New Patient Appointments: $900. This is a 2-3 hour in-person appointment which includes a comprehensive evaluation reviewing your health history, current symptoms, medical records, diagnostic test results, and a physical exam. Initial Follow Up Appointments: $600. This is a 1.5 hour appointment which includes review of medical history and any lab or imaging orders with your provider, an evaluation of your stabilization process, and the development of a specialized plan of care. Subsequent Follow Up Appointments: $450. This is a 45 minute appointment (in-person or virtual) to include an evaluation of your response to treatment and a plan for continued care and progression. Prescribing medications and ordering labs can be done during this appointment. Case Management Consults: $400. This is a 45 minute virtual follow up appointment reviewing medical information and your response to treatment. You will be given a treatment plan and/or recommendations which will be implemented by a local practitioner. No prescriptions or lab or procedure orders will be provided by RHW for these visits.

No, we do not take insurance. You are able to submit an invoice to your insurance for reimbursement depending upon your insurance provider, but payment to us is due at the time of your appointment.

We treat all ages including both kids and older adults. Patients under the age of 8-10 years old are considered on a case-by-case basis to ensure that we are a good fit. We currently have patients age 5 and older, however if we believe a child would receive the best care elsewhere, we will provide the family with appropriate referrals and resources.

You do not need a positive lyme test to be seen. We do appreciate reviewing any prior lyme/co-infection results you do have, but a positive is not necessary as this is usually a clinical diagnosis. We also appreciate any comprehensive labs you’ve had done in the last year as well as imaging (ex: MRI brain, SPECT scans, etc.)

Yes, we treat Lyme disease and all tick-borne illnesses. This includes co-infections such as babesia (including babesia duncani), bartonella, anaplasma, mycoplasma, ehrlichia, rickettsia, EBV, etc. We also address complicating infectious factors such as biofilm and cyst-forms, or round body formations, of the bacteria.

Yes, we have experience treating all kinds of complicating factors/comorbid conditions. This includes mold toxicity, parasitic infections, leaky gut, EDS, chronic pain, chronic GI symptoms, autoimmune disease, fibromyalgia, interstitial cystitis, MCAS, POTS, PANS/PANDAS, complex neurological issues, seizures, and many more. There are many additional comorbid conditions we have found to be associated with Lyme that patients may not be aware of: cervical instability, CCSVI, May Thurner Syndrome, acalculous cholecystitis, circadian rhythm disorders, etc. Your provider will be constantly evaluating for any complicating factors that need to be addressed throughout the course of treatment in order to provide comprehensive medical care.

Many of our patients have chronic infections in addition to some of the above listed comorbid conditions. Our approach to treatment includes addressing all of these various concerns to help with symptomatic management as well as treating the root cause of disease through antimicrobial agents. Not all patients present with the same symptoms, so treatment is individualized based on each patient's needs and preferences. We may employ alternative therapies or additional supportive medications and supplements in addition to antimicrobial agents.

Yes, we use antibiotics to treat Lyme disease. Our approach to antibiotic treatment is to use pulsed, combination antibiotic therapy to help tolerate herxheimer reactions (increased symptoms following antibiotic use), address coinfections, prevent antibiotic resistance, target the bacteria at different stages of their lifecycles, prevent significant gut microbiome imbalance, and promote immunologic strength so your body can eventually fight off disease and infection on its own.

We most often will use antibiotics as this is what we see the most significant improvement with, however for patients that don’t tolerate antibiotic treatment, would prefer alternative therapies, or are evaluated and determined not to need antibiotics, we offer other treatments.  Patients may be placed on herbal and supplement treatments, massage therapy, acupuncture, platelet replacement therapy, or supportive care targeted towards symptom management.

Yes, we do offer IV antibiotic therapy for some patients. Your provider may recommend IV antibiotic therapy due to specific indications such as an intolerance to oral medications, complicating GI conditions such as inflammatory bowel disease, significant neurologic degeneration or involvement, or a lack of response to oral therapies.  IV antibiotic therapy is a possible course of treatment for the majority of patients, however it is often not necessary. The use of IV antibiotics is always per your provider’s discretion to ensure appropriate and safe use of intravenous medications. If it is determined that you will be undergoing IV treatment, we will walk you through what that entails in more detail.

IV therapy will be a monthly fee of $2500. This will include the cost of taking responsibility and managing of the IV line, your monthly visit, access to on-call service, as well as other services that will be further outlined for patients who receive IV treatment. This will not include the price of antibiotics which will be supplied by a trusted compounding pharmacy.

Each patients’ response is unique due to a variety of factors, and this is a chronic condition with no reliable test of cure to ensure complete eradication of the infection. Our goal in therapy is remission; we cannot guarantee that patients will never experience a relapse (and we would caution you against providers who make such claims).  This being said, we would say that only 3-5% of patients see no improvement whatsoever with our treatment. In terms of improvements seen, it varies patient to patient based on their specific case. Many patients will say they see 100% improvement, however more often patients reach their goals but still have minor residual symptoms (I am able to walk again, I can now go run errands and watch my kids’ soccer games, I no longer experience daily pain, I can go back to work; BUT I still have some neuropathy, I occasionally still get sore joints, my ears still ring).

Yes, we require patients to come in person for their initial consultation and once per year thereafter. Your provider may request you come into the office sooner than 1 year depending upon your specific monitoring and treatment needs.  For patients who live out of state, many states have different laws and regulations surrounding telehealth appointments which may mean that you will need to either a) come in person more frequently to get your prescriptions/lab orders, or b) find a Lyme-friendly local provider who is willing to work with us to provide our recommended treatment plan. We can walk you through these requirements and your options as needed.

Once you schedule your appointment, registration paperwork and consent forms will be done virtually via the patient portal. An intake form detailing your past medical history will be provided on the portal to help prepare for and guide your initial appointment. Your previous medical records will need to be uploaded for your provider to review prior to your appointment.

Your new patient appointment will be a 2.5-3 hour consultation where your provider will take a comprehensive health history dating back to childhood, gather a complete inventory of all your symptoms, perform an in-depth physical exam, provide general teaching regarding relevant topics (Lyme disease, co-infections, suspected comorbid conditions, supportive medications), come up with a treatment plan that may include diagnostic testing with labs/imaging studies, prescribing supportive medications for symptomatic management, and providing any necessary referrals.

Yes, we accept international patients. We do require in person appointments once a year, but otherwise will provide care via telehealth. Patients who do not speak English will have to provide a translator for their appointment.