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    Dr. Yvonne Berry

    Dr. Yvonne Berry is a board certified Family Medicine Physician who developed impressive skills and knowledge related to Biotoxin Illn... read more

Biotoxin Illness

 


CIRS (Chronic Inflammatory Response Syndrome) – A form of Biotoxin Illness

We are fortunate to have both Dr. Berry and Dr. Berke see our patients with CIRS (Chronic Inflammatory Response Syndrome) a form of Biotoxin Illness caused by exposure to water damaged buildings. Both of our doctors use Dr. Shoemaker’s protocols.

New Patient Process – Biotoxin Illness / CIRS Program (New Patient Bundle)

The  New Patient Bundle includes the following:

1. Chart review and Physical Exam with the Doctor (120 minutes): Your first appointment with Dr. Berke consists of a comprehensive history and physical examination, ordering Biotoxin illness labs, HLA genetic testing, and discussion of the overall treatment of Biotoxin illness.  For the convenience out of state patients, this first interaction may be split into two components, including a 60 minute video conference to collect history and order labs, and a subsequent 60 minute in office physical examination.  This allows out of state patients to obtain lab work on the same day they schedule the physical examination, since we require that specific lab testing sites in our area be used for the sake of testing accuracy.  Initial physical examination will include Visual Contrast Sensitivity (VCS) testing, as well as MARCON testing.  Prior to your first appointment, please complete our online Biotoxin Illness/CIRS New Patient Questionnaire.  Please submit to the office any relevant past medical records two weeks prior to the first appointment for review.

2. Teaching Session at Natural Balance with Dr. Berry – In a Small Group Setting with 5 to 7 patients and their family members (3.0 hrs) - At Natural Balance, we have a passion for empowering patients with insights and understanding. During this session, will be covering information about Dr. Shoemaker’s cutting edge protocols for CIRS, and our clinic’s approach to working with patients. Prior to this appointment, you will have completed our online New Patient Questionnaire. Prior to the group visit, the Doctors will have reviewed every patient’s medical history  to ensure this interaction will be meaningful and productive. There will also be time for open group Q&A. Patients are encouraged to bring their significant other, or in the case of a child, both parents should attend if possible.

3. Additional  Chart review by the Doctor: Depending on the complexity of the patient’s past medical history and prior medical records, the doctor may require additional time to read the past medical record and organize a medical chart summary.  A chart review fee may be required, and this will be decided on an individual basis at the discretion of the doctor.

Please note: All the above interactions are part of the “New Patient Bundle”. The bundle however DOES NOT include any additional testing, subsequent visits to review lab results, or follow-up appointments.

What to Expect Next for Biotoxin Illness Patients?

Lab Review Visit: After the your New Patient Bundle appointments, you will be ready to review labs. This appointment is typically 2 hrs long, and it will be scheduled 6-8 weeks after your physical Exam.

Assessment and remediation of your environment: Treatment starts after the lab review. However, step 1 of the treatment is a mold assessment and remediation of your home, school, and work environment. Step 2 of the protocol (with the use of toxin resin binders) can be done while patients are working to mitigate the biotoxin exposure in their environment. However, please be aware that no further steps in the protocol can be done until the patient is in a “safe” environment.

Follow-ups: Patients are asked to follow up every 6 to 8 weeks, with the appointments lasting between 60 to 90 min.

Frequent Visits to the Ann Arbor Area: Active treatment of CIRS requires retesting about every 2 months at Quest and LabCorp laboratories (two separate locations). Dr. Berry has meticulously worked in concert with two sites in our area to train their staff to perform the labs properly and avoid erroneous data. That is why we require patients to use these two locations whenever they are working with our CIRS doctors.

Natural Balance and Doctors won’t be involved in Litigation: Our passion and focus will be to help your body feel better. For this reason we choose not to get involved in litigations, depositions, workman’s compensation claims, or writing for any work restrictions. Therefore, if you are seeking medico legal support, our office will not be able to assist you. However, we are more than happy to continue to treat you from a medical perspective.

Length of Treatment

There is no known cure to CIRS at this moment. Our treatments are aimed to make your condition stable, and help you to manage it in the future. Typically, the Active Treatment Phase could last anywhere between 1 year to a few years, depending on the severity of your own condition. Once the Active Treatment Phase is over, patients will come back to see us about once a year for retesting.

We hope you have found this information helpful and we look forward to working with you. Please contact our office and ask for Lili Boggess, our Clinic manager if you have any further questions! 734-929-23696, extension 11.

Please also visit the following link to learn about Insurance questions: Insurance & Payments

General Pricing Information

New Patient Bundle Biotoxin Illness:$893 (covers all appointments in the ”New Patient Bundle”  described above)

New Patient & Lab Review, Follow ups for Biotoxin Illness, appointments hourly: $370, prorated to length of time spent with the doctor.

Pricing & Diagnostic Codes

Natural Balance is out of network for all insurance, and we do not bill your insurance. We will provide you with a itemized superbill for every encounter with the appropriate E&M codes to submit to your insurance for reimbursement to you directly. However, please understand that we have literally given up on trying to figure out the whims of insurance and cannot guarantee you will be reimbursed as such. For your reference, we have included the codes and pricing we use for the New Patient Bundle and additional new and existing patient visits, phone consults, et cetera to assist you with checking with your insurance company ahead of time if you wish.

New Patient Visit (Bundle - Biotoxin Illness - with “Group Visit for ” $953.00):
Code        Description                                                           Amount
99205     New Patient Visit (120 minutes)                       $740.00
99354     Medical Office Visit -extra time                         $195.00
VCS Test                                                                                  $18.00

These codes are submitted in the same superbill with the Group Teaching Session ( 3.0 hours).

Medical Office Visit  (example of a 1.5 hours lab review appointment)
Code       Description                                                         Amount
99214     Medical Office Visit (60 minutes)                  $370.00
99213     Medical Office Visit (30 minutes)                   $195.00

Follow-up visits
Code       Description                                                         Amount
99213     Medical Office Visit (30 minutes)                   $195.00

Follow-up phone visits

Code      Description                                                           Amount
99443    Medical Phone Consult (25-30 minutes)       $195.00

To learn more about what to expect as our patient, make sure to read all three tabs below.

  • Biotoxin Illness Consults
  • Labs & Testing (Prices)
  • Biotoxin Facts?

What to do Prior to your Initial Visit with our Doctors

- Our office will send you an e-mail with all the new patient paperwork. You need to complete the the forms 1 week prior to your visit.

What to expect during and after your visit

- Much of the time is spent reviewing symptoms, educating about CIRS from exposure to water damaged buildings, and advising testing and treatment.
- Billing will be based on the amount of time spent for the consult.
- For phone consultations, our doctors  will forward your treatment plan and any other necessary documents via email to you, following your consult.

Follow up patients: will be expected to have following items available at the time of the consult:

- A log of major symptoms affecting your quality of life.
- A log of responses or reactions/side effects to treatments; the progression of your graded exercises if they were prescribed.
- Questions you would like to discuss during your visit.
- A local pharmacy number.- For phone consults, a reliable phone. Landlines work best for extended calls. If using a cell phone, please be in a location with good reception.
- Childcare arranged, if necessary.

Please Note for Dr. Berry’s Patients: She only manages CIRS from water damaged building exposures. She uses the diagnostic and treatment protocols based on the clinical research of Ritchie Shoemaker, MD, a well-known CIRS specialist. All other diagnoses will require care from your primary care physician or other medical specialists. Annual routine physical exams are a mandatory requirement for patients under our care.