TELEMEDICAL REQUEST FOR MAILING OF NEEDED MEDICATION

Price Increase Notice

Announcement Date: April 11, 2023

Effective Date: June 1, 2023


Dear Valued Patients,


I hope this letter finds you in good health and high spirits. I am writing to inform you about an upcoming change in our pricing structure at Holland Clinic. As a medical weight loss clinic, we have always aimed to provide the best possible care at the most affordable prices.

Unfortunately, due to several factors, we must adjust our prices effective June 1, 2023.

Our current pricing is based upon a 'base fee' of $49 per 28 days, combined with a fee for office-dispensed prescription weight loss medications that varies between $28 and about $56 for a 4-week medication supply. This results in our current prices per 28 days ranging from about $77 to $105. We have not raised prices since 2016, but the time has come for us to do so.

Effective June 1, 2023, the price of our base fee will increase by $10, bringing the base fee to $59 per 28 days. Additionally, the prices of our medications will rise slightly to a range of $35 to $70 per 28 days. This will raise the total visit price to a range of $94 to about $114 per 28 days, reflecting an overall price increase of about 22%.

There are many reasons for this price increase. First, the national and local inflation rate is currently at 6.5% after reaching a high of 9.6% last year. Second, wage inflation has been far more dramatic, and as someone who believes in paying more for excellent staff, I have raised the salaries of my employees commensurate with local wage inflation. This is a significant cost for a small business like mine. Finally, the cost of prescription medications has increased and continues to rise.

We have resisted price increases for as long as we could, but we can no longer run our business without making these adjustments. I want to assure you that even after these increases, we will continue to be the lowest-priced medical weight loss program in the state and, we believe, in the Western United States. For comparison, a well-known local competitor charges about $280-$400 per 28 days, which is roughly 3-4 times the price we charge.

We understand that some of you may not be able to afford our new prices, and we are profoundly saddened and sorry for the impact this may have on your continued care with us. However, the alternative would be to close our practice, which is not a desirable option. Please do not hesitate to communicate with our office or with me personally about these increases. We will do everything humanly possible to ensure that we can continue to offer you medical care.

Thank you for your understanding, and we appreciate your trust in us as we continue to serve you.

Sincerely,

Dr. Mark Holland, MD Holland Clinic

Announcement on website



Also, be sure to authorize us to charge an amount of money that will cover the cost of this mailing. We cannot bill your card for an amount larger than you authorize and this will again cause a 1-2 day delay. 
To figure an authorization amount, use your last charge with us as a basis. If your last charge was $83.55 (TOTAL) for 28 days of medication then the charge now for 28 days will also be $83.55 (unless your medications change) and you should authorize a $100 charge. If you need twice as many days this time, then the charge will be $167.10 and you should authorize $200 AND SO ON. 


If you indicate that you want us to call you with an exact charge, we are happy to do this but it will also delay the mailing by 1-3 days. 

The fastest way to get your mailing is to:

  1. Submit accurate information, especially card numbers and mailing address 
  2. authorize a sufficient card charge to cover the costs of your medication mailing 
  3. DO NOT request that we call you with an exact price before mailing. (Because cost depends on medication and that depends on a number of factors, we cannot generate an exact figure for you here on this form. BUT, we will NEVER charge you more than the actual cost, even if you authorize some enormous figure.)

EFFECTIVE MARCH 1, 2019: The fee we charge for mailing will increase from $10 to $15. As you may know, postage rates have increased and various regulations related to mailing prescription drugs have become significantly more complex and time-consuming
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HAVE MORE THAN 180 DAYS (6 MONTHS) ELAPSED SINCE YOUR LAST WEIGHT LOSS PRESCRIPTION SHOULD HAVE RUN OUT?
IN OTHER WORDS, ARE YOU MORE THAN 84 DAYS LATE FOR YOUR VISIT?

BECAUSE OF CONTROLLED SUBSTANCE PRESCRIBING LAWS IT MAY NOT BE POSSIBLE TO MAIL YOU MEDICATION

BECAUSE YOU HAVE BEEN AWAY LONGER THAN 180 DAYS, YOU MAY NOT BE ELIGIBLE FOR TELE-MEDICAL CARE. PLEASE CALL US AT (505) 232-6818 IF YOU HAVE ANY QUESTIONS. Please note that because of COVID-19, many of our prescribing policies have temporarily changed and if something here conflicts with what we have told you by telephone, you can rely on what we told you. DR. HOLLAND MUST CAREFULLY REVIEW YOUR ANSWERS TO QUESTIONS ON OUR 'RESTART' FORM BEFORE HE CAN ALLOW YOU TO RESUME TREATMENT..FORTUNATELY, THAT FORM IS SHORT.

YOU ARE WELCOME TO COMPLETE THIS FORM FIRST IF YOU LIKE AND THEN COMPLETE THE RESTART FORM OR YOU CAN JUMP TO THE

RESTART FORM

DO YOU WANT TO CONTINUE WITH THIS FORM NOW OR RETURN LATER?

YOUR TELEMEDICAL REQUEST

HOW MANY WEEKS WORTH OF MEDICATION DO YOU WANT TO REQUEST?*
84 Days is the absolute maximum by law
IF DR. HOLLAND DISALLOWS A MULTI-MONTH MAILING, WILL YOU WANT 4 WEEKS INSTEAD?*
IDENTITY PASSWORDS WILL BE REQUIRED STARTING JUNE 1. HOW DO YOU WANT TO SET YOURS?
WE WILL EMAIL INSTRUCTIONS TO YOU SHORTLY BUT FOR TODAY YOU DO NOT NEED A PASSWORD
Patient Name (legal name as it appears on your driver's license or other official documents)*
Last Name
Date of BIrth*
Must be in this EXACT format: (505) 000-0000 (Parenthesis THEN area code THEN close parethesis) then SPACE then first 3 digits THEN HYPHEN THEN last four digits

TEXT MESSAGING

If you would like us to contact you by text message (sms), just make sure the phone number you provide is mobile. We also need the name of your cellular service provider in order to send text from our network.

IF YOU DO NOT PROVIDE YOUR CARRIER NAME WE TAKE IT TO MEAN THAT YOU DO NOT WANT TO RECEIVE A TEXT MESSAGE.

The name of your cellular telephone carrier
We need this to send you a text message
HOW WAS YOUR BLOOD PRESSURE CHECKED THEN?*
LEAVE BLANK IF YOU ARE NOT DIABETIC
If yes, please write it in
IF YOU HAVE, PLEASE CAREFULLY WRITE THE NAME, DOSE AND INSTRUCTIONS
IF YOU HAVE, PLEASE CAREFULLY EXPLAIN IT
Your prescription weight loss medication status*
How did you take your last weight loss medication?*
Remember that it is never safe to take more medication than prescribed
Why did you reduce the dose of your medication?*
On days when you take your weight loss medication, have you experienced any of the following?*
Since your last office visit, how has your weight changed?*
What are your body weight goals at the moment?*
Overall, is this weight loss program helping you achieve the goal you just picked in last question?*
Pick how well you think the weight loss medication is helping with the same goals*
Describe your motivation for weight loss lately*
Describe your diet since you last contacted us*
Be honest. This is NOT some sort of test that you can pass or fail.
How often are you exercising these days?*
Anything at all...

PAYMENT

How do you want us to handle your payment today?*

PAYMENT METHODS

Card Type*
EXACT BILLING ADDRESS FOR CREDIT CARD*

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↑EXPIRATION DATE OF CREDIT CARD*

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CARD ON FILE

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Expiration Date of CARD ON FILE*
EXACT BILLING ADDRESS OF CARD ON FILE*

SPECIAL PAYMENT ARRANGEMENTS

MAXIMUM DEBIT AUTHORIZATION

Because the medication(s) you will receive are prescription drugs, Dr. Holland, as the prescriber, is the only person who can make the final decision about which kind and what strength of medication is most likely to help you. That means that there is no way for us to generate an exact price for you here and now. We can only know the price after Dr. Holland has actually written your prescriptions a few hours after you submit this form. 


There are two ways that you can address this price uncertainty. The best (fastest) way is to authorize us to charge an amount that is a bit higher than your last charge (we can always charge you LESS than you authorize, but never MORE). That way we can run the slightly lower real charge when we have calculated it after Dr. Holland has issued your prescriptions. BUT... If you authorize an amount that is lower than the actual charge, we will not be able to finish your order until we have spoken with you and you have authorized the exact amount. This usually causes delays of days or even weeks (depending on whether we can easily reach you over the phone.)


The second way you can do this is to have us call you to give you the exact price and get your authorization for that amount. This sounds simple but it usually is not. The problem is that it can be very hard to connect over the phone. We are still short-staffed after COVID-19 and often we end up playing phone tag with people for days or weeks.


Honestly, you are much better off simply authorizing a slightly higher amount. We will NEVER bill you that mount, we just need your authorization so that we can bill the actual amount.

How do you want to handle your charge?*
WE WILL ONLY CHARGE YOU OUR USUAL CHARGES BUT WE CANNOT CALCULATE THOSE CHARGES LIVE HERE AND NOW
Indicate the MAXIMUM amount you authorize us to charge your card*
We will never charge you anything more than regular price (but we cannot generate that figure here). If you authorize less than the actual price, we cannot process this request.

SHIPPING

During the Covid-19 emergency, the only option for mailing to you is U.S. Postal Service, First Class Parcel Service with mail tracking.*
In most instances, your medication parcel will arrive the very next day after we mail it. We mail every day except Sunday and on most days, we are able to fill, package and mail your prescriptions provided that you complete the request here before NOON.
EXACT SHIPPING ADDRESS TO WHICH YOUR MEDICATION WILL BE SENT---CRITICAL!!! Make certain you give us your EXACT address. Any errors will cause a serious problem and you may not receive your medications and we may not be able to mail to you in the furture. GET THIS RIGHT!*
IF YOUR CONTROLLED SUBSTANCE MEDICATION IS LOST OR STOLEN IN SHIPPING WE CANNOT REPLACE OR REFUND IT*
This is extremely rare but it has happened and controlled substance rules prevent us from replacing it.
Dr. Holland generally cannot change your medication dose or type through a tele-medical (mail) visit. During COVID-19, this has been relaxed a little but if you want changes, we must obtain Dr. Holland's approval and then speak with you over the phone.*
DEPENDING ON THE INFORMATION YOU SUPPLIED HERE, DR. HOLLAND MAY DISALLOW A TELEMEDICAL VISIT AND INSTEAD REQUIRE THAT YOU COME TO THE OFFICE*
IF YOU ARE HAVING SERIOUS SIDE EFFECTS OR OTHER PROBLEMS
YOUR MAILBOX MUST BE AT LEAST 14 INCHES DEEP TO HOLD THE 12 INCH TUBES WE USE FOR MAILING*

IF YOUR MAILED MEDICATIONS ARE LOST OR STOLEN

we cannot replace them and WE MAY NOT BE ABLE TO MAIL MEDICATIONS TO YOU AGAIN. If your mailbox is not secure, do NOT proceed. 

I understand that if my medication order fails to arrive, I will not be able to receive more until the lost prescription was due to run out.*
I understand that if my medication order fails to arrive, I will NEVER be able to receive mailed medications again EVEN THOUGH IT WAS NOT MY FAULT*

THANK YOU!


CORONA-VIRUS ISSUES:

The United States Postal Service is performing heroically during this public health emergency and generally, the mail is still working. BUT NOT ALWAYS! When a postal service employee tests positive for corona-virus, the whole office must be shut down and any mail present in the office that day must be disinfected through a process that the Postal Service has yet to announce. We cannot be sure, but we believe that mail needing disinfection is going to Denver and once it is disinfected, then it returns to the system for delivery. Again, we cannot prove that this is how it works but we think that we have pieced it together. This may cause delays lasting up to TWO WEEKS. But we have only seen this about three times in hundreds of mailings. Most mail arrives the day after we send it.

Can You Get Coronavirus From the Mail?

Nobody knows the answer to this question but most experts think it is unlikely. If a piece of mail were badly contaminated, it might have live virus on the outside and it COULD be risky so if you want to be sure, wipe the outside of the mail with bleach water. In any event, the mail you receive from us is sealed inside a coated tube and the medications inside cannot be contaminated (unless the tube and the seal were broken and you would obviously see this). We use tape-sealed tubes to pack our medication. And I (Dr. Holland) fill the prescriptions using a mask and gloves. The medications themselves cannot be contaminated even in the extremely unlikely event that the outside of the tube was.

DATA SAFETY

Your data remains encrypted (high level) on Amazon Web Services and we download the raw csv data to our machines several times daily where it is decrypted and added to our database. Dr. Holland reviews your data within hours on most working days and daily on days off.


    • If we have any questions we will contact you immediately
    • If we are unable to fulfill your request, we will contact you immediately
    • Unfortunately, during the Covid-19 crisis, we are unable to offer shipping confirmation automatically. But if we billed it, we sent it. If you have any questions, please call us.
    • Generally medications arrive 1-2 days after they leave our office but it can take 1-3 days longer depending on postal service 'issues'.
    • We usually suggest completing a mail request like this one about a week BEFORE your prescription is due to expire so that there is no interruption of your care.

Mark Holland MD, Amanda,Gretchen and Matthew

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