Working with Chris Kresser and Amy Nett

The way that Chris Kresser and Dr. Amy Nett work with patients differs considerably from the conventional medical model you may be accustomed to. Please read the following information thoroughly to familiarize yourself with their process. There is also a section at the end that describes the fee structure for Chris and Dr. Nett.

As a new patient, your treatment is broken into two phases:

Each phase is described in more detail below.

Phase One: The Case Review

The Case Review is the first step for all new patients. The Case Review process is designed to save money and time in the long-term by performing the appropriate diagnostic testing and evaluation before treatment begins. A cornerstone of our approach is “test, don’t guess.” Identifying the underlying patterns contributing to disease is the key to a successful and lasting outcome.

The Case Review serves several purposes. It enables Chris and Dr. Nett to more accurately estimate how long your treatment program will last, what it will include and how much it will cost. It gives you the chance to ask any questions you may have about your condition and what you should expect. It also provides an opportunity for us to get to know each other and determine if our clinic is a good fit for you over the long-term.

The Case Review includes:

  • An initial phone or video consult to determine which labs to order.
  • A thorough review of your medical history and relevant previous lab work (10 page limit).
  • A review of your current diet and nutritional supplements.
  • A detailed body systems assessment.
  • A 60 or 75 minute in-person consultation (duration depending on your clinician) to review your results and present your treatment plan.
  • A treatment plan including diet, supplements and lifestyle therapies.
  • Recommendations for further testing (if necessary).

The Case Review process includes two steps, which are described in more detail below.

Case Review, Step One: Initial Consult

During this 30-minute phone/Chiron video appointment, a staff clinician will interview you to determine which lab tests to order for your Case Review, based on your chief complaints and your history.

This appointment has two purposes: to make sure that we have all of the information needed to gain a comprehensive understanding of many of the factors affecting your health and to give you a head start on your treatment before you meet with us.

The exact lab testing ordered after the Initial Consult depends on your individual circumstances, but may include:

  • A comprehensive blood chemistry panel. This is the single most efficient, effective and affordable tool for quickly evaluating your health. It screens for a wide range of conditions, including several types of anemia; gut, viral and bacterial infections; insulin resistance and hypoglycemia; liver and kidney issues; and thyroid and adrenal problems. It offers important clues for how to structure and focus your treatment to get the best results. It also provides a baseline of biomarkers that can be used to objectively track the progress of your treatment over time.
  • Additional blood tests for specific conditions, such as high cholesterol, hypothyroidism, autoimmune disease and gluten sensitivity.
  • Advanced stool testing to screen for parasites, fungal overgrowth, bacterial infections, intestinal inflammation, dysbiosis and a deficiency of beneficial gut bacteria.
  • Urine organic acids testing to screen for small intestinal bacterial overgrowth, fungal overgrowth, problems metabolizing fat or carbohydrates, B-vitamin status, methylation issues, detoxification capacity, oxidative stress and neurotransmitter metabolism.
  • Urine hormone testing for adrenal and sex hormone status.

A Patient Care Coordinator will provide you with the Case Review health history paperwork to complete. It is important that you spend time and energy completing these intake forms, as they are vital in helping us understand your case. This paperwork includes:

  • A detailed health and medical history questionnaire
  • A survey of your chief complaints and most important health goals
  • An assessment of your most troubling and frequently experienced symptoms
  • A diet survey and questionnaire
  • A survey of your current supplements and medications

Finally, the Patient Care Coordinator will provide you with dietary guidelines to follow after your Initial Consultation. These are extracted from Chris’s New York Times Bestseller The Paleo Cure, as well as his online programs, and include:

  • Detailed instructions on how to perform a 30-day Paleo elimination diet (i.e. “30 day Reset)

It is critical that you implement the 30-day Reset diet to the best of your ability. When you speak with Chris or Dr. Nett, your experience with the diet will be as important as any lab findings in guiding the next steps in your care plan.

Once we’ve received your lab results and completed Case Review paperwork, you will move on to Step 2: the Case Review Consultation. This typically occurs between 60 and 90 days after the Initial Consultation, because some of the labs we use take up to 8 weeks to deliver the results to us after receiving your sample. While you wait for your lab results to come back, you will be implementing the 30-day Reset diet and making forward progress.

Case Review, Step Two: In-person Consultation

The Case Review Consultation is a 60-minute (with Chris) or 75-minute (with Dr. Nett), in-person appointment. If you live outside of the San Francisco Bay area, you must make arrangements to travel to our clinic for the appointment.

Prior to the consultation, Chris or Dr. Nett will review the results from the labs that were ordered along with your Case Review paperwork, medical history, diet and supplement survey, assessment forms and relevant prior lab work. Then they will create a Report of Findings, which is broken into three parts:

  • A summary of the underlying patterns that are contributing to your symptoms.
  • An outline of the suggested treatment plan, including dietary, supplement and lifestyle recommendations.
  • Recommendations for further testing (this will typically be minimal, if necessary at all, because of the completeness of the Case Review process)

During your consultation, Chris or Dr. Nett will present the Report of Findings as well as your treatment plan. They will also review all of your test results with you, discuss the results of your 30 day Reset, and answer any questions you have about the findings or the treatment plan.

Phase Two: Ongoing Treatment

Once the Case Review is complete, you’ll have follow-up appointments on an as-needed basis throughout the remainder of your treatment plan.

The first follow-up appointment generally occurs between six and ten weeks after your Case Review Consultation. At that time, Chris or Dr. Nett will review your progress on the treatment plan, along with any follow-up test results, and make additional recommendations as necessary.

From there, the frequency of your follow-up appointments will depend upon the severity of your condition as well as your response to the treatment.

You may schedule follow-up appointments in person in our office, or have via phone or Chiron video. If you live outside of the San Francisco Bay area, we ask that you return for an in person visit at least once per year.

Fees

Fee schedule for visits

The Case Review is the fastest and most efficient way to determine the underlying causes of your health problems and design an effective treatment plan. While a Case Review may cost more than a typical initial visit to a physician, it is designed to save you money and time over the long-term by performing the appropriate diagnostic testing and evaluation before treatment begins.

Here is a breakdown of the costs involved in the Case Review and follow up visits so you can plan accordingly. All of these are billed at the conclusion of the appointment.

Chris Kresser

Initial Consult: $295. Includes the 30-minute phone/Chiron appointment, Dietary Guidelines and Case Review preparation.

Case Review: $1195. Includes the Report of Findings and a 60-minute in-person consultation with Chris.

Regular Follow-ups: $240 for 30 minutes.

Dr. Amy Nett

Initial Consult: $295. Includes the 30-minute phone/Chiron appointment, Dietary Guidelines and Case Review preparation.

Case Review: $1195. Includes the Report of Findings and a 75-minute in-person consultation with Dr. Nett.

Regular Follow-ups: $240 for 30 minutes, $360 for 45 minutes and $480 for 60 minutes.

Laboratory Tests

The fee for laboratory tests ordered during the case review process is typically $600–$1,500 depending on complexity of condition and level of diagnostics required. The cost of some testing includes an administration and interpretation fee.

Supplements

The fee for supplements that are prescribed as part of your treatment plan after the Case Review is typically $150–$300. You will have the opportunity to approve or decline the supplements Chris or Dr. Nett suggest before you are charged for them (after the Case Review Consultation).

Grand Total of Case Review Fees

The total you should expect to pay for the entire Case Review process with Chris Kresser or Dr. Nett is roughly $1,750–$3,700.

Approximately $850–$1,850 of this will be due after the initial phone consultation and $900–$2,050 will be due after the in-person Case Review consultation.

Estimated Costs for Laboratory Tests for Ongoing Treatment

Ongoing lab fees vary considerably depending on the patient and treatment plan, but average approximately $200–400/month.

Estimated Costs for Supplements for Ongoing Treatment

Ongoing supplement fees vary considerably depending on the patient and treatment plan, but average approximately $150–$350/month.