Forms & Policies

Forms

At Tilia Natural Health, we ask you to fully participate in your healthcare. To this end, we ask that you take the time to complete forms prior to your first and all subsequent office visits.

For the first office visit, we suggest that you find a quiet hour where you are able to be reflective and honest in your responses. Please fax, mail, email , or drop off these forms at least 24 hours before your visit so that the doctor may study them before you meet. We have found that all of these steps will provide you with the very best care possible.
  1. Please download, print, and fill out one of each of these forms. You will receive a copy of anything with your signature on it.
  2. Please choose the appropriate intake form based on the age of the patient. Please download, print, and fill out this form, and include it with the others above.
  3. If you will be a patient of Dr. Eastman, please also download her welcome letter.

  4. If you would like the physician to include prior medical records in your first visit, please download, print, and fill out the following form. Please check the last box: “Other” and circle “All diagnostic labs and Imaging,” unless otherwise directed by Tilia Natural Health. Fax, mail, or bring it to the medical facility where your records are kept and your records will be sent to Tilia Natural Health. Please allow two weeks for this process.
    • Medical Records Release

      Note: The release of records does NOT mean you have inactivated your medical care at the other facility.
You do not need to drop this form off prior to your visit, but please be thoughtful in its completion. Your physician will look it over at the start of your visit.
  1. Please download, print, and fill out this form. Please bring it with you to your appointment at Tilia Natural Health.

 

Policies

 

Payment and Insurance

 

Laura Eastman, ND (formerly Walton)
  • Fully cash practice. This means that Dr. Eastman's clients pay in full at the time of service. Tilia Natural Health is able to provide you with a superbill to submit to your insurance company for reimbursement.

  • Not contracted with any insurance companies at this time, which means Dr. Eastman is considered an “out-of-network” providers for all insurance companies. All insurance plans in Washington state are legally obligated to cover naturopathic care to some degree.  Clients need to check with their insurance company to determine reimbursement coverage for out-of-network naturopathic care. To that end, we have created an insurance worksheet, which can be found here. Please complete this form prior to your first visit, and bring it with you.

Amy Wells, ND
  • In-network provider for the following insurance plans:
    • Regence
    • First Choice
    • FedMed
    • Premera.
  • Dr. Wells provides courtesy billing for her out-of-network patients. In order to provide this service, payment is due in full at the first appointment.
  • Please call the office for further information.

PIP and L&I

For our current patients only, we offer to bill Personal Injury Protection (PIP) to treat injuries from car accidents and Labor and Industries (L&I) for injuries resulting from employment activities that have been authorized by the Department of Labor and Industries. We will bill these agencies for payment as we provide you care. If payment is denied, the patient will be responsible for payment of all charges for service received.

PIP and L&I coverage generally does not cover medications, so these must be paid for at the time of purchase.

Phone and Email Consults

Phone and consultations are provided for established clients only, unless a new client lives out of the area. Email correspondence will not be accepted for urgent medical needs. Short emails clarifying follow-up on treatment plans or as requested by your provider are free of charge. Emails are reviewed and responded to in the order in which they were received. It may take up to 1 week for your doctor to be able to respond. Email is not the best way for your provider to assess any new health symptoms or concerns. Please call to make an appointment.

Notes on Phone and Email inquiries:

  • Phone calls and emails regarding an existing health issue that require more than 10 minutes of attention from your physician will incur a fee. A longer length of time spent responding to health concerns will increase the fee.
  • Phone calls and emails regarding a new health issue, regardless of the length of time of attention required, will also incur a fee.
  • Email consultations that require multiple communications will incur additional charges.
  • Phone and email charges are not billable to insurance.

This fee is not charged in the following cases: 

  • When you require clarification of on-going therapy
  • When the doctor has asked you to call

If there is any question about this service you are welcome to ask about a charge in your call or your email.  The physician will respond to your email within two business days; however, due to unexpected medical emergencies a response is sometimes delayed. If the doctor has not responded within two business days, please call or email the doctor again.

Off-hours phone calls

An off-hours number is available for contacting each doctor when they are not in-office. If your provider plans to be unavailable, the office voicemail will alert you to who should be contacted instead. There is a $75 fee for this service. Phone calls are not billable to insurance.

Antibiotic policy

Although the physicians at Tilia Natural Health have prescriptive authority to prescribe antibiotics, we will not do this over the phone. In order for all of our clients to receive the best medical care possible, an office visit is required to treat all infections. This will allow your physician to determine the best treatment options after a full physical exam and intake.

Bodywork

The physicians at Tilia Natural Health only provide bodywork for their current naturopathic clients. If you would like to establish care as a naturopathic client at Tilia Natural Health, our physicians would be happy to include bodywork in your treatment plan. If you are under the care of another naturopath and would like one of our physicians to provide bodywork, please provide a referral from your current provider with diagnosis codes and treatment guidelines.

Cancellation Charge

Dr. Eastman requires 24 hours notice for established patients and 48 hours for new patient appointments. Half the cost of the scheduled visit will be charged for cancellations with less than 24 hours notice. Full fee is charged if no notice is received. PIP insurance will not cover this charge- it remains the patient’s responsibility.

Dr. Wells requires 48 hours notice for all patients. This notice needs to be received during normal business hours, for any established patients to cancel or change an appointment. Appointments cancelled with less than 48 hours notice or those missed entirely will be charged the appropriate fee. This applies regardless of whether or when you received an email reminder, which we provide as a courtesy only.

Purchase & Return of Pharmacy Items/ Products

All pharmacy items must be paid for at the time of purchase.  Credit on account will be given for unopened items in perfect condition if returned within 30 days.  No credit will be given for items returned after 30 days.  Refunds cannot be made.  Injectibles, injection supplies, products packaged in the clinic, refrigerated products, homeopathics including UNDA, and birth control devices cannot be returned.

Payment terms

We accept payment by cash, check, or MasterCard / Visa / debit card.

  • Checks denied for lack of funds will incur a fee of $35.00.
  • All balances must be paid within 30 days of the invoice date. Balances over 30-days past due will
    be charged to your card on file. If that charge is denied, you will be invoiced at the end of the
    month.
  • A minimum billing fee of $10.00 or 2%, whichever is greater, will be added to any unpaid balance that is over 30
    days past invoice.
  • Payment plans are available upon request, though balances over $500 will continue to incur interest.
    We reserve the right to make changes to our fees and/or policies without advance notice.

Mailing of Pharmacy Items

Tilia Natural Health will mail items that have been pre-paid, including a minimum handling fee of $5.00 plus postage. Unfortunately, we cannot be responsible for your reception of these items. No refund can be made nor replacement sent if the items fail to reach you. 

Normal Business Hours

  • Mondays: 10:00 am - 12:00 pm
  • Tuesdays: 9:00 am - 5:00 pm
  • Wednesdays: 9:00 - 5:00 pm
  • Thursdays:  9:00 - 5:00 pm
  • Fridays:  9:00 - 5:00 pm

Our phone message will alert you to any change in our hours. You can access the off-hours phone number for your doctor through the phone system. Urgent messages left during our stated business hours will be responded to within the day, as possible.

 

Copyright © 2015 Tilia Natural Health
info@tilianaturalhealth.com  |  phone: 206.257.5817  |  fax: 206.257.5819