Frequently Asked Questions
How is a Functional Medicine different from conventional medicine?
Dr. Bera-Miller practices Functional Medicine and Integrative Medicine. In the Functional Medicine (FM) paradigm there is one core system (the Central Nervous System or the Mental, Emotional, Spiritual realms of our lives) around which seven other systems interact to support our optimal functioning and health:
Communication (hormones, neurotransmitters, etc)
Structural Integrity (musculoskeletal/spinal health at the macro level, and intestinal permeability at the micro level).
Dr. Bera-Miller's practice explores and addresses all of these factors that contribute to your health and well-being, including:
Stressors and stress resilience
Contribution of toxins to illness
Integrative Medicine means that Dr. Bera-Miller integrates all types of healing modalities in her treatment recommendations including diet, nutraceuticals, herbs, homeopathics, bioidentical hormones, acupuncture, massage therapy/body work, Ayruveda, and energetic healing. Dr. Bera-Miller recommends prescription medications only if absolutely needed.
The Functional Medicine approach can help many if not most patients, however it cannot guarantee any outcome and does not cure everyone. Whether someone improves with the Functional Medicine approach depends on many factors, including how ill they are, how long they have been ill, how able they are to implement recommendations for lifestyle changes, and sometimes how able they are to implement recommendations for labs and specialty referrals as needed.
It is very important to note that with the Functional Medicine approach and for the patients who benefit from it, they often can feel better within the first 3-6 months but sometimes it can take a year or longer to feel significantly better. This can depend on the same factors which determine whether a person will improve.
Who are the practitioners?
Dr. Bera-Miller's team members provide very valuable services to patients in between visits with her. The functional medicine approach recognizes five major pillars of health including Sleep and Rest, Nutrition, Movement, Stress Resilience Building/Maintenance, and Relationships/Community. Optimizing each of these pillars requires a lot of knowledge and support for anyone.
Dr. Bera-Miller's team members, as well as colleagues she refers to in the broader community, are extremely effective in helping people strengthen their pillars of health. While she as a Functional/Integrative Medicine physician has been trained in supporting patients in these realms it is much more cost-effective for patients to work mostly with non physician providers for this.
The new Blossom Group, an educational/peer support group which we aim to hold at least twice per year, also provides wonderful learning and support in a group and cost effective manner. Dr. Bera-Miller intends to also hold some day-long workshops beginning in 2019.
That is the reason why Dr. Bera-Miller has her team, to support patients in optimizing these pillars in their life towards optimal health.
Dr. Bera-Miller's current team includes a Functional Medicine Nutritionist (Susan Blanc), a Licensed Acupuncturist (Benjamin Dierauf), a naturopathic-type practitioner (Rashana Sharma who trained as a physician in India at Delhi University), and a Therapeutic Touch practitioner (Andrea Willoughby). Our Office Manager is Nila Santos, who has training and experience as a nurse and also in banking/customer service. Our New Patient Coordinator is Sue Benke and Sue also coordinates our support group called "Blossom."
What happens at the first visit?
At your initial appointment with her, Dr. Bera-Miller will review your in-depth intake form and ask you to share your health and emotional/social history, starting with your family medical history and mother’s pregnancy with you and extending all the way through the present time. She needs to understand all of the factors that have contributed to your present state of health or illness. She will then be able to give you an initial assessment of which systems are likely imbalanced and what laboratory testing would be helpful to further clarify imbalances.
Dr. Bera-Miller will also discuss nutritional/dietary approaches to your healing, and make recommendations for basic supplements personalized for your situation as well as lifestyle recommendations for enhancing your mind-body functioning.
At least 2 hours are needed for this initial appointment, sometimes as many as 3 hours with more complex cases. You will then follow up with Dr. Bera-Miller in approximately 4-5 weeks to discuss your initial laboratory results in detail, and create the next phase of your individualized healing plan.
The first follow up visit is 1 - 1 1/2 hours and the subsequent visits are usually 1 hour give or take 15-30 minutes depending on complexity of the case and questions patients have.
How much do visits cost?
Effective January 1, 2019, the rate to see Dr. Bera-Miller will be $375 per hour. This rate still remains for now at the lower end of rates for Functional/Integrative Medicine physicians, often $400/hour or greater. Our rates reflect not only the time we spend in office visits but also the substantive time that we spend behind the scenes preparing for patient visits, reviewing the information gathered during an office visit, formulating our root cause diagnoses and plans, and writing our chart notes and recommendations. This behind the scenes time can take up as much time as the office visit itself, and at the very least one third the time of an office visit. With my team approach I also spend a substantive amount of my time coordinating the approach and care that my team members provide for patients in collaboration with me.
Payment is required at time of service for all appointments. There will be no exceptions to this. If you anticipate that you are unable to pay at the time of your visit then please reschedule to another time, giving us sufficient notice (as per below) to allow us to schedule in another patient and to avoid your incurring a fee for a last minute appointment change.
A $375 deposit and a signed Policy/Consent form are required to schedule a new patient appointment. The deposit will be applied to your new patient visit fee at the time of your first visit. If you need to cancel your new patient appointment for any reason, your $375 deposit will be refunded unless we do not get 5 business days notice (the time we need to schedule in another new patient from our waiting list).
The fee for Functional Nutrition visits with Susan Blanc is $145/hour or prorated for shorter or longer visits. The initial nutrition visit is 60-90 minutes in length and follow up visits are often one hour although shorter or longer follow up visits can be arranged as well.
The fee for Acupuncture sessions with Benjamin Dierauf is $145 for the first visit and $95 for follow ups. The first visit is 1 1/2 hours. Follow up visits are usually one hour, though can be arranged to be shorter or longer as needed.
The fee for visits with our naturopathically oriented practitioner Rashana Sharma (whose skill set includes diet, mind-body medicine, Classical Homeopathy, Ayurveda, Reiki) is $295 for first visit which can last up to 2 hours and then prorated for future visits depending on the duration and type of follow up visits.
The fee for visits with our Therapeutic Touch practitioner Andrea Willoughby who also does light massage and body work is $125 per hour or prorated.
The hourly fees above apply to in person and phone appointments (for sessions that do not involve body or energy work).
Do you take insurance?
Our office does not have billing staff. For patients with Medicare and as of 1/1/2016, we require your completion and signature of the Opt Out private contract form which states that we do not and you must not bill Medicare for services provided by Dr. Bera-Miller.
For patients with all other types of insurance you may yourself submit the office visit receipt to request reimbursement. There is of course no guarantee that any individual insurance carrier will reimburse for Functional/Integrative Medicine services but we believe it worthwhile to explore this as patients have told us they receive anywhere from 10-75% reimbursement of office visit fees.
How do I get started?
Our New Patient Coordinator Sue Benke can help patients get started. Her phone# is 925-658-0661. She can let you know more about our practice and when is the next available appointment with Dr. Bera-Miller as well as our other team members. She will get you set up in our electronic medical records system and go over the forms necessary to complete in order to confirm your first appointment. She will also collect the deposit required to reserve an appointment with Dr. Bera-Miller which is $375 and applied to your first/intake visit.
We look forward to supporting you in your health journey.