Do you see out-of-state patients?
What is the Medical Clinic at Thoughtful House Center for Children?
This clinic integrates traditional science and medicine with recently developed and recognized treatments and therapy for children on the autism spectrum. We apply the most advanced published research to our clinical care of children with developmental disorders.
We take the time needed to form an understanding of each child and their particular biomedical profile, accomplished with a comprehensive history and physical examination. Any available previous laboratory results are reviewed. Additional lab work can then be recommended in order to further delineate your child's medical status. We put together a treatment course specific to the child based on our clinical observations and findings, together with the lab results.
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How do I make an appointment with Dr. Bryan Jepson or Lucas Ramirez, NP?
Please see: Clinical Services
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Do you bill insurance?
No, due to the variability of insurance benefits. We can assist you by providing invoices with coding and HCFA forms as needed, on request. You are responsible for payment for services, which is due at the time of service.
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What are your fees?
Consultations and follow-ups are billed at $390 per hour. This is pro-rated- that is, only the time you spend with the doctor is billed. We accept checks, Visa, and Mastercard.
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What is your cancellation policy?
We have a strict cancellation policy because so many children urgently need our attention and care: 48 hours is required for cancellation whether it's a phone or an office consult. If timely notice is not given, there will of necessity be a $100 charge.
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How long is an appointment?
Your first appointment will take between one and two hours. The first follow-up, when we review any lab results and monitor the beginning of treatment, lasts about an hour. As a general rule, later follow-ups take 30-45 minutes.
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When do I schedule our follow-up?
Because of the busy nature of our practice, at the end of each appointment with the doctor it's best to make a follow-up appointment. Generally, follow-ups are available in 4-6 weeks.
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May I email the doctor if I have questions between follow-ups?
We are able to answer many simple email questions . Complex medical issues can only be addressed with an appointment. If there is a medical decision involved (for example, concerning prescription for medication), there will be a charge based on how much time the doctor spends discussing it with you. Please keep in mind that our office can receive hundreds of emails daily, and reading and answering takes considerable time for the physician and his medical staff, as well as the office staff, and while we want very much to answer all questions, we must sometimes bill you for our time.
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What laboratory tests do you require?
Usually none prior to the initial consult. This is because we take an individualized approach to treatment and can't know what background we'll need to inform that approach until we see your child. After meeting with the physician, certain laboratory investigations may be recommended. The charges for lab tests vary, and are not included in the consultation costs. Some tests are covered by most insurance companies, some not. Your physician will assist you in determining which tests are absolutely necessary.
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What are the average lab costs?
Some lab tests are covered by insurance plans, but plans vary greatly and we can't determine what will be covered. Generally, you can expect that the initial cost will be between $600 - $1,000 paid to the labs directly by you, or by your plan. Some children will need to be monitored with periodic lab tests.
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What other costs may be involved?
Some that you might expect Thoughtful House to bill you for are:
Blood Draw (Phlebotomy) - $61
Blood Processing - $10 - $60 depending on the number of specific tests
Letters - We are often asked to write letters on behalf of our families, such as requests for adjunct therapies, leave of absence for parents, and letters that clarify "medical necessity". We must bill for the time required for each of these, as sometimes a good deal of review is called for before the actual composition.
Medication Refills - Have your pharmacy fax us with a medication refill request. Refills must be determined carefully, sometimes involving extensive review.
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Do you see out-of-state patients?
Yes, even some from overseas. Most appointments can be phone consults, but keep in mind that Texas law requires that we see your child annually. This is ideally at the time of your first consult with us, as it's naturally the best way for us to familiarize ourselves with your child, and annually after that.
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