General Questions about HGTC

What sets HGTC apart from the rest?

Most Americans who consult Alternative Medicine (CAM)  providers would jump at the chance to consult with a physician who has training in scientifically based medicine and is also open-minded and knowledgeable about, or even better, practices Alternative Medicine therapies.

HGTC is an integrated Gynecology office operated by Mylaine Riobe-Heron, MD, FACOG-a board certified female gynecologist specializing in Chinese Herbal Medicine and Acupuncture.  With her expertise, you will have a fully integrated evaluation, examination and treatment that will combine the best of both worlds to provide you with a balanced, complete treatment of your mind, body and spirit.  This is the first and only practice of its kind on the Treasure Coast.  All of your care will be provided by Dr. Riobe-Heron and you will not  receive your GYN care from one doctor and be referred for your Acupuncture or Herbal supplements to another doctor.  Many Americans are embracing Chinese Medicine and Acupuncture but do not share this information with their physicians.  Here at HGTC, we also embrace the Ancient Wisdom of China and bring it to you along with state of the art modern Gynecology care for one stop care!

What is Integrated Medicine?

This is a comprehensive approach based on the belief that health is a state of complete physical, mental, and social well-being not just the absence of disease. Integrative Medicine is patient-centered, emphasizes the importance of the doctor-patient relationship while blending CAM and conventional care to facilitate the patient’s healing process.  In the case of HGTC, I combine conventional GYN with Chinese Medicine and Acupuncture.These two accepted, tested forms of medicine combined give better results than either alone.

What will my first visit at HGTC be like?

During your first visit, you will have a comprehensive history review with Dr. Riobe-Heron followed by a comprehensive integrated examination consisting of your conventional examination-breast, abdomen and pelvic exam.  At the same time, Dr. Riobe-Heron  will also perform a Chinese evaluation consisting of what is termed a “tongue and pulse” evaluation.  This will reveal any patterns of disharmony or energy imbalances in the body and mind.  Dr. Riobe-Heron will then make recommendations to you to correct these imbalances while also addressing any conventional diagnoses and treatments.

How do I prepare for my first visit at HGTC?

A member of our office staff will contact you prior to your appointment to send you a history evaluation form to fill out prior to your appointment.  This form can be faxed, mailed or dropped off at the office prior to your appointment.  This will assure that Dr. Riobe-Heron has as much information prior to your appointment as possible to decrease your wait time and to assure that all your needs and goals are addressed.

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Chinese Medicine and Acupuncture

How does Chinese medicine work?

Chinese Herbal medicine is essentially working to assist the body to balance its energy from the inside out.  Natural, safe herbs consisting mostly of plants and food are used for this purpose.  The herbs are made in the USA and meet all FDA requirements.  They have been used throughout the world for centuries to cure diseases

What kinds of conditions are treated with Chinese Herbal Medicine?

Countless medical conditions are treated with herbs in a safe, natural manner.  A few examples are as follows:  Infertility, Menopause, PMS, Polycystic Ovarian Syndrome, Endometriosis, Irregular or heavy Periods, Headaches, Insomnia, Depression, Anxiety, Obesity, Chronic Pain, Low back pain, Painful periods, Fibroids, vaginal discharge, recurrent miscarriages, Common Cold, Urinary Tract Infections, Fatigue, Constipation, Irritable Bowel Syndrome and osteoporosis to name a few.

How does Acupuncture Work?

Acupuncture is the use of very fine needles on various points on the body in order to assist the body to balance its energy from the outside in.  When combined with Chinese Herbal Medicine, you rebalance the body both from the inside out and from the outside in for a holistic, comprehensive  treatment

What types of problems are treated with acupuncture?

Acupuncture can treat countless conditions.  A few examples are as follows:  Chronic Pain, Endometriosis, Low Back Pain, painful periods, Constipation, Irritable Bowel Syndrome, Infertility, Obesity.  Some conditions are best treated with a combination of acupuncture and Chinese herbs.  Depending on your condition, recommendations will be made at your visit after your evaluation.

Is acupuncture safe?

Acupuncture is extremely safe.  Side effects may include slight bruising, a very small amount of bleeding, minor pain and discomfort.  Rare complications can include infection.  The needles used are sterile and disposable.

Is acupuncture painful?

Acupuncture can be experienced as a relaxing time.  Many patients fall asleep during treatment.  The goal is to achieve “De Qi” which is the arrival of the Qi or energy to the site.  This is felt as radiation, numbness, or mild discomfort lasting for a few seconds.  This is a desired effect that tells me that the treatment is working.  Acupuncture is very well tolerated and there is no need for analgesia or special preparation.

How long will my treatment last?

Most sessions last about 20-30 minutes after the needles have been placed. 

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Anti-Aging and Beautification (BioRegenerative Aesthetic Therapy

What is BioRegenerative Aesthetic Therapy?

BioRegenerative therapy is the injection of FDA-registered homeopathic, herbal remedies into various acupuncture points to rejuvenate the skin and reduce wrinkles, fine lines and various other signs of aging.  This is often combined with acupuncture to achieve optimal results. Furthermore, I supplement the treatment with nutritional supplements that are FDA approved in order to treat your whole body and mind to achieve optimal results. There is no toxic substance such as Botox (Botulin Toxin).  You will  not experience the paralysis of muscles that can accompany Botox treatments. BioRegenerative therapy is also used for breast lifting in premenopausal women and can be used to target areas for spot fat reduction such as the abdomen, thighs or buttocks.

Is BioRegenerative Therapy safe?

BioRegenerative Therapy is extremely safe.  It is FDA-regulated  and is a natural alternative to “Botox” and Restylane therapy.  We’ve all been concerned about reports of paralysis of facial muscles with Botox.  BioRegeneration achieves a “Botox”-like effect without the toxicity.  Furthermore, I supplement this treatment with with acupuncture and nutritional supplements to treat your whole body and mind.  These supplements are FDA approved. Minor side effects may include mild bruising, minor discomfort.  Risk of infection is quite rare.

How many sessions of BioRegenerative Therapy will I require?

On average, 10 weekly treatments are recommended with follow up visits either monthly or quarterly depending on age and desired effects.  A more comprehensive treatment plan will be discussed at your consultation visit.

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Infertility

How can Infertility be treated with Chinese Medicine and Acupuncture?

Excellent results can be achieved in the treatment of infertility by combining a conventional infertility evaluation (consisting of blood work, basal body temperature charting, evaluation of the uterus and fallopian tubes with testing called a hysterosalpingogram) with a traditional Chinese medicine evaluation which will reveal the pattern of disharmony which is preventing pregnancy.  By treating the underlying pattern as revealed by the TCM evaluation and combining this with the modern evaluation, wonderful success rates are achieved. This method can be combined with Intrauterine Insemination in the office or In-Vitro Fertilization with coordination with your reproductive endocrinologist.

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Weight Loss and Nutrition

How can Acupuncture and Chinese Herbal Medicine help with weight loss?

Chinese Herbal Supplements and Acupuncture can help to strengthen the internal organs responsible for the metabolism of food.  This can help to process food more effectively and speed up metabolism. Along with a sensible diet and moderate exercise, this can promote successful weight loss that can be maintained long term. Many crash diets don’t address the underlying causes of weight gain and are unsuccessful long term.

What will my visits be like for weight loss therapy?

Your initial visit will consist of a review of your diet and exercise regimen as well as your goals. Dr. Riobe-Heron will then perform a Chinese evaluation to determine the patterns of disharmony responsible for weight gain.  She will then make recommendations for Herbal supplements, Acupuncture treatments, diet and exercise and help you to set a schedule of treatments and follow ups.  Number of treatment sessions will vary based on your individual needs, your particular patterns of disharmony and your goals. Follw-up treatment sessions will consist of a review of progress with diet and exercise and an acupuncture session which will last 20-30 minutes. After you’ve reached your goals, Dr. Riobe-Heron will recommend maintenance visits either monthly or quarterly depending on your individual needs.

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Financial Policy

What is the financial policy of HGTC?

Due to the nature of Integrated Gynecology, many aspects of care are not covered by insurance plans.  HGTC is a fee-for-service practice.  This means that payment will be due in full at the time of service. Insurance plans are not accepted for the reasons described above. Payment can be made by check, cash, or charge.

Why does HGTC not accept insurance plans?

Given the nature of the integrated practice of medicine, many aspects or care are not covered by health insurance plans.  Also given the time-intensive nature of the evaluations and treatments, it is not possible to accept insurance for this purpose.  An invoice of payments made will be given at the completion of your visit at HGTC.  This invoice may be submitted to your insurance company for reimbursement of your expenses.  Be sure to make your insurance company aware that all of your treatments are given by a Medical Doctor (MD) so that your reimbursement will be maximized.

Are there payment plans available at HGTC if I am unable to pay in full for my care?

Yes, we have established Care Credit, a medical savings and financing plan designed especially for healthcare.  An application can be made prior to your appointment and approval will be received within minutes.  You can then set up a flexible payment that will work for you.

What are the fees at HGTC?

Please see the financial policy page on my website for details.  Fees are based on the time requirements of the visit.  Initial visits are charged more due to their length.  Follow up visits are charged at a lower rate because they will be shorter.  The fees for visits do not include herbal supplements or cosmetic products. Fees for visits also do not include any needed laboratory testing.

How can I determine if my visits may be reimbursed by my insurance company before my visits?

Contact your insurance company and indicate that you would like to verify coverage.

a. Does the policy provide out-of-network benefits?
b. Is there an out-of-network deductible?
c. Does the policy provide coverage for the appropriate CPT code? (See list below)
d. Is there a limitation on the number of units that can be billed for this procedure within a certain time frame?

Note that this verbal verification does not guarantee reimbursement by your insurance company for your visits to HGTC.

CPT Codes Billed: 
The following codes will likely be used for Holistic Problem evaluation, New patient Nutrition Assessment Evaluation, Holistic Weight Loss Evaluation, Bio-Identical Hormone Replacement Evaluation:

99203: New patient detailed visit
99204: New Patient Comprehensive Moderate
99213: Established Patient Expanded 
99214: Established Patient Detailed
97811: Acupuncture without electrostimulation 30 minutes
97814: Acupuncture with electrostimulation 30 minutes
97802: Medical Nutrition Therapy, Initial Assessment, each 15 minutes (three units total=45 minutes)
97803: All subsequent nutrition therapy follow up visits, each 15 minutes (three units total=45 minutes)
83516 Antigen Allergy Test (ALCAT)
82670,84144,84403,84270,82627,82533,84443,84481,84439,86376: Female Blood Profile (Hormone Testing for Estradiol, Progesterone, Testosterone, Sex Hormone Binding Globulin, DHEAS, TSH, Free T3, Free T4, Thyroid Peroxidase Antibody)
82530 x 4: Cortisol Diurnal Levels (Testing for Adrenal Fatigue/Overload)

*Patients presenting for infertility evaluations should specifically request if this service or diagnosis is covered.

*Patients presenting for weight loss evaluations should specifically request if this service or diagnosis is covered.


CPT Codes for Preventive Visits (Holistic Gynecology Wellness Examination)

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Miscellaneous

Can I obtain my routine GYN care at HGTC?

Absolutely!  A comprehensive, integrated evaluation is performed.  This consists of a Chinese medical evaluation combined with a conventional exam consisting of full physical exams, breast exam, pelvic exam and pap smear  along with lab work.  Blood work  can be done at a local lab offsite. Referrals for ultrasounds, mammograms and any additional needed testing are available.  We offer a full range of evaluations for any GYN problems you may have.

What if I need blood tests during my visit?

Dr. Riobe-Heron will give you a prescription that you can take to any lab covered by your insurance plan.  You can have all your necessary blood work done at the lab which will be covered by your insurance plan as per your benefits. Please review your benefits prior to having any blood work so that you will be aware of any out of pocket expenses.

Is Dr. Riobe-Heron on staff at any area hospitals?

Due to the nature of her practice of Integrated Gynecology, Dr. Riobe-Heron has elected not to participate in any hospital plans.  In the case of an emergency, she will refer you to the nearest emergency room where a hospitalist or specialist will take care of your emergency. She will remain in constant contact with all consultants in order to coordinate your care and insure the highest standards of care.

What if my condition requires surgery?

Dr. Riobe-Heron believes that a conservative approach to many conditions is best, however, there are a number of conditions that require surgery.  She will refer you to a local board-certified surgeon who will provide you with quality care and she will be in constant communication with the surgeon throughout your evaluation and during the postoperative period.  Dr. Riobe-Heron has chosen not to perform surgery due to the nature of her practice of Integrative Gynecology.

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