FAQs

How do I make or cancel an appointment?

My time is spent being 100% present with my patients in office. I have voicemail, email and texting capabilities to make things easier for you; please:

Make an appointment with me before you leave, if we know you already need a follow-up appointment.
Log on to https://tinyurl.com/38f82n88 and send us a request for a scheduled visit.

How do I cancel an appointment?

Please do this as early as possible, either by sending a message through square: https://tinyurl.com/38f82n88 or by calling the office at 563 424-6306. We respectfully ask for at least 24 hours to avoid cancellation fee of $20.00

What should I expect for our first visit?

Our initial visit lasts up to 60 minutes. During the visit, we will address all your endocrine concerns to to improve your health. Please see our forms online and fill out the necessary paperwork or come in 10-15 minutes early to fill out paperwork at the time of your visit. This saves our valuable time together. Please have labs done prior to the visit so that we can review fresh information about your health at the time of the visit.

I want an earlier appointment, is there a wait list?

Yes. If you want to come in the soonest, please email the office with your request. If there is a cancellation, we will call you to see if you can come earlier.

How do we review labs?

In person! Labs provide us crucial information about your health. Patients need to be informed about their lab results and how labs contributes to the endocrine disease(s) at hand. I create a treatment plan and discuss in person to address and answer questions. Sometimes this involves new or changed medications and/or supplements.

How often should I come?

This is up to the individual, depending on the health concern, and ultimately your motivation and willingness to get the care you. need. When first treating chronic health problems, our visits should generally be more frequent so that we can attack the root cause and get you feeling better faster. Thereafter, our visits space out over time.

The following is a general guide for frequency of visits:

Come in ONCE YEARLY if you are:

Completely stable/have no new health goals
Have no changes in health over the last year

(Prior to that visit, we will need: yearly labs, based on your medical problem)

Come in TWICE YEARLY if you are:

On medications, still evolving in your endocrine problem, but stable overall

(Goals: get new labs, refill prescription(s), assess effectiveness, make sure there are not major changes in your health)

If you are starting a new medication for a new problem, we suggest appointments every 4-6 weeks until stable, then every 3 months, and every 6-12 months for maintenance.

For women starting hormone therapy, you should notice changes in symptoms within 2-4 weeks.

We then see each other at 12 weeks, 6, 9 & 12 months, in order to get the full benefit of therapy.

For men starting testosterone replacement, the first year of therapy involves the most monitoring for safety and effectiveness. Labs are checked at baseline 12 weeks, 6, 9 & 12 months. Once a therapeutic dose is established, we can lengthen our intervals.

How should I contact the office?

The Heartland Endocrine Group uses a n SSL encrypted email system that allows access to answers to questions in a 24-48 hour time frame. I review labs, imaging results and other medical reports and post them to our portal and can get you copies as needed. These results are electronic and can be printable, in case you need to share the info with another health professional. While we have a portal system at officeAlly, it has failed at some points (for one month or more) and is no longer the preferred way to contact our office.

What insurances do you take?

I am happy to see you—regardless of your insurance type. I do not accept payments from any insurance company, including Medicaid, TriCare or Medicare. Patients with insurance are billed in full at the time of service and can submit at superbly directly to their carrier. I do not accept workman’s compensation. It is your responsibility to understand your insurance plan and what is the deductible and out of network services are allowable, including co-pays and deductibles. Large patient balances will preclude you from making future appointments.

Why not insurance?

I will not sign a contract with a health insurer that:

will not pay for medications and options we jointly decide, and then penalizes me and you by not paying the price for professional services you deserve.

Why doesn’t Dr. Figaro accept Medicare?

I’m happy to care for Medicare patients, and, generally, they will get a refund between $60-90 for my visits by asking Medicare directly.

Why don’t I bill directly to Medicare? Let me fill you in.

I do not bill to Medicare because:

Medicare claims are more complex than any other insurer with more billing codes and rules and regulations that require hiring a team of staff to remain compliant.

Medicare requires compliance with multiple mandates and administrative requirements that my small office cannot handle.

How do I get a refill?

All prescriptions need monitoring for therapeutic effectiveness and potential side effects. This is part of your treatment. If you don’t have refills, you most likely need your follow-up appointment.

Please make an appointment before you run out of medications; if there is a problem with a prescription at the pharmacy, please contact our office directly to avoid delays. Refills require time, evaluation and management, so please plan ahead. I will review my prior notes and may deny script refills because of lack of follow up.

I will not refill medications if you have not been seen in the past 12 months. Refills that are not due to my error (not refilling during your visit, electronic submission error), will cost $25.

I’m running out of insulin early, what should I do?

PPlease provide the office at least ONE WEEK to prescribe a refill of your insulin, especially if your insurer has a limited formulary that requires prior authorization for insulin. Some insurance companies require prior authorization for insulin OR have a cap on doses. If you are using more insulin than discussed at the last visit, please contact the office directly so I can order more units for you. Please do not ration your insulin due to your insurer’s administrative requirements, however, please give the office ample time for refills due to use of more insulin than expected.

What is a superbill?

A superbill is a form that allows patients to be reimbursed directly from their health insurance companies. A superbill does not guarantee that an insurance will pay for the services provided.

Each insurance plan is different, and it is your responsibility to contact your insurance provider and find out exactly will be covered. By calling your insurer, you can ask, “I want to work with an out-of-network doctor, how much will you reimburse me?” Ask, “What is the best way to submit my claim with a superbill?” Be sure that your benefits are clear to you.

Release Authorization: Be aware that should you choose to submit a superbill to your insurer, you are releasing medical information that is protected by law and you are waiving some of your rights to privacy and confidentiality. It is standard for your insurance company to keep a record of your diagnoses stated on the superbill as part of your permanent medical file. The superbill you receive from use should be turned in to your insurer. Please keep a photocopy of all the documents you send in for your records and for any errors of submission.

I need a referral or an official form filled. How do I do it?

Referrals and official forms require that I assess you and document your therapy for your health condition. Often it requires exams, labs, vitals etc. as well as my time. I need to evaluate you in person in order to send a current and appropriate referral. Referrals often expire, while forms need to be reevaluated for necessity and documented. This is required by insurance. Please make an appointment.

My treatment requires a prior authorization. What does this mean?

It’s a cumbersome paper trail, along with phone calls and denial letters. It’s a way for your insurer to not pay for expensive things.

Sometimes there is some algorithm they want me to use with drug therapy (fail first, try a cheaper drug first) or a specific code to cover it. I fill out forms, send notes and my rationale.

Please be aware that denials are final and appeals are rarely successful. You pay for your insurance and they listen to you, not me, since the reasons for denials are no longer medical, they are financial.

Can I have an acute visit?

Yes. Please feel free to call or text see if there are any openings in the schedule. Let the scheduler know it’s acute and they can always talk to me about accommodating. I try to leave time at the end of day for this. Sometimes people call and cancel same-day, leaving last-minute openings.

Typical acute cases that I see include: sore neck with thyroid disease, hypoglycemia on current insulin regimen, side effects of hyperthyroidism or allergic reactions to a medication, needing a letter due to missed work or filling out an FMLA form.

What is an e-patient and am I one?

A patient who participates fully in his/her medical care. e-patients see themselves as equal partners with doctors in the healthcare process. And e- patient is informed, empowered, and savvy with health. With the change in information access patients have resources readily available. There are over 2000 published researched health articles a day (not including popular media). The medical databases house millions of research articles. We can’t all keep up. The goal is to collaborate as partners in your health journey. I’m open to listening to what you have read and bring in. I’m willing to read. I’m happy to direct you to good sources for information and to recommend books. I do the best I can to stay current so we both benefit.