Specialty clinical care, with a clear starting point

Yes. Thyroid, metabolic, and hormone concerns are not a women’s health issue, and men are frequently told to push through symptoms that deserve a proper evaluation. Fatigue, weight change, poor recovery, low mood, and reduced strength get attributed to age or attitude rather than investigated.

The evaluation is the same: full history, symptoms, medications, previous laboratory work, function, nutrition, and movement, reviewed together. Where hormonal assessment is relevant it is included, and it is specific to you rather than to a template.

Adults of any sex are seen, provided you are physically located in New York State at the time of your visits.

Raven is a cash-pay practice and does not bill insurance. If you have commercial insurance, an itemized superbill is available on request so that you can seek out-of-network reimbursement yourself. Whether you are reimbursed, and how much, is decided by your carrier.

Superbills are not issued to Medicare or Medicaid patients. Neither program reimburses patients for care received outside it, so the document would serve no purpose.

Medicare. Raven does not participate in Medicare and does not bill Medicare for any service. Patients enrolled in Medicare are seen under a private contract, signed before any care begins, which confirms that you accept responsibility for the cost of services and that neither you nor the practice will submit a claim to Medicare. Medicare will not pay for these services, and Medigap and other supplemental plans generally will not either.

Medicaid. Raven does not participate in Medicaid or in any Medicaid Managed Care plan. If you are a Medicaid beneficiary, the services this practice offers may be available to you at no cost from a provider who participates in your plan. You are welcome to be seen here as a private pay patient instead, but that choice is entirely yours, and it must be made and documented in writing before any services are provided.

In both cases the agreement is signed in advance, never afterwards. Please raise your coverage on the introductory call so this can be arranged properly before you proceed.

Adults who are physically located in New York State at the time of the visit. This is a licensing requirement and applies to every appointment, not only the first one.

Raven is a telehealth practice. Clinical appointments are conducted through secure video visits for eligible patients physically located in New York State at the time of care. Raven does not currently maintain a patient-facing office.

No. Prescribing requires that you be physically located in New York State at the time of the visit. If you live in New York but will be travelling out of state, we will need to reschedule your appointment for a time when you are back in New York.

No. GLP-1 therapy is one clinical tool among several, prescribed only when it is clinically appropriate for your situation. Many patients are managed without it. Raven is a specialty clinical practice, not a medication service, and a prescription is never the automatic result of an evaluation.

It depends on who started them.

Medications prescribed here are managed here. That includes GLP-1 therapy, and thyroid medication when your results indicate it is needed and you are not already taking it. Dose adjustments, monitoring, and follow-up are part of your ongoing care.

Medications you already take continue to be managed by whoever prescribes them — thyroid medication, blood pressure and cholesterol medication, insulin, and anything else already in place. Your full medication list is reviewed as part of your evaluation, and relevant findings are communicated to your prescriber so decisions are made with current information. Dosing remains their call.

Medications managed by a specialist stay with that specialist — biologics and other treatments outside this practice’s scope.

This matters most when a new medication interacts with one you already take. If GLP-1 therapy is started, your other prescribers are notified so that any medications affected by it can be reviewed.

We will never tell you to stop or change a prescription written by someone else.

Laboratory testing is part of the initial evaluation. A Quest Diagnostics requisition is sent with your welcome email and completed before your consultation, so your results are available when we meet.

Laboratory services are billed separately by the testing laboratory and are not included in Raven’s fees. Cost depends on the panel ordered and on your own insurance coverage, if any. Recent existing results may be incorporated where appropriate, which sometimes avoids unnecessary repeat testing.

Possibly. Many patients are able to use HSA or FSA funds for eligible clinical services and prescription medications. Because every plan is different, we recommend confirming eligibility with your HSA or FSA administrator. Upon request, we will provide the itemized documentation typically needed to support eligible reimbursement.

You receive a written plan with clear priorities and next steps. If laboratory testing was ordered, results are reviewed and interpreted as they arrive. Most patients then continue with Ongoing Clinical Management, where the plan is monitored and adjusted based on how you respond.

Yes. Ongoing Clinical Management includes secure messaging through the Practice Fusion patient portal, at no additional cost.

Messages sent during office hours are answered within two hours. Messages sent outside office hours — including after noon on Friday — are answered the next business day.

Messaging is suited to straightforward questions: clarifying something in your plan, confirming an instruction, or scheduling. Anything requiring clinical judgment needs an appointment, where it can be given proper attention rather than answered in a few lines.

The portal is not monitored for emergencies. If you are experiencing a medical emergency, call 911 or go to the nearest emergency department. For urgent concerns that are not emergencies, contact your primary care clinician or an urgent care center. Raven does not provide urgent or emergency care.

No. Raven is a specialty practice focused on thyroid, metabolic, and hormone health. It does not replace your primary care clinician, and patients are expected to maintain an established relationship with a primary care provider for general medical care, preventive screening, and acute illness.

That is common and it is not a problem. Raven works alongside the clinicians already involved in your care rather than replacing them. Where it is helpful and with your permission, we can coordinate so that everyone is working from the same information.

Four things, all completed before we meet. Once payment is received you will receive an email containing everything you need.

Sign your consent forms. Practice consents, telehealth authorization, and billing disclosures, signed electronically.

Complete the Raven Self-Assessment Questionnaire. Your health timeline, sleep, nutrition, and current barriers.

Complete the Raven Comprehensive Assessment Guide. The deep-dive evaluation. Set aside about an hour, longer if your history is complex. The more complete it is, the more precise the work can be.

Complete your laboratory work. A Quest Diagnostics requisition is included with your welcome email. Take it to any Quest patient service center.

Your consultation is scheduled once your intake has been reviewed and your results have returned, so the appointment is spent on findings rather than on gathering information.

Preparing for your blood draw: fast for 10 to 12 hours beforehand, plain water only. Schedule early morning where possible, ideally before 9:00 am. Hold biotin for 72 hours before the draw — including hair, skin, and nail supplements and any multivitamin containing it, as biotin distorts thyroid results. If you take thyroid medication in the morning, take it after the draw rather than before.

Visits are held on Google Meet. You will receive a link once your consultation is scheduled.

You need a device with a camera and microphone — a computer, tablet, or phone — and a reasonably stable internet connection. No software purchase is required. You must be physically located in New York State at the time of the visit.

The Practice Fusion patient portal is used for messaging, documents, and results rather than for the visit itself.

Nothing is needed to begin, and nothing needs to be bought before your first appointment. Movement guidance is written around what your body allows and what you already have.

Where strength and lean-mass work is part of your plan, it is built for a chair rather than a gym. Most patients end up with a short list of inexpensive items:

A sturdy chair — stable, no wheels, ideally without arms. It serves as bench, balance support, and anchor.
Light dumbbells — a small ascending set, roughly 2 to 5 pounds. You begin lighter than you expect.
Loop resistance bands — graded from light to heavy. These carry the lower-body work.
A wall or counter within reach — so support is always a hand away during any standing movement.
A bathroom scale, and a tape measure for tracking the changes a scale does not show.

An ordinary cloth tape works. A retractable tape with a consistent tension mechanism works better, and they are inexpensive — the common problem with a plain tape is that it slips and pulls a little differently each time, so real month-to-month change gets lost in measurement error. Either is fine; measuring the same way every time matters more than which tape you use.

Bought new, the whole set typically comes to well under a hundred dollars, and none of it is brand-specific. Anything you already own that meets the description is fine.

Movement is adapted to real limitations, including joint problems, fatigue, neuropathy, balance difficulty, and cardiac history. Seated options exist for nearly everything. As with any change in physical activity, discuss it with your primary care clinician before beginning, particularly if you have a cardiac condition or another condition affected by exercise.

The next available appointment, which depends partly on you.

Your consultation is scheduled once your intake has been reviewed and your laboratory results have returned. How quickly that happens depends on how soon you complete the assessment and have your blood drawn, and on the laboratory’s turnaround. Most of the timeline is in your hands rather than in the appointment book.

The complimentary introductory call is usually available within a few days.

If you are new to the practice, start with the introductory call. It costs nothing, takes twenty minutes, and exists precisely so that you do not have to guess. If you already know you want a full evaluation, you can book that directly.

Life happens, and a first missed appointment is not charged. We reschedule it and move on.

After that, a missed appointment is charged $50, payable before the next appointment is scheduled. A ninety-minute block held for someone who does not attend is time that cannot be offered to another patient, and the fee reflects that rather than any wish to penalise you.

There is no charge for rescheduling in advance. A message through the patient portal or a phone call is enough.

Appointments are built with a buffer, so a few minutes will not derail the visit.

If you are more than fifteen minutes late, the appointment is rescheduled. There is not enough time remaining to do the work properly, and a rushed evaluation is not worth having.

Before your intake is reviewed, yes. If you change your mind before any work has begun, your payment is returned in full.

Once your assessment and laboratory results have been reviewed and your written plan has been produced, the fee is not refundable. That plan is yours to keep and to use whether or not you continue with the practice — it includes your individualised findings, specific recommendations, and next steps. The work of producing it has been done.

Yes. Ongoing Clinical Management may be discontinued at any time. To avoid the next monthly billing cycle, cancellation requests should be submitted at least seven days before your next scheduled billing date. Patients who discontinue care are welcome to return, subject to appointment availability and current pricing at that time.

Founding Patient pricing is maintained only while patients remain actively enrolled in ongoing care, subject to the Patient Agreement.