Frequently Asked Questions
and Patient Information

You will find answers to our most frequently asked questions here.

Our office is quite different from other doctor offices!  We have returned to the old-fashioned way of providing superlative health care in a home-based office setting with limited staffing and reduced administrative costs so that we can keep our fees as low as possible. 

This FAQ page will help you to understand our stream-lined office policies and procedures, which allow us to keep your costs as low as possible while still providing exceptional care!

Do you accept insurance?

Dr. Richey does not accept any third party payments from any sources including but not limited to private insurance, Medicare, Medicaid, Workers' Compensation, injury lawsuits, etc. You are responsible for all interactions with your third party payors.

However, she will provide you with a receipt for your appointment that you can turn into your insurance company for reimbursement if you ask for one at the time of your visit. Receipts will not be mailed or faxed. Most insurance companies (except Medicaid and Medicare) do reimburse your appointment fee on an out-of-network basis.  

Also, most insurance companies (except Medicaid) accept laboratory testing and prescriptions written by Dr. Richey.

Because Dr. Richey is not a provider for Medicaid, they will not reimburse their patients for office visits, prescriptions or laboratory testing.  Therefore, Dr. Richey does not accept any Medicaid patients.  If you are receiving free health care, then it is mostly likely Medicaid even though the name is different. 

What laboratory tests do you order?

Dr. Richey uses the Igenex Lyme Western Blot test, many “regular” tests, many co-infection tests, and biotoxin labs if needed. Insurance companies (except Medicaid and Medicare) usually cover everything but the Igenex test. You would be responsible for any co-pays and deductibles. She can order other specialty tests if requested and if needed, but these tests are rarely covered by insurance companies.

Blood work is not drawn at this office. Instead, you can have your blood drawn closer to your home at a facility of your choice.

Lab results will be thoroughly discussed with you at your next appointment and copies of the results will be given to you at that time for no charge. You will be contacted immediately for emergency lab values.

Monthly labs are needed for chronic antibiotic usage. You will receive an email letting you know if your monthly labs are normal or if further action is needed.

I have heard that Lyme tests are often negative even when a person is infected with Lyme disease. What do you do in this case?

Laboratory testing is important and is used, but most of these chronic infections are difficult to detect. Thus, clinical diagnosis is usually based on history and symptoms and response to treatment. Laboratory testing is used to confirm the clinical diagnosis. 

What is your approach for treating Lyme disease?

Dr. Richey uses an integrative medicine approach which combines the best of traditional medicine and the best of naturopathic medicine (often called natural medicine or holistic medicine or alternative medicine). Antibiotics are prescribed along with natural products OR natural products can be used alone. She follows much of the ILADS Evidence-Based Guidelines for the Management of Lyme Disease.

Do you prescribe oral antibiotics or IV antibiotics or natural antimicrobials?

At this time, Dr. Richey only prescribes oral antibiotics because her patients improve with this treatment approach. So far, she has not needed to use IV antibiotics.  She also uses Byron White products for treating a multitude of infections naturally if you prefer.

Do you recommend natural products, such as herbs, supplements, probiotics, and antioxidants?

Most ILADS doctors are discovering that Lyme disease cannot be successfully treated with antibiotics alone. Instead, patients need natural products to help with healing your body, detoxing toxins, and modulating the immune system. In addition, natural products help to minimize herx reactions. Dr. Richey will recommend natural products for you and help you manage these products, but it is your decision whether to use them or not. She does not assist you with products that you use on your own or that you obtained from other health practitioners.

If you would like to use natural products, you can purchase some products with cash or check, and other products with credit card. So, please bring all forms of payment with you to your appointments. Again, it is up to you whether you want to use natural products or not.

What are herx reactions?

Jarisch-Herxheimer reactions are an inflammatory response to the interaction of the immune system with microorganisms and their toxins as a result of killing these organisms with antibiotics or natural products. Simply, they are “die-off” reactions. If you have Lyme disease, you will herx with treatment.

The symptoms can be quite diverse, such as headache, fatigue, pain, fever, and rashes. Herxes can also be very serious and even life-threatening. Each person is unique in their response to herxing. However, herxes can be minimized by weaning up slowing on medication and by using detoxification products. Most ILADS physicians believe that the risks of chronic infections outweigh the risks of herxing.

Do you address other problems connected with chronic infections?

Yes, other problems need to be addressed with the infection for maximal improvement. For example, nutrient deficiencies must be corrected, hormonal levels may need to be optimized, and diet must be improved. Furthermore, biotoxin illness often complicates chronic Lyme disease and must be addressed for maximal improvement. Cavitations can also block treatment.

How do you treat biotoxin illness?

Dr. Richey has studied the treatment protocol of biotoxin illness (including mold and Lyme neurotoxins) from Dr. Shoemaker who has pioneered this area since about 1997. His methods are backed by extensive research. You can read more about his research at Surviving Mold.

Do you offer primary care appointments?

No. Dr. Richey prefers to only treat patients with chronic infections and biotoxin illness at this time. You should maintain your relationship with your primary care physician for primary care needs including any controlled medications (such as narcotics and anxiety medications), hospitalizations, medical emergencies, preventive care, and general medical care.

Can you tell me more about office appointments?

New appointments are at 10 am, and follow-up appointments are at 10 am or 11 am. Appointments will be scheduled on selected weekdays. No appointments are scheduled on weekends.

New appointments are about 1 3/4 hours, and follow-up appointments are about 45 minutes. We see patients initially, at one month, and then at least every 3 months while on active treatment in order to monitor you closely. 

Appointments are held in the comfort of our home-based office. We are able to keep appointment fees low because our office is our home.  We ask for your consideration of our home during your office visit.  We do offer our guest bathroom to our patients during appointments.  Also, our home does have dogs (who are caged, but who bark with movement of strangers through the house), cats (who wander through the office and offer pet therapy for patients), and bunnies (who are caged, and are just too cute).  A HEPA filter is provided in the office for those who may experience allergies. 

What are your appointment fees?

As noted above, we strive to keep our appointment fees as low as possible by avoiding bounced checks and by avoiding credit card fees.  We believe that we have the lowest fees (but exceptional quality!) in the country among ILADS physicians who do not accept insurance.  

All fees must be paid in full at the time of your appointment.

All payments for office visits are CASH ONLY at the beginning of your appointment. 

New Visits (1 3/4 hours for chronic Lyme): $450

New Visits (45 minutes for new onset Lyme with tick bite within the last 1-2 weeks): $350

Follow-up Visits (45 minutes): $200

Visits that extend over the allotted time are prorated at $200 per hour.

For your convenience, we can now accept PayPal (or your credit card through PayPal) at least 24 hours prior to your appointment with a $20 administrative fee.  Please contact us if you are interested in this payment method.

What should I bring to my appointment?

Please bring the following items to your first appointment: new patient forms, a list of previous diagnoses, a list of previous surgeries, current medication (bring bottles), current supplements (bring bottles), and copies of pertinent lab and test reports that we can put directly into your chart. We will not make copies for you because it is too time-consuming and we would rather spend time with patient care.

You are welcome to bring a friend or a family member to help you remember the details of your appointment. Please do not bring more than 1-2 guests.  Make sure that any guests have thoroughly read these FAQs, too.

The office is maintained at a cool temperature so please wear layers or bring a sweater/jacket to be more comfortable. For the comfort of other patients and staff, you will be asked to remove shoes in order to avoid tracking in mold and allergens, and to minimize office cleaning. You may wear slippers if you prefer.

What should I NOT bring with me to my appointment?

For the comfort of staff and other patients, please do not wear any type of perfumes, colognes, fragrances, scented lotions, scented deodorants, scented hair spray, scented hand cream, scented hair gel, etc. Seriously, we will not be able to see you if you and/or your friend/family are wearing any of these products.  Please do not wear anything scented for our health and for your health.

Also, we would appreciate it if you and your guest(s) refrain from distractions, such as chewing gum, eating, texting, answering phone calls, playing electronic games, reading books, constantly clicking pens, excessively rattling papers, etc during your appointment so that we can concentrate on you better. Yes, patients and their guests have actually done these things.

In addition, we are not set up to accommodate children in our practice at this time. Please do not bring your children to your appointment. This policy is for your benefit so that we can spend more time focused on you. 

Where can I find directions to your office?

You can find directions to our home-based office by clicking on the directions button on the left side of this screen.

What local hotel do you recommend?

If you need to arrive the day prior to your appointment, you may want to stay at the Countryside Inn & Suites which is the only local hotel in the immediate vicinity. They are located at 100 Leininger Street, Mount Orab, Ohio 45154 about 2 miles from the office at the intersection of SR 32 and SR 68. They offer breakfast, a pool, and a clean facility; their rates are very reasonable. You can make an appointment by calling 937-444-6666.

What happens if I am late to my appointment?

We strive to run on time; therefore, your appointment will start promptly at your scheduled time. If you are late, we will not be able to cover as much in your allotted time. If you are consistently really late, we may not schedule future appointments.  

What is your cancellation policy?

This topic is so important the we have created a separate page for our cancellation policy.  Please let us know if you have any questions.

Do you offer telephone appointments?

You will obtain the best service with office visits. However, you may elect for telephone consultations for new issues between routine visits, such as new symptoms, herxing problems, side effects, medication changes, treatment changes, etc.

Patients must be established in the practice before telephone appointments will be considered; we do not offer long distance consultations for patients who have never been seen in person previously.

Telephone appointments are $200 up to 30 minutes and then prorated $200 per hour thereafter. You are responsible for sending the symptom list, medication/supplement list, and check to arrive BEFORE your telephone appointment.  And you are responsible for calling the office at your appointed time.

Telephone appointments are not in lieu of regular appointments or cancelled appointments.

What do I do for medical emergencies?

If you have a medical emergency, please go straight to the emergency room. Your primary care physician should respond to all emergencies. If your situation is not resolved, you may call for further advice. Emergency phone calls are billed at $200 up to 30 minutes and then prorated at $200 per hour thereafter.

How do I get my prescriptions refilled?

Prescriptions will only be refilled at your office visit. Please check that you have received all prescriptions at the time of service in order to avoid an administrative fee. Treatment plans are not changed between visits unless you schedule a telephone appointment.

How do you handle communication between office appointments?

Routine communication is done via email for efficiency and documentation.  All patients must have a personal email address that they check frequently. You are welcome to ask a few simple questions about current treatment via occasional emails for no charge.

However, if you have many questions, complex questions, confusing questions, or complicated medical issues, you will be asked to make a follow-up appointment or a telephone consultation instead in order for us to provide better advice.

In addition, you will be charged a retroactive administrative fee at a rate of $200 per hour if more than 30 minutes is spent answering your emails per 30 day period.

What do I do if I need administrative paperwork and services?

Our philosophy is to keep appointment fees as low as possible. We believe that it is fairer to keep rates low for everyone, and only charge extra for those who need extra services. Most patients do not need any additional services. However, some patients need work forms, insurance pre-certifications, disability letters, etc. Dr. Richey may perform administrative paperwork and services for an additional charge on a case-by-case basis. Usually, simple tasks can be performed for free during appointments. Between appointments, fees are usually $25-50 for simple services, and $200 per hour for longer documents and tasks.

Can I get copies of my medical records?

You will be given copies of labs at your next office visit free of charge. You will be charged for all other medical records or additional copies of labs according to current allowable Ohio rates.

Do you treat adults, teens and children?

Dr. Richey has been trained in Family Practice and in the medical care of the entire family. Therefore, she can treat all ages. However, at this time, she only treats adults and teens who are at least 12 years old, who are over 100 pounds, and who are able to swallow capsules/tablets. Our office is not set-up to accommodate young children. 

Do you treat pregnant women with Lyme disease?

Dr. Richey believes that it is best if a woman does not become pregnant until her Lyme disease is in full remission. She will treat pregnant women who are already existing patients according to ILADS recommendations, which involve antibiotics for which there is a successful track record. Natural products are not used for killing infection since no manufacture will declare their products safe in pregnancy. However, some supplements that are safe for pregnancy are recommended.

The father of the baby will need to be present for at least the first appointment in order to understand risks and benefits of treatment and to sign the consent form with the pregnant woman. Dr. Richey will not treat the baby after delivery, but will refer the baby to a knowledgeable pediatrician who is familiar with Lyme disease.

Do you provide family discounts?

No, we do not provide family discounts since our rates are already incredibly low.

Why do I need a Lyme doctor?  How do I choose a Lyme doctor?

Lyme disease is complex, and complex diseases require specialists. You will actually get better faster and for less cost with the assistance of a specialist who exclusively treats Lyme disease, associated infections, and biotoxin illness.

Your Lyme doctor should be a member of ILADS.  Extensive training in naturopathy is highly desirable.  Fees should be quite reasonable, and follow-up visits should not be excessive. Your doctor (not staff) should be easily accessible for questions day and night via email.  In addition, your doctor can relate to your concerns much better if they have personally battled Lyme disease, too.  Finally, but most importantly, your Lyme doctor should have at least 10 years of experience in treating Lyme disease in many patients. 

Dr. Richey meets and exceeds the above qualifications.  Furthermore, she has trained several of the doctors who treat Lyme disease in Ohio.

Do you have any other advice for Lyme patients?

No one wants to be sick with Lyme disease and biotoxin illness. However, if you ignore it, it usually does not go away - it usually only gets worse. Therefore, we highly recommend that you give Lyme disease treatment high priority in your life including keeping all appointments.  Also, we suggest that you take on the victor role as opposed to a victim role. Your treatment should address physical, emotional, and spiritual factors in order to maximize your healing. We look forward to helping you heal!

I want to make an appointment. What do I do next?

Awesome!  Please click on the Appointment button on the left side of this screen after you have read all of these Frequently Asked Questions. The adult patient must make his/her own appointment using his/her own email address.  Then, Dr. Richey will email you back with appointment options. We are looking forward to working with you!

Let food

be thy medicine, 

and medicine 

be thy food.  




Your word

is a lamp

to my feet

and a light

to my path.

~Psalm 119:105



I will cure them,

and will reveal

to them the

abundance of

peace and truth.

~Jeremiah 33:6