Because Lyme and associated diseases are a complex problem for scientists, practitioners and patients, controversy abounds in the medical profession as to how best to diagnose and treat Lyme disease. For example, some physicians and health agencies deny even the existence of an entity called “chronic Lyme disease.” Additionally, different conclusions have been drawn from peer reviewed research on the disease fueling debate as to whether or whether not to use long-term treatment strategies. All of this has led to an environment in the medical community where there are two standards of care:
1) Some physicians rely on a narrow definition of what Lyme disease is, how it should be diagnosed, and how it should be treated. (An example of this narrow view is the guidelines published by the Infectious Disease Society of America.) As a result these narrow guidelines, physicians will fail to diagnose some patients who actually have Lyme disease. Or, in cases where Lyme is a diagnosis, some physicians will prescribe short-term treatments. When these short-term treatments don’t produce sustained health or better outcomes for the patient, this leads to the conclusion that Lyme was not the problem and other diagnoses are given like fibromyalgia, chronic fatigue, MS, “post Lyme” syndrome, etc.
2) Other physicians use broader clinical criteria for diagnosing Lyme and associated diseases. (An example broader guidelines would be the guidelines published by the International Lyme and Associated Diseases Society.) While diagnostic certainty is being debated in the medical community, some physicians believe it is better to err on the side of treatment because of the serious consequences of failing to treat active Lyme disease. These physicians sometimes use longer treatment protocols and use clinical responsiveness of a patient to specific treatment to assist in diagnosis and follow-up treatment. It is also true, however, that fibromyalgia, lupus, rheumatoid arthritis, etc. often exist alone, without any relation to Lyme Disease, Babesiosis, Ehrlichiosis, or Bartonellosis. In these cases, a rheumatologist or neurologist or other specialist may be best suited to manage a patient’s care.
At NHIM, we have seen that successful treatment and good outcomes are a result of careful clinical diagnosis, a longer-term treatment plan, and consistent monitoring of the patient’s response to treatment. We agree with and see value in the International Lyme and Associated Diseases Medical Society’s (ILADS) guidelines for diagnosis and treatment.
As a new patient, the concept of a “therapeutic alliance” between the caregiver and patient must again be emphasized. This means that the patient has to work with and become part of the medical team and takes responsibility for complying with the recommendations given.
INSURANCE AND FEES
Because this is a unique medical practice and because we desire to maintain high levels of service and wish to maximize the time and quality of care given to patients, and to keep office expenses and your fees as low as possible, we DO NOT bill your insurance directly for the doctor visit fees. However, we will provide you with appropriate documentation during your visit so that you can bill your insurance provider directly, if you so choose.
We are not Medicare providers and we do not bill Medicare, nor may Medicare patients bill Medicare for services or items received at our office. Medicare patients will be asked to read and sign a contract (available in advance upon request) that serves as an agreement between Dr. Lentz and her associates and the Medicare patient that Dr. Lentz and her associates are not Medicare providers and the patient will not bill Medicare for office fees and services.
Dr. Lentz will see Medicaid patients, but we do not bill Medicaid nor is Dr. Lentz registered in any Medicaid system, which may impact the coverage of prescription medications for Medicaid patients.
Due to the fact that there are a large number of patients in need of evaluation for tick-borne illness, incoming new patients frequently have long wait times before their appointment date comes around (in some cases there is a many month wait time for the first available new patient appointment). At times, the practice does put a pause on accepting new patients for that reason. We do our best to see as many patients as we can, but please understand that we simply cannot accommodate all who inquire. We operate on a first come, first served basis when scheduling. Patient visits are by appointment only. To inquire about our scheduling status, please contact our reception (317-708-3708) to schedule all appointments.