I: On Matters Practical
Only active patients at Haven Medical are able to purchase supplements through out website or at our office.
Haven Medical sees children six months or older. For those families already established as patients, Haven will see children under six months.
When Haven initially opened, we made it a point of principle that we did not sell supplements, believing that there is an inherent conflict of interest when the health care provider recommends supplements that that same health care provider sells. However…however there are some supplement manufactures that will sell their products exclusively through knowledgeable practitioners, and we came to find some of these exceedingly effective. Indeed, some of these supplements are so effective and potent that our practitioners are every bit as cautious and circumspect in recommending them as they are of prescribing many pharmeucital drugs. These are not supplements available at retail locations or on line. Many of the supplements that we sell that have grocery store or health food store corralaries, are of higher quality and of comprabable or lower price. Many supplements we recommend have very high quality and reasonably priced alternatives available at local stores, and we routinely send patients that way. Furthermore, we always suggest other sources and alternatives, whether locally or on line.
The most direct way to set up an appointment is to call us at 919.969.1411. Haven sees patients Mon—Thurs 8:30 – 4:00, and Fridays 8:30- 11:00.
Yes. Dr. Rapaport routinely interacts with hospitalists and specialists, and makes hospital visits to her patients.
We carry Standard Process, Researched Nutritionals, Design For Health, Metagenics, ProThera, Klaire Labs, Boiron, Integrative Therapeutics, Davinci Labs, Salina Salts, Professional Complimentary Formulas, Eco-Nugenics and more. Please see our Marketplace page for a complete inventory.
Please bring any prior records and labs that you have and the completed intake forms if you have chosen not to use the portal. (See question below for more about using Updocs, our patient portal.)
Haven uses Quest, Labcorp, Genova Labs, The Mayo Clinic, Igenex, Fry Labs, Advantage Labs, Great Plains Labs, Diagnostechs and Cyrex. Which lab we use is a function of the assays being requested, and the patient’s insurance policy.
Haven has a well-developed network of chiropractor, acupunturist and other bodywork professionals, some of whom are here at the same location as Haven.
II: On Matters Financial
HSA’s are ideal means of employing insurance coverage at Haven. Most HSA’s issue a card, which can be used at qualifying providers in the same manner as a credit card.
Haven does not directly process insurance; patients pay for services at the time of the visit. However, each patient, at the conclusion of their visit, is provided a “Superbill,” with all the requisite ICD-9 and CPT coding, filled out by Dr. Rapaport. This Superbill is the operative form that patients use to file directly with their insurance companies. Rates of reimbursement vary greatly. If you’d like to find out prior to making an appointment what percentage of your visit charge you will be reimbursed by your provider, contact your agent, tell them you are going to see and M.D. (make it explicit that you are seeing an M.D., as opposed to a different Doctor, such as a chiropractor, etc.), and that you will receive a coded superbill filled out by the M.D. Your insurance agent should be able to tell you what reimbursement you will receive. If there are any labs attendant with a patient visit, these charges generally are successfully charged directly to the insurance company, and the patient does not need to pay for them up front.
Fees are assessed by the length of the visit. There is no set amount of time for a first, or a subsequent visit, however a first time visit is generally 90 minutes (visit times here refer strictly to the amount of time spent one-on-one with the doctor). There are no additional fees for the first time visit/chart set-up/orientation/etc. Follow-up visits are scheduled for sixty minutes. The rate for a visit with Dr. Rapaport is $420/hour, for Dr. Fraed is $380/hour. The hourly rate is unaffected if multiple family members are present at the same time. Certain types of visits, such as the Shoemaker Biotoxin/Mold/CIRS Protocol initial visit, which entails an entire day, work under a alternate flat-fee structure. Please inquire for details.
Haven accepts most major credit cards, HSA cards, cheques and cash. We do not accept American Express.
In January 2008, Haven ceased to accept Medicare. This means that when a patient receives services at Haven, Haven cannot bill Medicare, and the patient cannot submit a claim to Medicare for reimbursement. The biggest disagreement between physicians and Medicare involves the issue of “medial necessity.” Medicare doesn’t believe that it is medically necessary to spend time to counsel and educate patients or to try new or alternative treatments, even when conventional ones fail, so they won’t pay for these services. If they pay for a bill and later decide that the treatment was unnecessary, even if it worked, the physician can be penalized—$10,000 for every service they don’t allow. By opting out of Medicare, Haven is free to offer many services to patients that were forbidden by the Medicare system, and many patients learn that their care can be more comprehensive and complete once Medicare is no longer interfering with the medical decisions that affect them.
The vast majority of costs attendant to lab fees associated with a visit to Haven Medical are directly covered by your insurance company. Even though we do not directly process insurance for visit charges, we nevertheless collect your insurance information so that we may provide it to the laboratories to which we send samples, so that these labs (see Matters Practical FAQ’s for a list of what labs we use), may send the charges on to your provider. In other words, if a lab is requisitioned by an M.D. for a patient, it is irrelevant, from the insurance providers standpoint, if that M.D. is in or out of network. For those patients who have no insurance, we have negotiated very favorable rates with our laboratory providers. In these cases, the labs bill Haven directly, and Haven then bills the patient.
III: On Matters Philosophical
The taxonomy of medical approaches quickly overlap, become complicated and lack clear distinction. Much of the language to describe one modality may justly apply to Holistic Medicine. At Haven Medical the only thing we dogmatically oppose is dogmatism. Anything that is effective is, by definition, valid.
Functional medicine emphasizes an approach which looks to the body as a series of integrated systems, inextricably linked, that can fall out of balance, and, being systems and not isolated symptoms, this lack of balance can manifest in seemingly disparate but related ways. For more on Functional Medicine, see Functional Medicine. Narrative Medicine rejects the notion that medical issues can be reduced to something a simple as ‘a problem to be solved.’ It looks to integrate an issue of the moment into the larger personal, psychological and physical history of the patient. Complimentary and Alternative Medicine (CAM) is a diversified and fluid group of approaches that do not adhere to the approaches of conventional (or “Western” or “allopathic”) medicine. Acupuncture, chiropractic, homeopathy, mind/body medicine are all modalities that fall under the rubric of CAM.
In a world where doctors treat—as expeditiously as possible—symptoms, are quick with the band aid, whether metaphorical or literal, holistic medicine views the individual as complete person, in their entirety, mind, body and spirit. Holistic physicians understand that medicine is not a science, or not strictly a science; it is the intuitive and artistic application of a body of science to the practice of healing. Cooks follow recipes from a book; chefs create. Doctors should be more than technicians, however sophisticated; they should be healers.
Before Haven Medical first opened its doors in Chapel Hill, we set out to craft a logo, and with it a tag line (“A Different Kind of Healthcare”). One of the earlier proposals was “A New Kind of Healthcare,” but the truth is that this would have been inaccurate. If you conjure forth the archetypal American country doc from the Twenties or Thirties (what was then called a G.P.), with his great leather bag and his white hair and his kindness, then likely you are imagining a physician who incorporated many elements of holistic medicine into his practice. If, for instance, young Johnny’s mother brought him to the office with a stomach ache, this old country Doc might well know that it was quite likely that Johnny’s gastrointestinal dysfunction was a manifestation of witnessing his parents fight again. And this doc might know that this was likely a matter of Johnny’s father having been laid off from the mill. This Doc would know your parents, know your children. This Doc would have a context in which to place the totality of his patient’s symptoms, and failings and hopes and resources. In the present culture of medicine where the average visit with a doctor is eight minutes, this is an approach that is sadly rare.
For more information on holistic medicine, please visit our Introduction Page, or the website of the American Holistic Medical Association.
Holistic medicine looks to the entirety of the patient, who she or he is—their bodies, their relationships, their work, their place in the world they inhabit. Integrative medicine looks to the entirety of modalities that might balance and heal the patient. While the archetypal country doc conjured forth in the discussion above might well be holistic to a lesser or greater degree, it is less likely that he was integrative. He was unlikely to refer his patient to a chiropractor, or suggest meditative practices, or recommend yoga. The integrative physician has a much bigger set of tools at her disposal. And while the two approaches overlap, it is possible to see an integrative physician who is not holistic, and a holistic physician who is not integrative.
IV: On Matters Artistic (and Canine)
Here: Kerry Hudson
That would be Ruby: