Do you take insurance?

Many people have learned to equate Health Insurance and Health Care.  Especially over the last 10 years, these things have gotten further and further apart.  Here at Advanced GYN, we aim to provide complete whole woman care, and that is at odds with the way insurance works.  In order to provide the kind of care we think is best, it requires us to work outside the “insurance system.”  What many people will find is that the cost is equivalent over time and when services are needed above one preventive care visit a year, this model is much less expensive for patients.  We don’t want you to ever get a surprise bill and we will make our pricing as transparent as possible.

What is a healthcare subscription?

For patients that desire to know that an entire year of costs with us is covered, we offer a subscription service.  There are multiple options available so you can pick the one that best meets your needs.  These subscriptions entitle you to certain benefits, but most importantly, it entitles you to fast access to your doctor.  In order to provide high quality care, we have to see fewer patients.  The subscriptions cover the cost of having the office always available to you because we won’t take as many patients.

Are there different levels of healthcare subscriptions?

Yes!  As a patient, you are the one most aware of your healthcare needs.  We are offering different packages to make healthcare as affordable and accessible as you need it to be.  Our goal is to meet each patient’s needs by being as flexible as we can.

Is this type of practice only for rich people?

No.  One of the most frustrating things in medicine is to have a great treatment plan to help a patient and then not be able to move forward because the patient can’t afford the medicine or surgery.  Even worse, if you try to do something you think is reasonably priced, the patient may get a surprise lab or hospital bill.  Even minor procedures in the hospital generate facility and anesthesia fees that can be upwards of $10,000.  The patient cannot get an up front guarantee of cost.  This leaves the uninsured and those with high deductible plans – often the working class – with minimal access to health care even though they are spending alot of money on "insurance."

Working for a corporate entity, most doctors aren’t even informed of what the service they are providing is being billed for.  They aren’t told how much the supplies they are using cost or what their use is being billed for. More importantly, if you are using insurance, your doctor has no idea what your bill will be even if they know how much is typically charged.  When Dr. Moore was in private practice she knew what was charged for each service, but then each insurance negotiated (or more often than not when dealing with a small practice – told us) a price.  Often hospitals and large medical systems are the big guy and can negotiate high reimbursements for their services – the result?  You pay more.  All of that ends when we have radical price transparency and remove the middle man.

By creating a system with no hidden costs, we are also serving the people for whom healthcare is out of reach because a very high deductible is effectively a barrier to accessing care. 

Can I pay for services as I go?

Yes!  Our goal is to help people find the best health care solution for them.  There are many times when everything is stable and good and you don’t have any ongoing needs outside of your annual exam.  Other times, you may know something is going on and more follow up is needed or you want to work more on achieving your optimal health you may choose a higher level of care. 

If I have insurance, why would I go to a doctor that doesn’t take it?

We believe in providing the best care at Advanced GYN and Wellness.  We think it should be the doctor and the patient that decide what’s most important.  Your insurance will have very specific regulations about what we can and cannot talk about.  When the doctor patient relationship is the only thing controlling the conversation, we think you get better care!  We also promise that because of our flat rate pricing model, we will never order extra tests or imaging you don’t really need in order to increase the billing charges.  We are happy to provide you with the necessary ICD 10 and CPT codes to file with your insurance so you can be reimbursed for a portion of your care.  Because we desire to have a small personalized office where we provide better care, we will not have an insurance billing department.  By keeping overhead low, we keep prices low for all the things insurance doesn’t think are important – like helping you reach your best health rather than just managing chronic diseases.

What if I need labs drawn?

There are times when lab monitoring is key to medication adjustment as well as routine screening.  To meet this need, we have contracted with laboratories to provide you at-cost testing.  This is as transparent a model as we can provide.  If you have a test done, we have a good idea of the cost ahead of time and we will give you good faith estimates.  We offer both in office phlebotomy as well as allowing you to go to your closest Labcorp or Quest office to get labs drawn.  Also, some of our plans include labwork and these can be very economical.  Additionally, you can submit any lab bills to your insurance and they may provide reimbursement or count toward your deductible.  We promise not to do any test we think is unnecessary just to generate higher office billing codes.

What happens if I need surgery?

For many people there are minor procedures that can be performed in an office setting with the right setup.  By virtue of Dr. Moore’s specialty certification in Minimally Invasive Gynecologic Surgery, she is able to bring a number of procedures out of the hospital OR and into the office setting.  This allows you to be more comfortable, stay with the team you know and trust and significantly reduce your cost.  We are able to offer “moderate sedation” (similar to a colonoscopy) for office procedures.  This keeps you comfortable and wears off very quickly – but don’t forget your driver! 

There will always be some procedures that require more complex care or equipment than we cannot provide in the office.  These include laparoscopic procedures and hysterectomy.  It is our firm belief that every patient deserves access to a minimally invasive surgeon.  Today, we can do a hysterectomy for someone that allows them to go home the same day, return to light duty in 2 weeks and have a quicker, more comfortable recovery that minimizes narcotic need.  This is possible even in women with multiple prior Cesareans, very large fibroid uteri and with severe endometriosis.  We are contracting with a local ambulatory surgery center to provide these services.  ASC’s offer hospital surgery without the hospital and they have the ability to provide deep sedation and general anesthesia.  It’s essentially a free standing Operating Room. We can give you up front pricing and you can focus on your recovery instead of wondering about the cost. 

What happens if I have to go the to ER?

My number one hope is that the majority of ER visits can be avoided by having quick and easy contact with your doctor.  Women’s healthcare is generally not best done in an ER, but there are times when emergencies happen.  If you are not sure this is an emergency, please call us and we will counsel you about when/how to seek care.  If you are having an emergency, please contact 911 or proceed to your nearest emergency room. 

What determines if a procedure is an “office procedure” or a “hospital surgery?”

There are a number of things that go into where a procedure is done.  There are many things that can be done in the office, but every patient may not be a candidate for that procedure in the office.  This may relate to pain management, comorbid conditions such as respiratory and heart disease or the risk of complications.  This is also often limited by what capabilities the office maintains.  Some things, like colposcopy for an abnormal pap smear, are almost universally available in gynecology offices.  Others, like a hysteroscopy where a camera is inserted in the uterus, are only available in offices that offer certain anesthesia services and have the setup to perform them.  Under the insurance model, hospital procedures are much more expensive.  By moving moderate sedation out of the hospital, we can provide office procedures at a much more affordable cost in a much more comfortable setting.  Any procedure that requires more than moderate sedation cannot be performed in an office setting. 

Is anesthesia provided with office procedures?

Yes!  At Advanced GYN and Wellness we want to change the whole concept of how care is provided.  By bringing moderate sedation to the office, we are providing a significantly higher level of care than the average office.  We want you to be comfortable.

Is anesthesia necessary if other offices aren’t offering it?

Yes and No.  Anesthesia is necessary for more complex office procedures such as hysteroscopy and Novasure ablation.  We are proud to offer this in the office to help patients avoid the expense of a hospital procedure.  For less invasive procedures, some people will be fine with taking some oral medication beforehand such as ibuprofen or Ativan.  For others though, anesthesia allows them to have a procedure they would otherwise not be able to tolerate.  Due to the intimate nature of gynecologic procedures, the effects of age on vaginal tissue and the long lasting results of trauma, we do not judge a person’s need for help in achieving her desired level of comfort for her procedure.

Do you provide fertility services?

Yes!  We provide fertility workups including labs and imaging.  We also offer ovulation induction and cycle monitoring.  If you are going through IVF with an out of town provider, we are happy to provide imaging services.

Do you provide pregnancy care?

Once you have an established viable pregnancy (12 weeks gestation), we will need to transfer your care to another provider who offers prenatal and delivery services.  Given the extreme shortage of Obstetric providers in the Grand Strand area, we are happy to provide a pregnancy confirmation and help you get established with an obstetrician that offers delivery services.  This includes ultrasound dating, prenatal labs and NIPT testing. We also provide preconception counseling for women planning to conceive to help get your pregnancy off to the best start!  We will provide you and your planned obstetric provider complete records of labs and imaging to help make the transition as seamless as possible.  You will also have appropriate ICD 10 and CPT codes to file with your insurance company.  If you need proof of pregnancy to apply for additional insurance coverage, we are happy to provide this.

Do you provide miscarriage care?

In the unfortunate incidence of early pregnancy failure/miscarriage (less than 12 weeks), we can help you with management as this is considered a gynecologic issue rather than an obstetric one.  Miscarriages are common and it’s absolutely not your fault.  It’s not because you slept wrong, had too much caffeine, didn’t realize you were pregnant and had a glass of wine or smoked a cigarette.  Almost all early miscarriage is caused by a genetic problem with the developing embryo.  For patients who desire the answer, often we can do genetic testing.  It’s not always covered by insurance, but the out of pocket cost (as determined by the company doing the testing) is generally not excessive.  We can provide expectant, medical and office management of miscarriage.  If you require surgery, we will make arrangements to perform this at a hospital. We can also provide workups for people with repetitive miscarriages.

What if I have an ectopic pregnancy?

An ectopic pregnancy is one that happens outside the uterus and sadly, this is not a viable pregnancy.  Please be reassured that there are no state laws in South Carolina that restrict the care of ectopic pregnancy.  I know that this hyperbolic point has been brought up in discussions of early pregnancy care post Dobbs, but it is untrue that South Carolina’s “heartbeat bill” applies.  It defines ectopic pregnancy as a medical emergency. An ectopic pregnancy, when caught early and while still unruptured, can often be managed with medications in the outpatient setting that preserve fertility.  An ectopic pregnancy with any sign of rupture – abdominal pain, ultrasound findings consistent with bleeding, unstable vital signs, etc – is a surgical emergency and most appropriately handled in the hospital setting.  Once in the OR, if the fallopian tube isn’t ruptured, fertility sparing salpingostomy (a procedure to open the tube and remove the pregnancy) is an option.  Not all providers are capable of performing this procedure, but as a Minimally Invasive Gynecologic Surgeon, Dr. Moore has frequently been able to save a woman’s fallopian tube if the patient desires future pregnancy.  No matter how an ectopic pregnancy is managed – medical, surgical – even tube removal, the risk of recurrent ectopic pregnancy is 50%.  For this reason, we tell a patient that if she becomes pregnant again, she can tell one other person first, but call us second.  This way, we can provide her with the best early ectopic diagnostic testing possible.

What is IV therapy?

IV fluids have long been used for a variety of things in medicine.  Sometimes its just getting extra fluid into the patient for hydration – important for people who are ill or vomiting from pregnancy or food poisoning – and sometimes its about providing minerals, medications and vitamins that aren’t well absorbed from the gut.

What we offer with IV therapy is a way to bypass the gut to get increased fluids, essential vitamins and minerals into patients.  This offers significant advantage to patients who fail to absorb these vitamins and minerals naturally or who cannot consume them (e.g. vegans being B12 deficient).

IV therapy also offers significant benefits in the wellness arena.  Have you ever noticed that when traveling you get a cold at the worst time?   Or that you feel like you need a vacation to recover from your vacation?  This is common because travel is a challenge to the immune system.  You aren’t eating and drinking normally, you are exposed to new sets of germs and your gut is often getting exposed to new things.  The end result is that you get sick and/or feel run down from what should be a relaxing time.  In order to help with this, we recommend pre and post travel IV therapy.

Is everyone a candidate for IV therapy?

No.  As with all medical procedures there are risks and benefits.  For people who have heart or kidney disease, the risk of fluid overload often exceeds any benefits.  For this reason, we only offer IV therapy to patients who are established with the practice.  Because your care is managed by your doctor, you can know there is an experienced provider looking out for you who isn’t driven by a desire for profit, but a desire to improve the health of her patients.

Is this the same as what happens at Med spas/IV therapy clinics?

Yes and No.  Many of the ingredients are the same, but the difference here is that it’s your physician who is making the decision about what will work best for you and is safest for you.  At many places that offer IV therapy, you may only fill in a medical questionnaire or have a quick telehealth chat with a “medical director” who has never even been to the clinic site.  By making IV therapy a part of your wellness plan, we are working on whole person care.

Do I have to be an established patient to access IV therapy?

Yes!  The SC Board of Medicine and Dr. Moore agree that prescribing IV therapy constitutes the practice of medicine and it should only be done in the setting of an established doctor patient relationship.  If you have been seen as a patient at the office in the last 3 years, you are considered an established patient.  We will just need to update your history and get some information about what’s going on currently. If you haven’t already discussed IV therapy within a visit, Dr. Moore will still work with you to establish what your health goals are so we can best tailor the therapy to you.  If you are doing pre and or post travel IV’s this is quick and easy and just requires a few questions.  If you have other goals, let’s talk about it!

For patient’s who desire IV therapy but are not yet patient’s of the practice, we are happy to have an establishment of care visit where we evaluate your health concerns, discuss options for management and develop a treatment plan.  If you aren’t a good candidate for IV therapy, it won’t be prescribed.  If you are a good candidate, we can move forward.

Do you see male patients?

Dr. Moore’s specialty is in women’s health and it’s something she’s been passionate about since high school.  She went to medical school specifically with the intention of providing excellent care to women and entered a specialty that is solely focused on the care of women.  She is happy to make recommendations for care providers for male patients.