Weight Loss Clinic

Do I have to take medicine?

The short answer is no. We have patients who prefer medicine and some who prefer none. Both groups of patients are successful.  The benefits of medications will be discussed during your consult as well as possible side effects. You can also choose to start or stop medications during your weight loss journey at any time. 

If I take medicine for weight loss, do I have to stay on it forever?

 Absolutely not! This is a common misconception with weight loss medicine. While some of the medicines are used long term for other health reasons, no medication is needed to maintain weight loss if you followed the program correctly. 

Will I regain the weight if I stop the medicine?

If you have corrected the underlying reason for the weight gain, then no. This is always our goal in the program and the reason why we will never prescribe separate from coaching and educating. If a person simply takes the medicine to decrease their intake but does not correct the underlying health problems or learn how to eat correctly then yes, the weight returns when the medicine is stopped and the “yoyo” effect in weight leaves the person unhealthier than at the start of their journey. 

Do I have to wean off the medicine?

No. We do not use any weight loss medications that require weaning the dose to stop. We sometimes choose to wean slowly instead of stopping when a patient graduates, but this decision is tailored to each individual need and is a preference, not a requirement. 

What if I run out of my medicine before my next follow-up?

Refills are given at follow up visits and during this time we discuss tolerability, side effect, efficacy and sometimes make schedule or dose adjustments to best fit the needs of the patient. Each follow-up appointment is made at the prior visit, and we count the weeks to prevent running out of medicine. If you have last minute schedule conflicts and have to change that appointment, we will try our best to get you in to be seen for a refill though we can never guarantee last minute availability.

Will insurance cover the cost of the program?

Insurance will not cover the consultation fee or the optional fat burning injections. Some insurances cover prescription medications. We do accept HSA credit cards for services in the office. 

Will insurance cover the cost of the program?

Insurance will not cover the consultation fee or the optional fat burning injections. Some insurances cover prescription medications. We do accept HSA credit cards for services in the office. 

Will my insurance cover prescription medicines?

This is dependent on your individual plan. The only insurance plan which excludes everyone from weight loss medication benefits is the government Medicare (red, white and blue card only). All commercial plans (including Medicaid and Medicare commercial) depend on the individual plan. We will request this information from your plan following your consultation. We can only ask about a specific medicine tied to a specific diagnosis which means we can not get this information from your insurance before we see you in the clinic.

Can I call my insurance to find out if they cover a particular medicine? 

If you have a preference on medication and would like to call your insurance, then you absolutely can. However, we caution against this because insurance coverage for medications is dependent on the diagnosis. For example, nearly all insurances will cover a common weight loss medication called Ozempic. However, most will not cover that medication unless the patient has diabetes. Unfortunately, when you call your insurance company, they typically do not ask for the diagnosis or explain these limitations, leaving the patient with inaccurate information. You may be able to find out if your insurance covers weight loss medications in general by calling your representative -this may be your insurance agent, HR person for work plans, or case manager for government plans. 

Can I still use weight loss medication without insurance coverage?

Yes! There are affordable options at the pharmacy which are great for patients without insurance coverage as well as medications that can be given in the office for a substantial savings over pharmacy pricing. 

Will my insurance cover fat burning injections?

No. Insurances do not cover these however we can accept HSA credit cards as a form of payment. These are compounded by a specialty pharmacy and are administered in the office. Retail pharmacies can not obtain these formulas. 

Will my insurance cover labs?

This is patient dependent based on medical history. We do not submit labs to the insurance with a diagnosis of obesity because this typically results in a large Labcorp bill for our patients. We will use other diagnoses as it applies to each patient. Generally speaking a patient who does not have chronic medical conditions will be self-pay. The self-pay price is $60 with no additional office or Labcorp charges for the labs.

Can I participate in the program if I do not have weight loss benefits?

Absolutely! We can not bill your insurance for this program and we can work with you to lay out the most affordable weight loss medication options that are appropriate and safe for you. 

My insurance states they cover a medicine but the prior authorization was denied. What is the reason for this?

Our office completes prior authorizations as needed for weight loss program participants at no additional charge. If your insurance representative informed you a medication is covered but the request was denied, this likely means you do not meet the criteria to get the medication. Criteria is set by each individual prescription insurance plan. For example, two patients with Anthem can have very different prescription coverage. Following a decision on a prior authorization request, most insurance companies will issue a letter which explains the reason for denials. This helps direct us to the next steps. Common reasons for denials may be: weight loss medications are excluded, BMI not high enough, weight loss medications are not covered without comorbidities (other health conditions), no documentation of weight loss counseling for period of time prior to requesting the medication coverage. 

This is dependent on your individual plan. The only insurance plan which excludes everyone from weight loss medication benefits is the government Medicare (red, white and blue card only). All commercial plans (including Medicaid and Medicare commercial) depend on the individual plan. We will request this information from your plan following your consultation. We can only ask about a specific medicine tied to a specific diagnosis which means we can not get this information from your insurance before we see you in the clinic.

Can I call my insurance to find out if they cover a particular medicine? 

If you have a preference on medication and would like to call your insurance, then you absolutely can. However, we caution against this because insurance coverage for medications is dependent on the diagnosis. For example, nearly all insurances will cover a common weight loss medication called Ozempic. However, most will not cover that medication unless the patient has diabetes. Unfortunately, when you call your insurance company, they typically do not ask for the diagnosis or explain these limitations, leaving the patient with inaccurate information. You may be able to find out if your insurance covers weight loss medications in general by calling your representative -this may be your insurance agent, HR person for work plans, or case manager for government plans. 

Can I still use weight loss medication without insurance coverage?

Yes! There are affordable options at the pharmacy which are great for patients without insurance coverage as well as medications that can be given in the office for a substantial savings over pharmacy pricing. 

Will my insurance cover fat burning injections?

No. Insurances do not cover these however we can accept HSA credit cards as a form of payment. These are compounded by a specialty pharmacy and are administered in the office. Retail pharmacies can not obtain these formulas. 

Will my insurance cover labs?

This is patient dependent based on medical history. We do not submit labs to the insurance with a diagnosis of obesity because this typically results in a large Labcorp bill for our patients. We will use other diagnoses as it applies to each patient. Generally speaking a patient who does not have chronic medical conditions will be self-pay. The self-pay price is $60 with no additional office or Labcorp charges for the labs.

Can I participate in the program if I do not have weight loss benefits?

Absolutely! We can not bill your insurance for this program and we can work with you to lay out the most affordable weight loss medication options that are appropriate and safe for you. 

My insurance states they cover a medicine but the prior authorization was denied. What is the reason for this?

Our office completes prior authorizations as needed for weight loss program participants at no additional charge. If your insurance representative informed you a medication is covered but the request was denied, this likely means you do not meet the criteria to get the medication. Criteria is set by each individual prescription insurance plan. For example, two patients with Anthem can have very different prescription coverage. Following a decision on a prior authorization request, most insurance companies will issue a letter which explains the reason for denials. This helps direct us to the next steps. Common reasons for denials may be: weight loss medications are excluded, BMI not high enough, weight loss medications are not covered without comorbidities (other health conditions), no documentation of weight loss counseling for period of time prior to requesting the medication coverage. 

• Initial Consultation $100
• Monthly Follow up consultations $75
• Optional Fat burning injections $30 each or $100 for 4 prepaid
• New patient self-pay weight loss labs $60 
• Follow up labs $60 or less depending on the labs needed.

I received a bill from the office but I have paid each time at check in. Do I owe this balance?

No. This is an error that rarely has occurred within the computer system. All weight loss visits are paid in full at the time of service. If you receive a bill, please notify us so we can look for errors in your account. Do not pay the bill. 

Are the fat burning injections vitamin B12?

It is incorrect to refer to the fat burning injections as “B12 shots”. While they do contain vitamin B12, this is one of 4 ingredients in the medication. Vitamin B12 alone is not considered a fat burning medication. 

What is in the fat burning medications? 

Vitamin B12, methionine, inositol and choline. The later three are amino acids, commonly referred to as the building blocks of protein. 

What are the benefits of the fat burning injections?

Increased fat loss, increased energy levels, promote liver health which is essential for weight loss, promote appetite suppression, reduce brain fog, boosts metabolism, assist in detoxification. 

Do I need to take fat burning injections?

No. These are safe injections for nearly all patients and therefore can be offered to help patients reach their goals faster but absolutely no medication is required for success in this program. We will discuss the benefits in more detail at your first consultation. 

Do I take a prescription medicine plus a fat burning injection?

Most patients do opt for both the fat burning injection and a prescription medication which has a stronger effect on suppressing the appetite. The mechanisms of these two approaches are completely different in the body and compliment each other well. That being said, patients have the option of no medications, fat burning injections without prescription medications, prescription medications without fat burning injections, or both. The options are discussed during consultations. 

Can I be refunded for previously purchased injections?

These injections are not refundable. The discounted price of the fat burning injections is provided when purchased in bulk, or patients can pay per injection. 

What lab work is needed for the initial consult?

• All patients need:
• Complete metabolic panel (also called a Chem 14; or a basic metabolic panel (Chem 7) plus a liver panel)
• Hemoglobin A1c
• Thyroid panel (if you have labs done elsewhere please ask for the panel, not a TSH)
• Fasting lipid panel
• Vitamin D level

In some cases, we may add labs based on past medical history if the information is relevant for success with weight loss or prescription safety but this is uncommon. 

How often do I have to have labs?

At least annually. We do not obtain follow up labs more frequently than annually unless we are following a particular abnormal lab. Labs which are drawn to follow up on an abnormal lab can almost always be billed to insurance. Patients can request to have labs more frequently. Please note insurances dictate how often they will pay for labs so while we try to accommodate reasonable requests for labs, we may not be able to bill it to insurance. 

What if I receive a bill higher than $60 (self-pay price) from Labcorp for my weight loss labs that were billed to insurance?

Just bring us the bill and we can charge you the $60 self-pay price in office and this will eliminate the Labcorp bill. 

I paid for my labs in the clinic as self-pay. Why did I received a Labcorp bill?

This is an uncommon error that can happen within the computer system. Please call Amber Kea at our office and we can have this corrected. Do not pay the Labcorp bill.

Do you offer evening and weekend visits?

The short answer is yes, but on a very limited basis. Availability for these appointments is rare and offered to patients based on seniority in the program. Sometimes we have to wait for patients to graduate prior to offering these to newer patients in the program. If your schedule will only allow you to participate in the program if you can follow up nights or weekends, please discuss this prior to joining the program so we can make sure we can meet your needs long term. 

How do I schedule an appointment?

Amber Kea is our designated scheduler for this program. You may contact her directly at akea@hospitalityhealth.net or by calling the office at 434-230-9080. Her typical office hours are Monday-Friday 8am-4pm. Outside of these hours the office staff will be happy to take a message for her to reach out to you when she returns. Please do not contact us on Facebook as we do not receive regular notifications on this profile and may not respond in a timely manner. 

How soon can I be seen for a new patient appointment? 

It is common to have a 6-8 week waiting period for a new patient appointment. We do not schedule out further than 8 weeks so typically patients are put on a waiting list to be called when the next month’s schedule opens. 

Do you accept walk-ins?

We do not accept walk-ins for new patient visits. We have  a very limited number of walk-in times available only on certain days for follow-ups for patients with less predictable or less flexible schedules. Please keep in mind this typically results in longer wait times than scheduling the follow-up time. 

Can I schedule with my spouse/friend/relative?

Yes! We often see mothers and daughters, husbands and wives, or close friends in combined appointments. Having support is amazing in this journey! 

Can I be seen more frequently than monthly?

Yes. We have some patients who depend on this accountability and we can see patients more frequently than monthly for the same follow up price of $75 per visit. This is a full provider visit and consult. Keep in mind we typically book at least 3 weeks out for follow up visits so we will need to add these appointments in advance. We only have one body composition analyzer so this is not used separate from a provider follow up visit. 

Can I schedule a telemedicine follow up visit?

Partially, yes. To accommodate patient schedules, we can have you come in prior to a telemedicine consult anytime the office is open for a weigh in then we can do the remainder of the consult on the phone or computer. 

Do I have to track what I eat?

No. While some patients do very well with this method, others may find it too tedious. Any program that is successful must fit with each person’s needs. There are benefits to tracking but it is certainly not required for success. 

Can I participate in the program for other health reasons without weight loss goals?

Yes! While this is technically called a “weight loss program” we rarely see a patient without other health goals. On occasion we even see patients with no weight loss goals but with other health goals.  Other common reasons we see patients include infertility or PCOS, diabetes, blood pressure, anxiety and depression, chronic pain, chronic fatigue, chronic gastrointestinal complaints (IBS, IBD, CIC). So many chronic health conditions can be helped and, in some cases, corrected with proper nutrition.

What diet will I be on?

This is not a one size fits all program. Patients have individual weight loss and health needs, and most have already logged quite a bit of weight loss efforts prior to coming to us. Most of what is taught about nutrition here does not have a name because it is tailored to each individual’s need. We simply describe it as “balanced”. However, if you have a certain interest or want to be taught a certain program, we can work with you whether it be keto, paleo, low carb, mediterranean, whole 30, intermittent fasting, Atkins, high protein, plant based, pescetarian, vegan or vegetarian, etc. All these programs can be successful for health and weight loss if done properly. 

How long do I need to stay on the weight loss program?

This is something we can discuss at your first consultation. This varies greatly depending on the health challenges and the amount of weight loss desired. The average time for patients in the program is 6-12 months. 

Do I have to exercise while on this program?

No. In fact, in some cases we advise against it when starting the program. Generally, if patients are healthy we will aim to add it at some point during this journey, but exercise should never be required simply for weight maintenance. It does, however, offer amazing health benefits.

Is meal prep required?

No. This would be unrealistic for many. Meal prep can help on busy days and be a cost effective way to eat healthy, but we have other options because no one should ever fall off track just because they were not able to meal prep. 

Can I participate in the program remotely?

We do not have a telemedicine-only program. We do need to see our patients on a monthly basis in the office. 

Can I weigh in weekly?

You are welcome to use our scale (not the body composition analyzer) for weekly weigh ins with no appointment needed. 

Should I weigh between monthly appointments? 

This answer varies. If a weigh in makes you feel supported and motivated then absolutely, go for it! You can weigh daily, weekly or however often you would like. If you tend to stress over the exact number and become dependent on it moving, then please reserve weigh ins for our monthly visits. The body composition analyzer can determine the difference in water weight and fat mass which sometimes will show a fat loss even without a change in overall weight.  

Do you test and manage hormones?

Some hormones we test and manage directly and others indirectly. These include insulin, thyroid, cortisol. While we can test reproductive hormones such as testosterone, estrogen and progesterone we do not offer this as a part of the weight loss program and we do not manage these hormones. We will sometimes discuss this if needed and can refer patients for this service. 

Are there age restrictions on this program?

We do not have age restrictions on this program. So far we have served patients age 14 to 79. We do not offer medications to patients under the age of 18 and can discuss this more in detail with a parent if needed. This nutritional counseling at a young age can change a person’s life without using any medication. 

Who will I be seeing for these visits?

Heidi Bishop is a physician assistant with a background in research who has a passion for health and wellness coaching. While weight loss is typically the primary goal for most patients, Heidi’s goal is to teach the patient what they need to know to never need weight loss or nutritional coaching again. This program is the culmination of over 7 years of research studying obesity including the rolls hormones play, diabetes, nutrition and wellness including how to treat the body with food and 13 years of practicing medicine. 

Can you see patients with complicated medical histories?

We have yet to come across a patient we could not serve in our weight loss program based on their medical history. If you have specific concerns, please reach out to us directly.