recommend you check with your carrier prior to any laboratory testing. We can provide you with the specific billing codes that correspond to the laboratory testing we plan to run, and your carrier can give you a better idea of what they cover.
Why do you recommend certain nutrition supplements when I could get cheaper ones over the counter?
I recommend nutritional supplements as an adjunct to dietary and lifestyle modification. This approach is central to the well-researched and science-based practice of functional and integrative medicine. I recommend therapeutic, quality nutritional supplements as a service to my clients. With a few exceptions, I do not offer nutritional products of similar quality to those that are widely available over the counter. I only recommend high-quality nutritional products from the top nutritional research laboratories in North America and Great Britain, and I price them at a discounted rate. Clients are in no way required to use any supplements as part of their treatment plan, and they are welcome to obtain their supplements elsewhere. Unfortunately, with years of experience reviewing lab work on patients taking a varying quality of supplements available over-the-counter, I can confirm that quality does matter.
How many tests do I have to do, and how much do lab tests cost?
You are not required to do ANY tests in order to see benefits when working with me. However, I do find that in many cases it is important to test not guess, and most clients prefer to use some testing data to find subtle underlying causes of their symptoms. This generally offers more rapid results and helps to target your therapy. Common tests may include typical annual labs, nutrient deficiency testing, food allergen and reaction testing, comprehensive stool testing, cortisol testing, various hormone levels, Omega 3 indexing, and organic acid testing. Testing can be done using blood, urine, saliva, or stool, depending on the test performed. Clients can also provide a copy of previous labs for my review via their patient portal.