Precision Medicine & Genetics
Precision Medicine Program in Ann Arbor, MI
As one of our most novel and sought-after services, our Precision Medicine Program attracts patients to Ann Arbor from all over the country. Patients enrolling in this program often present with puzzling and complex health conditions or they are interested in the most precise and detailed preventative strategies available.
Patients enrolling in this program must be motivated and ready to invest fully in the educational, clinical, and diagnostic efforts required to solve their health puzzles.
To determine if our Precision Medicine program is right for you, we kindly ask you to review the following material to answer initial questions regarding structure, cost, etc. Once finished, please call our office OR schedule a phone appointment via our online scheduler and we will answer any other questions you have about the program.
Watch Our New Patient Information Video
(Note: Due to COVID-19, all portions of the Orientation are currently one-on-one rather than in Group Format)
Learn More About Precision Medicine
Video of Dr. Boggess Reviewing Labs with a Patient to Better Understand our Approach
The Precision Medicine - New Patient Bundle ($1,745) with educational sessions represents the most comprehensive and cost-effective care our clinic offers. Once enrolled, you’ll meet with several clinicians and doctors in person, on the phone, and via videoconference, as we gather your medical history, decide on initial labs, explain our clinic process, and prepare you for educational sessions, lab reviews, and treatment planning visits.
The enrollment fee includes the following visits:
As a candidate for this program, you start the process by speaking with Dr. Boggess or Dr. Soorya directly prior to fully enrolling. This is a no-obligation M&G meeting billed as a 30 minute interactions.
Prior to your M&G with Dr. Boggess you’ll be asked to watch our introductory videos but will not have completed our online New Patient Questionnaire. The purpose of this meeting is to briefly tell Dr. Boggess about your health concerns and hear his initial thoughts about your case. At this point, no doctor-patient relationship is established, but rather the interaction allows you the opportunity to “pick Dr. Boggess’s brain” and consummate your decision to proceed with the program.
At this point you will have completed all our new patient paperwork, consent forms, and online New Patient Questionnaire. The purpose of this intake will be to undergo a complete medical history and more fully “hear your story,” as well as get you started on initial labs (some labs, especially genetic testing, can take up to 8 weeks to process and get results).
Many of the diagnostic tests we recommend have specific instructions for collection as well as “hoops” for insurance coverage. Therefore, we schedule dedicated time to answer your questions and assist you with collecting specimens and submitting specimens and paperwork in a timely and efficient manner.
We also use the opportunity to set up your computer for secure video consults and educational sessions when/if needed based on your local and preferences.
In preparation for your educational sessions, our doctors review your chart summary again to tailor the discussion/presentation to your specific needs. (Note: Patients are not present during the chart review).
This visit includes doing a complete physical exam and review of the below assessments. It allows further opportunity to decide if there is need for any further testing.
Our Brain Health Center is well known for assessing and treating brain- and mood-related conditions from a holistic perspective. We use HIRREM (high-resolution, relational, resonance-based, electroencephalic mirroring) to look at the brain’s electrical activity. This study allows us to evaluate the brain’s ability to relax and balance and helps to determine if you are a candidate for certain protocols we offer.
Total body hydration and electrolyte imbalance is a primary concern with many patients. If the body is not optimally hydrated at the cellular level, it is difficult to efficiently absorb and assimilate nutrients as well as remove toxins. Using a bio-impedance analyzer (BIA), we collect various electrical parameters that reveal the water content inside and outside of the cells versus fat, muscle, bone mineralization, and soft tissue status. This information allows us to further tailor an individualized hydration and nutrient replenishment plan for each individual, which often gets patients feeling better quickly.
At Natural Balance, we have a passion for empowering patients with insights and understanding. During this session our doctors will be covering cutting-edge theories about genomics and precision medicine as they apply to your specific concerns. The session will also create a solid frame of reference to help you understand the labs and genetic tests we have ordered for you. Patients are encouraged to invite significant others, or in the case of a child, both parents are encouraged to participate if possible.
At Natural Balance, we offer an interdisciplinary team approach to our patients. After your in-person physical exam you will be meeting with our registered dietitian and/or health coach for an in-depth dietary, lifestyle, and emotional health assessment as per your individual needs. These visits can be either in-person or via videoconference as per your preference and local.
These meetings are intended to reiterate information reviewed during your initial visit and your lab review and will serve to assist you in getting the most out of your treatment course with our clinic.
These small-group teaching sessions (for Precision Medicine patients and their family members only) are tailored for 10-12 patients and no two sessions are alike. The intended purpose of the session is to further orient you to the tenants of precision medicine and effectively prepare you to fully enjoy, understand, and participate in your ongoing treatment course with our clinic.
The sessions also provide next-level understanding of our multi-step protocols and the scientific rationale for the diagnostic and genetic assessments our clinic utilizes. There is also lively open group Q&A providing opportunity for reassurance and clarity, along with the opportunity to connect with other patients and build your own support network.
Patients are encouraged to attend these sessions (whether in-person or via video) with their significant other, or in the case of a child, both parents are encouraged to attend if possible (there is no additional charge for family guests).
Please note: This price includes the visits described above. The price DOES NOT include any testing, visits to review lab results, or future follow-up appointments. Those are billed at our standard physician hourly rates (see below for details).
What to Expect After the New Patient Bundle
Once you have completed the New Patient Process and your tests and genetics are completed, our doctors and clinical team will be teaching you how to interpret your labs and genetics and will develop a treatment plan specific to your needs.
The results will be fully explained, summarized, and dictated, and you will be given a copy of all our reports and impressions. The doctors will also develop, in partnership with you, a fully outlined treatment plan, including logical ordering of protocols, estimated time frames, etc.
By the time you have finished your Lab Review session(s), you will have a full understanding of your labs, genetic predispositions, current state of health, and the treatment process that lies ahead.
The one-on-one Lab Review sessions typically take 2 to 4 hours in total, over the course of 1 to 3 visits, depending on the complexity of the situation and how many labs are being reviewed. Those appointments are billed at $450/hr prorated to the time of the appointment.
Please watch this abbreviated video of Dr. Boggess with a patient during a one-on-one Lab Review to better understand the process.
Typical Follow-up Schedule
After completing the Lab Review process, the time frame and hourly rates switch to our standard follow-up fee schedule (please see below) and are generally 20-30 minutes every 3-12 weeks, depending on the situation.
We follow-up frequently because your condition and the recovery process are dynamic and changing, so our treatment approach has to be equally dynamic and changing. The same approach that is ideal for you in the beginning may be harmful 3-6 months later. Likewise, too much nutritional supplementation for too long can be equally or even more harmful than the original deficiencies being treated. Therefore, we work intensively, follow up closely, and adjust our protocols carefully and frequently in partnership with our patients.
Determining Length of Treatment
Our clinic works closely with most of our Precision Medicine patients for approximately 1.5 to 3 years, depending on the complexity of the situation. You will receive a written summary of all labs and suggested protocols at the completion of all one-on-one Lab Review sessions, as well as estimated time frame to accomplish our treatment goals.
Our job is to rehabilitate your health and return you to “natural balance.” Hence, the nutraceuticals/supplements we prescribe are not meant to be taken long term. They are given in an aggressive YET careful, systematic way for a predetermined timeframe before moving to other protocols. In other words, the order in which things are rehabilitated, and the degree to which a reliable foundation is laid, is the key to our success.
Q: What is the success rate of our Precision Medicine Program?
A: Dr. Boggess -“Keeping in mind that our Precision Medicine program attracts very complicated, yet ALSO very motivated patients; let's define success as discharging from active care after 1 to 3 years OFF all supplement protocols and feeling 70 to 100% better... My best estimate of how often this occurs is that out of every 10 patients who enroll in the program, 8 to 9 (on average) will continue beyond 6 to 12 months. Of those 8 to 9 patients who continue past 6 months, 7 to 8 will succeed (as defined above). In any case, some drop off because they are feeling better quickly, only to risk ending up right back where they were because the process was not completed. For others, life circumstances change. Some find the program more effort than what they were ready for, etc. That said, while the remaining 1 to 3 patients who stayed the course may not have achieved 70-100% improvement upon discharge, rarely do they indicate they are disappointed in our clinic’s effort, OR dissatisfied with feeling 30, 40, or 60% better, etc.
Many patients come to us from outside of Michigan. In such cases, we customize the New Patient Bundle based on the complexity of the patient or situation, and whether or not you are traveling from out-of-state or overseas. A paid, $225, 30-minute phone meeting with the doctor is the first step to solidifying your decision to work with our clinic. Many of the initial medical and education visits associated with the New Patient Bundle are done via phone and videoconference. However, please keep in mind that all patients must be seen at least once in person at our clinic, and we highly recommend this visit be coordinated with a Lab Education session to take full advantage of the educational experience our clinic is known for. Thereafter, all future follow-up visits can be done via phone or videoconference. We are set up for video screen sharing and work with our out-of-state and overseas patients efficiently and effectively, and we ship all testing materials and products from our office to your home reliably.
This program is designed for busy executives, athletes, or any patient that wants the highest level of one-on-one interaction, teaching, and coaching with Dr. Boggess. A paid, 60-minute phone meeting with the doctor is the first step to enroll yourself or your child into this program.
Please note: There is limited availability for this program and all patients must be seen at least once in person by Dr. Boggess, either in our office, or under select circumstances, a patient’s private residence. Thereafter, all future follow-up visits can be done via phone or videoconference at a distance.
Natural Balance Wellness Medical Center is out-of-network for ALL insurances. We are happy to provide you with an itemized superbill for every encounter with the appropriate codes to submit to your insurance for reimbursement to you directly. However, please understand that we have literally given up trying to figure out the whims of insurance and cannot guarantee you will be reimbursed. For your reference, we have included the codes and pricing we use for the New Patient Bundle and follow-up visits, phone consults, etc. to assist you with checking with your insurance company ahead of time if you wish.
A Note Regarding Visits: The times below for follow-up visits include preparation and post-counseling with the nurse or clinical assistant, as well as direct collaboration with our physicians or clinicians.
At Natural Balance, we bill based on decisions, complexity and relative value (RVU) rather than time.
New Patient Precision Medicine Program -(New Patient Bundle) ($1,745):
The program includes all the items listed under "Program Details" in this page. The super bill will have the following codes.
|99205||New Patient Visit||$450|
|99354||Medical Office Visit -extra time||$945|
Please Note: The bundle DOES NOT include any testing, visits to review labs, or future follow up appointments.
The following price list will apply to any Lab Review or Follow up visits
Visits to Review Labs (example of a 90 minute Lab Review appointment)
|99215||Medical Office Visit||$450.00|
|99354||Medical Office Visit -extra time||$225.00|
Follow up visits (in office appointments)
|99215||Comprehensive Planning or Lab Visit, Level 5||$380|
|99215||Extended Planning or Lab Visit, Level 5||$295|
|99214||Basic Planning or Lab Visit, Level 4||$230|
|99213||Follow Up, Level 3||$160|
|99212||Simple, Level 2||$105|
Remember that a follow up is typically only 20 to 30 min.
Follow up visit (video or phone appointment)
|99443||Comprehensive Planning or Lab Visit, Level 5||$380|
|99443||Extended Planning or Lab Visit, Level 5||$295|
|99443||Basic Planning or Lab Visit, Level 4||$230|
|99443||Follow Up, Level 3||$160|
|99443||Simple, Level 2||$105|
Billing Process: As a medical center, it is our sincere intention that your visit be recognized by insurance AND qualify for reimbursement based on your out-of-network benefits. Our clinic’s ability to provide superbills for your visit and utilize insurance for testing is why we are able to save patients thousands of dollars compared to other practices run by limited license clinicians such as chiropractors, naturopathic doctors, acupuncturists, etc. That said, we are unable to guarantee that your insurance will reimburse your visits, nor can we project how much reimbursement you might receive.
|“Simple” Check-up on a particular protocol without further instructions or decisions. Patient or staff requested a simple visit to solve a problem that cannot be solved by a clinical assistant without a doctor. This also included DBS follow up visits.|
|“Follow up”: Review response to existing protocol, troubleshoot if needed, update Review of Systems (ROS), provide and explain next steps, answer questions.|
|“Basic Planning or Lab Visit”: Multilevel decision making required. Creating a new ROS. If re-testing, 1 or 2 simple labs are reviewed, explained and documented. Wrapping up a previous protocol, establishing and explaining a new protocol, etc.|
|“Extended Planning or Lab Visit”: Same as Level 4, but more extended / higher complexity. If re-testing, 1 complex, multi-page lab OR multiple simple labs reviewed, explained and documented.|
|“Extensive Planning or Lab Visit”: Same as Level 5 Extended Planning or Lab Visit, but more extensive / higher complexity / more time spent. Typically used when reviewing and documenting multiple labs OR re-establishing care. This level of visit is rare for an established patient undergoing follow up visits or lab reviews.|
Our clinic policies include important information about working with our clinic, insurance billing, refund policies, payment information, cancellation policies, etc. We request that all new patients review this material prior to enrolling with our clinic.