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Patient Guidelines for Health Centers of America


  • A specialty clinic:Health Centers of America is a specialty clinic, specifically designed to offer in-depth care of patients with chronic illness. Our treatment involves a complexity of care rarely available in a primary care setting. We care for patients from all over the globe offering treatment for persons with complex infectious diseases, degenerative diseases, autoimmune diseases, and several other chronic medical conditions. Our unique approach is that we treat of all aspects of a person’s medical condition. Because of the intensity of our service and the energy investment required of our patients, we follow a rigorous approach to medicine.
  • Services: We specialize in the treatment of Chronic Illnesses such as Chronic Fatigue, Fibromyalgia, Lyme disease, chronic hormonal disorders, autoimmune diseases and preventive medicine by re-building the immune system. The type of treatment is dependent on each individual patient and the treatment plan is based on that uniqueness. Services include both traditional and integrative modalities.
  • Definition of patient:You will be considered a patient of Health Centers of America when you have had an in-person, initial medical evaluation by Carol Ann Ryser MD or Karen Beatham DO. We cannot give any medical advice, order lab testing or order prescriptions without having an initial appointment.
  • Medical Care:Our medical office and staff is designed for the treatment of chronic illness, therefore, we do not provide: critical care, emergency care, any services which require hospitalization, or primary care.
  • Pre-Requirement to become a patient:: Since we do not provide primary care, therefore, you must have a primary care physician in your hometown to provide regular medical services, emergency care, and hospitalizations.
  • Office hours:Office hours are 8:00 am to 4:00 pm, Monday through Friday, except for holidays. While the physicians may see patients after 4:00 pm, you will need to get your supplements, calls for appointments, changes in schedules, calls for prescriptions and other phone messages between these hours. The answering service will not call our physicians unless it is an emergency.


  • Initial evaluations:Making an initial appointment: You must call and have a 5-10 minute interview with one of our staff prior to obtaining an initial evaluation. Our physicians make their own schedule after being given new patient information. This includes family members and relatives of current patients.
  • Initial evaluations: All first time initial evaluations are 3 hours in length (cost $400). For patients coming from out of town, the initial evaluation covers 2 – 3 days involving 6-9 hours (cost $ 600 - $1,000). These costs do not include lab testing.
  • Be sure to bring all medical records to your initial evaluation: such as lab results, doctor evaluations & notes, hospital and surgery records, etc.
  • Medical Records: Please have a copy of your medical records sent to Health Centers prior to your initial visit or bring copies of them with you. The copies you bring to us will not be re- copied for you.
  • Bring lists: of all medications and supplements you are on. Please include names of meds/supplements, dates, dosage amounts, and how you are to take the medication.
  • Bring Prescriptions: in their original bottles to your initial appointment.


  • Length of appointments: All initial evaluations are 3 hours in length. Most follow up appointments are 2 to 3 hours in length. Most regular appointments are from ½ hr to 1 hour in length and can be longer.
  • Making appointments: When calling for an appointment please leave message with whomever answers the phone and allow up to 48 hours for a response.
  • Losing your appointment: Be sure to keep your appointment time in a place where you will remember it. If you miss your appointment time, you may not get another appointment for several weeks and be put at the end of other patients asking for an appointment.
  • Emergency appointments and walk-in appointments: Based on the clinic structure we are not equipped to handle emergencies nor walk-in appointments.
  • Tape Recording: We highly recommend you bringing a tape recorder to tape your physician and nurse appointments. This will help you with all the information you will be receiving and will help keep a record of treatment instructions.
  • Length of appointments: appointments will be made for complex and length of medical conditions, and on occasion last longer than was made for the original appointment.
  • Canceling an appointment: Since we set aside significant amounts of time for our patients, you must cancel at least 48 hours of working days, in advance in order not to be charged for the appointment. New patient visits must be cancelled at least 5 days in advance of scheduled appointment. If you are canceling a Monday appointment, you must cancel by the previous Friday by 10:00 AM. Not showing for an initial evaluation will cause you to be charged a minimum of $150. A non cancelled appointment will be charged to the patient also.
  • Arrival Times: Please arrive at least 15 minutes prior to your scheduled appointment and for lab appointments. IF you are a new patient, please arrive ½ hour prior to your appointment.
  • Non Compliance and Office Visits: If we find you to be noncompliant with office policies, including: not keeping appointments, not paying your bill, not being responsible for follow up visits, not following your treatment protocol of our physicians without consultation, creating on-going conflict with staff and other patients, you will be permanently dismissed as a patient to make room for other patients. You will not be given another appointment.
  • Phone appointments: Two days prior to your phone appointment, fax a one-page summary of your medical status since your previous appointment. Include what has gotten better, worse, current symptoms and note what is worse. Also fax your current medication lists including supplements. It will be very helpful if you pick upa check list to fill out when you leave from your previous appointment, fill it out, and fax along with your summary. If you have lab work you want reviewed, it must be sent to the doctor 2 days prior to your phone appointment.


  • Health Centers of America is fully compliant: with Federal Health Insurance Portability and Accountability Act (HIPAA). IF you have not received a copy of our privacy policy, we would be happy to furnish you with one. You will need to sign a HIPAA agreement upon becoming a patient.
  • Respect of other clients: Since we are a chronic illness clinic and our patients become acquainted with one another, we ask that you respect other people’s privacy as you would want your privacy protected.
  • Privacy of patient treatment: Each patient’s treatment protocol is different, therefore we ask that you do not give any advice to other patients about treatment.


  • General Statement about fees: We do not establish our fee schedules based on the fees charged by other providers as we are unlike any other providers. Our fees are based on the cost of providing treatment at our facility.
  • Fees Include: Time spent with the doctor, nurse, lab, IV treatment, reviewing medical reports (lab, x-rays, consultant reports), making and receiving calls on your behalf (other providers, insurance companies, pharmacies, etc.), preparing paperwork, writing letters of medical necessity, and other forms of communication.
  • Fee Structures:
    1. Initial 3 hour evaluation - $400
    2. Follow up visit, minimum of 2 hours - $270 and up depending on time spent
    3. Established patient generally an hour - $140 with ½ hour costing $80
    4. Lab costs may range from a few hundred dollars to several thousand. Lab costs are the responsibility of each individual lab and Health Centers nor our physicians have any responsibility with the labs and we are not in any way connected with the labs.
    5. Other fees may be incurred from time to time due to ancillary treatments or extra work required for your treatment.
    6. All Supplements are to be paid for when received and are not included in the price of the appointments. We will not charge supplements to your account.
    7. We will bill your insurance company on your behalf for the physician/nurse visits but not for supplements. Supplements are never covered by insurance.


  • General Statement: our billing staff will bill your insurance carrier for appropriate charges for services on your behalf. However, as our physicians have no contractual arrangements (not a participating provider including Medicare) your insurance carrier will reimburse at out-of-network rates, if they reimburse.
  • Self Pay:All patients are considered a self pay patient even though insurance may reimburse for any part of our charges.
  • Co-Pay: Co-pay may or may not be allowed based on each individual insurance company and their payment record with Health Centers.
  • Initial Evaluation(s):All initial evaluations must be paid in full at time of service.
  • Medicare: We do not have a contract with Medicare and we do not take assignment on Medicare or Government programs. Medicare patients must sign a waiver stating that they understand we will not bill Medicare. The waiver also states that the patient will not bill Medicare for charges incurred at Health Centers after the date of signing the waiver. rules as to what we charge. Also, many of our charges are not covered by Medicare.
  • Blue Cross: As stated previously, we are out of network for Blue Cross. Based on this Blue Cross will usually not assign (send) any insurance reimbursements to us. The checks will only be sent to the patient. Therefore, as with Medicare, all patient charges must be paid for at time of service.


  • Prescription refills: Unless it is an emergency, please have your pharmacist fax us your request for prescription refills. Fax to 816-763-9208. On the request, whether faxed by the pharmacy or by the patient, please have the following in the fax:
    1. Patient name and Date of Birth
    2. Patient phone number
    3. Prescription Medication Name and refill number
    4. Dosage, quantity, number of refills and directions for taking medication
    5. Pharmacy Name and phone number
  • Patient calling in script: Calls for medication or prescription refills must be done during the business hours 8:00 am to 4:00 pm. IF you call after 4:00 pm you will get the answering service and the script will not be filled until the next day or in the case of a Friday, the script will be filled on the next Monday.
  • Length of wait for refills: Please allow up to 3 days for script pre-certifications to be completed when involving insurance companies. This may take 5-7 days.
  • No prescription will be given: unless the patient has been seen by one of our physicians within the past 6 months. Do not wait until the last minute to get an appointment for medication or to have your pharmacy call for a refill. Plan ahead.
  • Prescriptions from other physicians: will not be refilled, such as heart meds, birth control pills, etc.
  • Drug formularies and Insurance: Your insurance company keeps drug formularies which our office needs to be updated. We keep a copy of the formulary in your medical chart.


  • Relationship: We have no business relationship with any lab, we do not collect for them nor conduct business for them. When ask, we will send them medical information that will help with insurance reimbursement.
  • Drawing Blood: Blood drawing is performed by our in-house lab and sent to reference labs or specialty labs for evaluation. A fee is charged for the draw and shipping and handling.
  • Charges for lab testing: Each lab we send blood to sets their own charges and they are responsible for their collections. There will be extra charges for some of the labwork.
  • Insurance and labs: Insurance may pay for some of the lab work but not all of them. Be prepared to have some out of pocket expenses for blood work. Several of the labs ask for payment to be sent with the blood and the labs are responsible for billing the insurance company.
  • Collections on lab charges: We are not a collection agency for the labs. Each lab must be contacted for information. We will give you when you have blood drawn, a copy of the labs we use and the reason we use each specific lab.
  • Lab results: Do not call for lab results as we do not give them out until you have your next doctors appointment.
  • Critical lab reports: if your lab results are of critical nature you will be called by our nurse and given the results along with appropriate treatment measures. If it is not critical, you must wait until your next appointment to get the lab results.


  • General Statement: emails to and from Health Centers of America is to be used for administrative purposed only. We will not give any treatment recommendations or medical questions answered via email. Emails are viewed on a daily bases. However, responses to emails are usually completed within a reasonable time frame (48 hours) depending on the request. Do not expect an immediate response.
  • Urgent request: If urgent, you must call our office and not use and emails so our physicians can respond accordingly.
  • Emails to: Health Centers are to be used as follows:
    1. Information, data, logistics and requests for scheduling will be shared with the doctor within a reasonable time frame.
    2. Orders for supplements to be sent to patient
  • Emails from: Health Centers are to be used as follows:
    1. Confirmation of scheduling and logistics
    2. Confirmation of supplements that were sent if needed
  • Emails will not be responded to for the following questions: they need to be answered by one of our physicians or nurses in an appointment.

    1. Medical questions regarding diagnosis
    2. Medical questions regarding lab tests
    3. Medical questions regarding treatment
    4. Medical questions of any nature

  • General Statement: In general, faxes by patients are for urgent matters only. If you fax a question that is urgent, keep the question short and to the point.
  • Content of fax: No major discussions will be done via fax. You must make an appointment if you need a detailed answer. We do not have the time to respond to general questions by fax.
  • Appointments by fax: you can send in a request for an appointment by fax
  • Prescriptions by fax: see prescription section
  • Medical questions: You may send in a fax regarding a medical question but it will not be responded to until you have an appointment. If it is an emergency or of urgent nature (Medication or Herxheimer reaction) you will need to call and talk to a physician or nurse.


    General Policy Regarding Urgent/Emergency and Non-emergency Phone calls for Health Centers of America, KC, LLC is as follows:
  • Medical emergencies: go to emergency room and have the hospital call us if needed.
  • Emergency after hours: leave a message with the answering service and they will contact whoever is on call.
  • Non emergency phone: calls allow 48 hours for response. Go to the emergency room for the following – immediately.
    1. vomiting
    2. diarrhea
    3. high fever
    4. heart attack
    5. seizures
    6. extreme pain
    7. injury
    8. other emergencies as indicated
  • After hours urgent: phone calls that are critical such as reactions to medication will be answered as soon as possible. If you do not get a response within one (1) hour, call again.
  • After hour non-emergency: phone calls will be answered the following day.


  • General Statement: As a general rule we will give the patient one copy of their medical records when requested. It will be on a disk. Patients are then responsible for copies should more be needed.
  • Other physician records: We cannot copy medical records from other physicians to give to you.
  • No medical records: will be sent if you have an outstanding bill with Health Centers or have not been keeping your arranged agreement with Health Centers about payments. If you have any questions about this, please contact our business office.
  • Charges for copies of any paperwork: There is a charge for coping medical records and any paperwork not connected with a physicians treatment of a patient. There will be a charge for a second copy of medical records by patients. Charges for copies are as follows:
    1-5 pages $5
    6-10 pages $10
    11-15-pages $15
    16-20 pages $20
    <21-50 pages $30
    over 50 pages $75
    complete charts $100
  • Insurance companies: We will send medical records to insurance companies when they ask. They will be sent on disk.
  • Other physicians and professionals: We will respond accordingly when we receive information ask for and the patient has signed a release of records.
  • Requests for medical consults and information: will be granted when the proper request has been signed by the patient. We will not talk to any person, physician or insurance company without as signed consent by the patient.


  • General: our answering service is for medical urgent situations that a physician or nurse needs to be called.
  • General questions: Please do not use the answering service for general questions, prescription orders, etc. They must be done during regular business hours.


  • Disability forms: We do not do disability physicals. We will respond to disability information ask for in forms as it relates to your chronic illness. However, to fill out the forms, you will need to make an appointment with our nurse at least 1 week prior to due date. There will be an appointment charge for filling out the paperwork. This includes Family Medical Leaves (FML).
  • Narratives: We do not prepare narrative reports, under any circumstances.
  • Letters of Medical Necessity: We will prepare a letter of medical necessity when ask for my an insurance company. All records will be sent on a disk.
  • Use of cell phones: Cell phones must be turned off inside the office building and all treatment areas. If you need to talk on the cell phone, please step outside or go to an area that will not interfere with patients or the business of Health Centers.
  • Chemical Sensitivity: Many of our patients are very chemical sensitive due to their chronic illness. Therefore, we ask that no one wear any strong smelling perfume, etc. We also ask that patients respect chemical sensitivity and not bring food that is strong smelling into the building such as garlic or onions.