Our Policies at 
Natural Endocrinology Specialists™ (NES)

Before Your Appointment

After scheduling your appointment, please complete the necessary paperwork and set up your login details for the ChARM EHR Patient Portal. The intake forms and consent documents will be sent electronically with your appointment confirmation. Completing this step, which takes approximately 30-45 minutes, helps us better understand your health background, allowing us to provide a tailored and effective approach to your care. We kindly request that these forms be completed 48 hours before your initial visit.

Scheduling an Appointment

To book an appointment with us, you can use our convenient online scheduling system on our website, schedule directly through the ChARM EHR Portal, or contact our office

To keep your care on track, we highly recommend booking your follow-up consultation immediately after each appointment. This ensures alignment with your doctor’s schedule and avoids delays in your treatment plan. Our office will send two reminders via the ChARM EHR portal to schedule your follow-up appointment. If you do not respond to these reminders, it becomes your responsibility to book a follow-up visit to review your test results and discuss how they may impact your care. Timely scheduling is crucial, especially for complex or ongoing cases, to ensure your treatment plan remains on schedule and effective.

Preparing for a Successful Visit

To ensure an efficient and productive consultation, we encourage patients to provide all pertinent medical records before their appointment. Organizing and sharing this information helps us perform a thorough review of your health history and optimize your treatment plan.

How to Submit Your Medical Records

We recommend uploading all records to our secure, HIPAA-compliant ChARM EHR portal. This ensures your data is safe and accessible to our team before your appointment. Submitting records ahead of time helps reduce administrative delays and allows us to dedicate more time to your care.

Records We Need to See

Providing a complete medical history helps us create the best care plan for you. Please share the following:

  • Lab Results: All test results (positive and negative), including hormone, thyroid, and metabolic tests.
  • Endocrine Records: Past thyroid, adrenal, or hormone-related diagnoses and treatments.
  • Imaging: Ultrasounds, MRIs, or CT scans of the endocrine system. If possible, upload the actual images to the ChARM EHR portal.

How to Organize Your Submission

To maximize the value of your visit, we recommend the following:

  • Organize your records chronologically (most recent first).
  • Include a brief summary of your primary health concerns and goals for the visit.
  • Create a list of any questions or concerns you’d like to address with your provider.

Benefits of Preparing Your Records

  • Saves time during the consultation, ensuring more focus on your current health needs.
  • Ensures our providers have the necessary context to develop an accurate and personalized treatment plan.
  • Facilitates a smoother and more productive discussion during your visit.

If you have any questions about how to upload your records or need assistance using the ChARM EHR portal, please contact our office. We’re here to help make the process as seamless as possible!

New Patient Policy

At NES™, we specialize in treating adults (ages 16–75) with hormone-related concerns and metabolic conditions through a personalized, integrative approach. To ensure our care aligns with your needs, we use a two-step qualification process before scheduling new patient consultations.

Step 1: Self-Qualification

Potential patients complete a detailed health survey to share their medical history, symptoms, and overall health goals. This helps us determine if your concerns fall within our areas of expertise, which include thyroid conditions (such as hypothyroid, hyperthyroid, Hashimoto’s, and Graves’ disease), adrenal imbalances, female and male hormone issues, metabolic conditions, and wellness/prevention care. Common symptoms we treat include fatigue, hair loss, insomnia, brain fog, mood swings, and more. We do not treat children under 16, Addison’s disease, Type 1 diabetes, advanced Type 2 diabetes, or complex autoimmune conditions unrelated to thyroid health.

Step 2: Meet and Greet Appointment

If your health concerns align with our expertise, you’ll be invited to schedule a 10-minute Meet and Greet appointment. This introductory session allows us to discuss your concerns, review your survey responses, and determine if NES™ is the right fit for your care. 

This process ensures we provide the most effective and personalized care for each patient. Let us know if you have any questions or need assistance starting the process!

What to Expect as a New Patient

Initial (new patient) and regular follow-up appointments are primarily focused on reviewing and analyzing your health history and current health concerns. The initial appointment does not include bloodwork, specialty tests, and other diagnostic services.

Patients are welcome to bring any recent labs or imaging results, which we can review during the appointment. However, please understand that treatment typically begins after a comprehensive case review in the second appointment.

At NES™, when you establish a new physician patient relationship, we require that you fully review the new patient forms in detail and ask as many questions you may have.

Re-establishing New Patients

If a patient has not been seen for 2 years or more, they will be subject to the new patient fee. This policy ensures that we have up-to-date information and can provide the best care possible, given any changes in your health status or treatment needs.

Initial Consultation

For qualified patients, the initial consultation is a comprehensive 60-minute session designed to:

  • Review your detailed health history.
  • Perform a thorough physical examination (if in person).
  • Order appropriate lab work to confirm diagnoses and inform your personalized treatment plan.
  • Provide initial recommendations for care and ongoing treatment options.

Prepayment Policy

To ensure fairness and accommodate patients on our waiting list, we require prepayment for the New Patient Consultation at least 1 week before the scheduled appointment. This policy helps us maintain a commitment to all patients.

Follow-Up Appointments

At NES™, our Post-Consultation Appointment is designed to review and analyze your initial consultation findings, integrate any additional testing, and provide detailed recommendations to continue optimizing your care. This is the next step for most patients following their initial consultation.

First Follow Up

  • Up to 45 minutes to review results and discuss next steps.
  • Comprehensive analysis of laboratory results and other diagnostic studies in the context of your unique health situation.
  • Development of a detailed follow-up plan, including personalized recommendations for treatment or further testing.
  • Preparation of a detailed consultation report summarizing the visit, findings, and next steps.

Regular Follow Up

  • Up to 30 minutes with your NES practitioner to review results and refine your treatment plan.
  • Additional time outside of the appointment to analyze lab results and prepare recommendations, scaled to the complexity of your case.

Appointment Goals

During your Follow-up Appointment, we aim to:

  • Thoroughly explain and interpret your test results.
  • Answer your questions and address any concerns.
  • Refine and adjust your treatment plan based on updated findings.
  • Empower you with actionable steps to continue improving your health.

Respecting Time and Managing Expectations

At Natural Endocrinology Specialists™ (NES), we deeply value the time and well-being of both our patients and our doctors. We strive to ensure that each appointment is conducted in a timely manner, with ample time dedicated to understanding and addressing your health concerns. However, we also recognize that unforeseen circumstances may occasionally affect appointment schedules.

When the Doctor is Running Late

While we do our absolute best to keep to the scheduled times, there may be instances when our doctor is delayed due to the complexity of care needed by another patient. If the doctor is running more than 30 minutes behind your scheduled time, rest assured that we will still provide the full, dedicated appointment time you deserve. We appreciate your understanding and patience in such instances and will make every effort to stay on time.

When the Patient is Late

We ask that you respect the time reserved for your care by arriving on time for your appointment. If you are late, we will still do our best to accommodate your visit; however, the time you are late will be deducted from the total appointment duration. This ensures that we can remain respectful of the schedule for all patients. For example, if you are 15 minutes late for a 60-minute appointment, your session will be 45 minutes instead of the full hour.

Commitment to Your Health

We understand that scheduling medical appointments can be a challenge, but we strongly encourage you to prioritize the time dedicated to your health. When booking an appointment, please plan to allow 1-2 hours to ensure your visit is thorough and unhurried. This flexibility gives us the opportunity to provide the highest quality care while accommodating any unexpected delays that may arise.

We appreciate your partnership in helping us maintain an efficient and respectful schedule for everyone. If you need to reschedule or have any concerns, please don't hesitate to reach out to us.

Initial Consultation

At NES™, we will send out a 72-hour appointment reminder. It is the patient’s responsibility to keep track of the appointment date and time and to arrive in a timely manner. In order to provide all patients with high quality care, we require a 48-hour cancellation notice.

This reserved time has been allotted to you and if you need to change it, we would appreciate the notice so that we can better serve you and our patients receiving care. If you are 5–15 minutes late to your appointment, this time will be deducted from your allotted time of consultation as it impacts the doctor's schedule. Patients arriving more than 10 minutes late to their appointment will be subject to the providers’ decision to be seen, rescheduled or changed to a brief visit.

Patients arriving more than 20 minutes late will be subject to a rescheduled appointment. Patients who do not call or show up for the scheduled appointment will be subject to a missed appointment fee of 100% of visit. Anytime there is a no call/no show or missed appointment, this will be documented in your chart. Numerous missed appointments can result in dismissal from the practice and/or require you to prepay for your visit. We understand that emergencies do occur and you may not be able to communicate your absence for a scheduled appointment.

Appointment Timeliness

We strive to remain on schedule for all appointments; however, delays can occasionally occur due to the detailed and individualized nature of our care. We ask for your understanding and patience, as there may be a 45-minute window after your scheduled time in case of unexpected delays.

At NES™, we aim to provide the highest standard of care—whether in person or via telehealth. Please feel free to reach out to our office with any questions or concerns about telemedicine services.

Care Agreement

At NES™, we are committed to supporting you through your health journey. Managing chronic and complex conditions often requires time and careful adjustments to your treatment plan. Please understand that achieving optimal results may involve multiple iterations of treatments and follow-up visits.

Scope of Practice

NES™ specializes in the management of common hormone-related concerns. While we are here to provide comprehensive care for your ongoing needs, our practice is not designed to handle acute or emergency care.

  • New or Unrelated Symptoms:
    If you develop new or unrelated symptoms, we recommend consulting your primary care provider to rule out other conditions.
  • Acute or Worsening Symptoms:
    If you are experiencing acute or worsening symptoms, please seek immediate care by contacting 911 or visiting the nearest urgent care facility or emergency department.

Provider Communication

For direct communication with your doctor, please use the ChARM EHR Patient Portal. While we welcome non-medical inquiries through the portal, please note that any medical advice or similar requests will require a scheduled appointment.

Medication Changes and New Prescriptions

  • Most medication adjustments or new prescriptions are made during scheduled office visits after a thorough evaluation.
  • Requests for medication changes cannot be processed through office staff or portal messaging unless an appointment is scheduled to assess your needs.

Patient Portal & Communication

We aim to respond to messages sent via the patient portal within 72 hours during the workweek and weekends. For phone consultations, these must be scheduled as an appointment, with a fee applied for the allocated time. In the time between appointments, we offer the convenience of sending up to two messages in your patient portal to address any questions, seek clarification, or discuss concerns related to your treatment plan. Please be aware that after these two messages, each subsequent message will incur a fee of $25.

Emergencies and After-Hours Support

If you experience an emergency, please call 911 or visit an emergency care facility immediately. NES™ does not provide after-hours on-call care. However, our practitioners will address your concerns during regular business hours via the ChARM EHR portal or during your scheduled visits.

Text Messaging Policy

Please note that NES™ does not use text messaging as a method of communication. While you may receive automated appointment reminders via text, two-way texting is not supported. For any questions or concerns, please use the Patient Portal, email, or phone call as outlined above. This ensures secure, consistent, and documented communication between you and our clinic.

Payment Policy

At NES™, we strive to provide the best care while respecting the time and needs of all our patients. To ensure fairness and efficient scheduling, the following payment policies are in place for all appointments.

Appointment Deposits

  • New Patient Consultations and Follow-up Visits:
    • A 50% deposit is required to schedule your appointment.
    • The remaining balance must be paid in full at least one week before your scheduled appointment.
  • All Other Appointments:
    • A 50% deposit is required to reserve your appointment.
    • The remaining balance of the estimated payment is due in full two business days prior to your appointment date.

Financial Agreement

At NES™, you will have a couple of payment options. You can either prepay for the visit online or by calling the office or pay at the time of service. We are a cash-pay practice and are not associated with any insurance companies.

Please keep in mind that our practice does not accept Medicare or supplemental Medicare plans for services. This policy applies to all our office's services, including consultations, bloodwork, imaging, and diagnostic tests. Patients are fully responsible for payment at the time of service.

We can assist you with reimbursement documents that you can submit to your insurance if needed. We cannot bill directly to any insurance company and it is your responsibility to check with your insurance provider to see if you are eligible for coverage and/or reimbursements for any visits and services you receive. If you cannot pay for the visit at the end of service, you will be sent a bill within 7 days. If you do not pay your bill within 30 days of receiving it, it will be sent to the Professional Credit Services (Collection agency) and you will be responsible for any fees incurred.

No Refund Policy for Completed Visits

At NES™ (NES), we are committed to providing high-quality care during every patient visit. Once a scheduled appointment is completed in full, we do not offer refunds. The time and expertise provided by our doctors during your appointment are dedicated to thoroughly addressing your health concerns, and we strive to offer the most comprehensive care possible during that time.

If your consultation has been conducted for the full duration of the allotted time, regardless of outcomes or treatment decisions, no refund will be issued. This policy ensures that our practitioners' time and expertise are fully respected, and reflects the value of the services provided during your visit. We encourage patients to come prepared to each appointment and engage fully in the care process to maximize the benefit of their time with our doctors.

No Refund Policy for Specialty Test Kits

All specialty test kits provided by NES™, such as Food Sensitivity Testing, Stool Tests, Saliva Tests, WatchPat, Galleri tests, and similar offerings, are non-refundable. These tests are not covered by insurance and necessitate upfront payment at the time of service. This policy applies to all specialty test kits we offer but is not limited to these mentioned. Purchasing a test kit indicates your commitment to follow through with the doctor's recommended course of action. We strongly encourage you to carefully consider all aspects and consult with your healthcare provider to ensure you are fully committed before making a decision or proceeding with your purchase.

Refund and Exchange Policy for Supplements

Refunds are available only if specific conditions are met. Items must be sealed, undamaged, and in good condition. Refunds cannot be issued for sealed items with dents or packaging damage, as they cannot be resold. Supplements may be returned and exchanged within 3 days of the purchase if they meet these conditions. 

Promotional items are final sales and are not eligible for returns or exchanges. We carefully ensure all supplements are in excellent condition before purchase, confirming this with patients at the time of the transaction. Therefore, we cannot exchange damaged items for the same product.

Telemedicine Policy for Arizona Patients

At NES™, we are committed to making our services accessible to patients across Arizona, including those who may be unable to visit our office in person due to the disabling nature of the conditions we treat. We offer remote telehealth consultations using secure, HIPAA-compliant systems to ensure the same level of care as in-person visits.

Telemedicine Consultations

  • Telemedicine appointments are billed at the same rate as in-person evaluations.
  • We use a secure, HIPAA-compliant platform to maintain the privacy and confidentiality of your information.
  • While telemedicine is highly effective, there are limitations due to the inability to perform a physical examination or collect vital signs. When necessary, we may recommend in-person follow-ups or additional testing.

Prior Authorization Policy

At NES™, we do our best to help you get the treatments, medications, and services you need approved by your insurance. However, these requests often require time-consuming documentation or communication with your insurance company, so we must charge a fee for this service. Administrative requests like prior authorizations or letters of medical necessity will be charged $50 per medication, treatment, or service, while requests that involve a provider, such as peer-to-peer consultations, will be billed at the provider’s hourly rate.

Before we proceed with any prior authorization, we will contact you for approval and require an active credit card on file. While we make every effort to secure insurance approval, we cannot guarantee their decision. Thank you for understanding the complexities of this process and for allowing us to advocate for your care.

Surgical Clearance Policy

We no longer provides medical clearance for surgical procedures. 

Patients requiring preoperative clearance must obtain this through their Primary Care Provider (PCP) or the appropriate provider involved in their surgical care.

Laboratory Testing

We encourage our patients to review their health insurance coverage for laboratory testing, as prepaid rates offered by labs are often a cost-effective option when certain tests are not covered. To ensure efficient care, NES™ sends a 72-hour reminder before appointments; however, it is the patient’s responsibility to track the date and time and arrive promptly.

Please note there is a $10 charge for blood draw appointments that are missed without notice or canceled with less than 48 hours' notice. This policy helps us manage resources and provide quality care to all patients. We appreciate your understanding and encourage timely communication if you need to reschedule or cancel.

Blood Draw and Appointment Cancellation Policy

If you cancel your blood draw appointment, please note that your follow-up appointment may also be canceled unless you inform us that you wish to keep it. This ensures that your provider has the appropriate lab results available for a meaningful consultation.

If you plan to keep your follow-up visit without completing labs, you must notify our office at the time of cancellation. This policy helps us provide timely and effective care while avoiding unnecessary scheduling conflicts.

Test Results Policy

At NES™, we are happy to provide your medical records and test results electronically through our secure ChARM EHR portal upon request.

We understand that you may be eager to receive and interpret your test results. However, many of the tests we order require detailed analysis by a provider to understand their significance in the context of your overall health. For this reason, we ask for your patience in waiting until your next appointment to discuss your results. Rest assured, if anything serious is identified, we will contact you immediately.

Urgent or Significant Results

Your provider will review your lab results upon receipt, and you will be contacted promptly if there are any urgent issues. If you have concerns about a test result and do not wish to wait until your scheduled follow-up appointment, you may send a message through the portal. However, time spent by the provider addressing your concerns will be billed at the provider’s hourly rate.
For specialty tests, please note that results may take 6–8 weeks to be finalized. Schedule your follow-up appointment accordingly to allow enough time for all results to be received and reviewed.

Prescription and Medication Refills

At NES™, ensuring the safety and proper monitoring of prescriptions is a top priority. To facilitate this, we dispense medications with the maximum number of refills permissible until a follow-up visit is required. We advise scheduling an appointment during the last month of your current refill cycle to prevent any disruptions in your medication regimen. It is important to note that medications that have exhausted their refills will not be renewed until an appropriate follow-up visit, often including lab work, has been completed.

To streamline the process, we kindly request that you give us a 72-hour notice for any prescription refill requests. This lead time helps us ensure that your medication management is handled efficiently and effectively, maintaining the continuity of your care without interruption.

Controlled Substances

Natural Endocrinology Specialists™ has updated our policy and will no longer prescribe or refill certain medications, including some controlled substances. We are committed to helping you find safe and effective alternatives and may refer you to your primary care doctor for management. Please schedule an appointment to discuss your treatment plan and explore other options.

International Supplement Shipments

At Natural Endocrinology Specialists™, we do not ship supplements or health-related products to destinations outside of the United States. This policy ensures compliance with international regulations and helps avoid potential shipping delays or issues that could impact product quality and timely delivery.

We appreciate your understanding. If you have any questions or need assistance with your treatment plan, please don't hesitate to contact our office to explore alternative solutions.

Medical Records Release Policy

At NES™, we are committed to ensuring you have access to your medical records when needed. You are responsible for obtaining records from other healthcare providers or facilities. To authorize the release of these records to NES™, you must complete a Request for Medical Records form and contact the appropriate healthcare provider. NES™ cannot request or obtain these records without your authorization.

Your medical records at NES™ are available electronically at no cost through our secure, HIPAA-compliant ChARM EHR portal. We can also send your records electronically to the providers of your choice. If you prefer paper records, we follow Arizona State Statute 12-2295 guidelines for fees, which include:

  • Pages 1–50: $1.25 per page
  • Pages 51–100: $0.96 per page
  • Pages 101+: $0.62 per page

Mailing and shipping costs are charged based on the actual expense, including postage, electronic media, and applicable taxes. Laboratory and other test results can be obtained directly from the testing facility. If you have any questions about accessing or transferring your records, please contact us for assistance.

Insurance Policy

  • We do not accept any insurance, including HMO plans or any government insurance (Medicare, Medicaid, or AHCCCS).
  • Patients with PPO plans can request a superbill to submit for potential reimbursement. Health Savings Account (HSA) funds are accepted for eligible services.
  • All patients are responsible for full payment at the time of service. Flexible payment options are available for those without insurance.
Dr. Linda Khoshaba is the Leading Integrative Health and Hormone Doctor in Scottsdale, Arizona. She has extensive experience working in the field as a Hormone Specialist and Natural Endocrinologist.

Phone: 480-687-0054
Fax: 833-605-1101
Email: contact@nesaz.com
Address: 
Suite A 109
7500 E. Pinnacle Peak Rd. 
Scottsdale, AZ 85255

Hours of Operation:
Mon: 8:30 AM - 4:30 PM
Tue: 8:30 AM - 4:30 PM
Wed: 7:30 AM - 4:30 PM
Thu: 8:30 AM - 4:30 PM
Fri: 8:30 AM - 3:30 PM
Sat-Sun: Closed
This Site may include a variety of features, such as health tips and videos, services provided at Natural Endocrinology Specialists™, our online Supplement store, NESAZ Programs, email, and patient portal services. DISCLAIMER: These statements have not been evaluated by the Food & Drug Administration. These programs and products are not intended to diagnose, treat, cure, or prevent any disease. The information contained herein is for informational purposes. Please be sure to consult your doctor before taking this or any other product/program. Consult your doctor for any health problems or before starting a new program.
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