Please reach us at office@RootsandRivers.health if you cannot find an answer to your question. You may also call & text (509)537-3660.
Please note prices are subject to change.
A commitment of 2 appointments is required to become established. This includes:
Appointments may be in In-person at the Private Office Location or via our secure Telemedicine Platform. Please bring any labs , records and current supplements with you. Please have your New Patient Paperwork completed at least 48 hours before your appointment so that I may prepare for your case.
* please plan extra time for appointments so as to not rush.
My specialty is Natural Medicine. I practice in the Vitalistic tradition which means my job as a physician is to assist in bringing balance to the body so that it can heal itself, like it was designed to do. This philosophy is different because it assumes there is a vital force that animates life, not just mechanical and biochemical processes.
I have academic and clinical interests in iatrogenicity (i.e. mitigating harm and nutrient deficiencies from pharmaceutical medications while finding the least effective dose with the least side effects) and Environmental Medicine (illnesses acquired due to environmental factors such as neurodegeneration, allergies, inflammation, toxic exposures).
The service I provide is my time and expertise in natural medicine. This takes time and I want you to get the chance to tell your story. I do a comprehensive physical & nutritional exam which many find informative. I present you the treatment plan at the second visit and I take much time to teach you about health, diet and your susceptibilities that can be prevented. I encourage patients to bring all of their supplements with them as I teach you about ingredients and figure out what you need or don't need (and maybe even find something that was more harmful than beneficial). The visit includes the use of a traditional naturopathic modality to determine your individualized anti-inflammatory diet.
No.
Superbills are available to those who have out of network reimbursement benefits. A superbill may be sent to one's insurance company for reimbursement or to be applied towards their deductible.
The insurance company dictates their own pricing structure. For example, if a new patient first office call (coded 99204) is billed at $375, your insurance may say that $211.09 is the allowable amount which they put towards your deductible. They may or may not reimburse 40% of that cost back to you if you have out of network coverage so you could receive $126.65 back.
HSA (Health Saving Account) credit cards can be used to pay for appointments, procedures, and supplements that have been prescribed to you by the doctor.
Click here for the link to the Pricing Page. Rates are subject to change. It is customary to increase prices annually or bi-annually to reflect cost of living increases, inflation, and experience in the field.
I would like to take a moment to discuss pricing. In 2023, at a local health care system, it costs $495 for code 99204 to establish care which included a medical assistant compiling medical history for 15-20 minutes and a 15 minute visit from a Physician Assistant. In contrast, our medical visit coded as 99204 is a 2 hour visit with a Naturopathic Physician was $550. My wish is to support you better by giving you ample time with a doctor to teach, treat, and diagnose so that you are heard and feel well-cared for.
The insurance model is meant for catastrophe and is really a discount program for other services outside of an emergency. Similar to car insurance, I do not ask my mechanic to cover the costs of new tires, oil changes, car washes, or accessories; I budget myself accordingly to maintain my vehicle.
If I were to take insurance, I would have to hire a billing/compliance person for the practice which would require me to have shorter visits with you and to see many patients each day. I believe this reduces my ability to help my patients.
I would rather see you getting back to work and being with your family sooner by reducing the overall appointments needed to get results.
I use Science-based medicine which values clinical experience, research, expertise in anatomy & physiology, and intuition. Evidence-based medicine relies on peer reviewed literature but this alone, to me, this does not encompass a large component of health that cannot, by design, be measured or studied.
No, this phrase "functional medicine" is trademarked and hence can only be used by those with the certificate from IFM (Institute of Functional Medicine) which entails a curriculum which was designed by Naturopathic Doctors to bridge conventional providers towards more holistic approaches. Though I appreciate the role functional medicine has had, it primarily works by targeting organs and functions with chemicals trying to address what might be called metabolic disturbances or biochemical disturbances. The philosophy is basically a conventional medical model such as: begin with a person, the person has the disease, here's the diagnosis, we're going to approach that diagnosis. Instead of using drugs, we're going to use natural substances, nutrients, nutrient chemicals, essentially, we're going to use a more natural chemical to address the symptom. But they're not doing level one, level two, level three of the therapeutic order.
When you do the therapeutic order, patients get better, and they don't need you to address their symptoms, because they don't have symptoms anymore, because the underlying reasons why they were sick are gone in the first place.
1. Identify and remove, or moderate, disturbing causes or causes of disease
a. Dr. Snider changed that to establish the foundation for optimal health, identify and remove obstacles, assess the determinants of health
2. Stimulate the vital force (e.g. using homeopathy & hydrotherapy)
3. Support or restore weakened systems
4. Address physical alignment restored proper structural integrity.
5. Symptom control. Use of natural substances to palliate symptom disturbance.
6. Synthetic symptom relief, the use of drugs to palliate
7. Suppress symptoms
from
Dr. Jared Zeff, ND and Dr. Pamela Snider, NDs updated Therapeutic Order of Naturopathic Medicine
Those methods which:
1. Establish normal surroundings and natural habits of life in accord with nature's laws.
2. Economize the vital force.
3. Build up the blood on a natural basis; that is supply the blood with its natural constituents in right proportions.
4. Promote the elimination of waste material and poisons without in any way injuring the human body.
5. Correct mechanical lesions.
6. Arouse the individual in the highest possible degree to the consciousness of personal responsibility and to the necessity of intelligent personal effort and self-help.
from Henry Lindlahr
I do both! As much as technology is a wonderful tool, I have found it to be a time-drain in my practice. I utilize an EMR (Electronic Medical Record) service for billing, scheduling, documents, faxing, prescriptions, etc.) But, I offer paper-only charting where applicable and upon request.
Homeo ("similar") Pathy ("disease")
Homeopathy is the art of curing founded on resemblances, introduced by Samuel Hahnemann. The principle is, that every disease is curable by such medicine as would produce, in a healthy person, symptoms similar to those which characterize the given disease. The Latin expression is "similia similibus curantur", in opposition to the "contraria contrariis" - allopathic appraoach, aka. heteropathy.
Yes. I do House Calls for Established Patients within a 10 mile drive of Wenatchee, WA beginning at a minimum of 3 physician billable hours . Trips further out require a trip fee of at least $75.
Please log in to: https://us.fullscript.com/welcome/drgussak
Two easy ways:
Price List may be subject to change. Inflation expectations usually suggest price increases annually of 5-15% for services.
Telephone calls, e-mail and chat communications may be subject to time-based invoicing at the hourly physician rate.
A Credit Card is required to make an appointment and held via Healthie, the secure and PCI compliant Electronic Medical Record System, for the purpose of invoicing. Payment is collected at the time of the appointment.
Cancellation & Rescheduling Policy: Notice must be by email, text, or voicemail and be sent no later than 24 hours prior to the start of your scheduled appointment time. Appointments cancelled within 24 hours (including no-shows) are charged 100% of the scheduled visit’s value. Regarding rescheduling outside of 24 hours advance notice, the first time has no penalty. The second reschedule is charged 50% of the visit’s value. The third reschedule is charged 100% of the visit’s value. For established patients, one cancellation charge is waived. Please give your calendar a thorough look before scheduling.
Roots & Rivers Naturopathic Medical Center
Dr. Maria Luisa Gussak - Naturopathic Physician & Medical Director
5 S. Wenatchee Ave Suite #301 Wenatchee, WA 98801
P:(509)537-3660 F:(833)390-1316
Naturopathic Doctor, licensed and insured
Washington state. Holistic & Natural Medicine Consultant
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