Office Hours with Angelique and Toby, episode 4. Released May 27, 2025. 31 minutes.
Listen: Apple Podcasts · Spotify
About this episode
Angelique Britt has just finished her clinical doctorate, and Toby Daly asks why she went back for it after starting graduate school at 40. She describes a doctoral program centered on Daoist traditions, with its close cohort and emphasis on spirit, heart, and classical Chinese medicine, in contrast to her TCM-focused master's training.
The two then work through a challenging case of recurrent severe vertigo with motion sensitivity, ear blockage, hearing changes, and long-standing digestive symptoms, including the changes Angelique tracked after treatment and diet adjustments and Toby's reasoning about channel choice for dizziness and wind. They also discuss treatment frequency, with three visits in the first week as an ideal start for significant pathology, how to recommend a plan while leaving patients in control of their time and money, and insurance versus cash practice.
Topics
Why a clinical doctorate after starting graduate school at 40
A doctoral program centered on Daoist traditions
Case: recurrent vertigo, ear blockage, and digestive symptoms
Channel reasoning for dizziness and wind; a cracked heel as a caution
How often to treat significant pathology
Recommending a plan while leaving patients in control
Insurance, cash practice, and sliding-scale sessions
How a billing service works
Key terms
Saam acupuncture (舍岩): a Korean Buddhist monastic acupuncture tradition that treats imbalance on one channel system at a time, using combinations of the five transport points.
Shen (神): spirit; Xin (心): heart-mind.
A note for listeners: this is a conversation between licensed practitioners, offered for education, not as medical advice. Patient details have been kept general to protect privacy.
Transcript
This transcript was generated automatically from the published audio and lightly edited for readability. It may contain errors in names and terms.
Welcome to Office Hours. Whether you're new to the acupuncture profession or have been at it for decades, this is the place where we discuss all things Chinese medicine and more. Join Toby Daly, a seasoned acupuncturist of the Saam tradition, and Angelique Britt, a nurse turned acupuncturist who is brand new to the field as they explore topics in and around the world of acupuncture and Chinese medicine. There's something for everyone here. Drop in anytime. Okay. How's it going, Toby?
Toby: Everything's going pretty well with me. How's everything going with newly Doctor Britt? I
Angelique: No, I am. At least I think so. There's still a couple of things left on graded.
Toby: Okay. You don't ha you don't have the piece of paper yet?
Angelique: No, I'm flying down tomorrow and there's still some things left ungraded. So I'm assuming that if it was problematic, they would have told me already. So yeah. I have a doctor Angelique Britt, which feels really weird.
Toby: That's awesome. Hopefully they don't pull you off the stage tomorrow, and say, just a couple more things.
Angelique: That would be something I would yeah rate and probably make the newspaper.
Toby: Okay, so do you feel different? You're gonna have your patients referred to you as Doctor Britt now. What's gonna be different with you?
Angelique: I don't think I'm gonna do that. I think that it's important in our profession to go to the end of the degree if you feel that it's gonna be helpful for me. I wanted to do this one because I had some momentum. I was already I started, you know, grad school when I was 40. So I felt like I was gonna go through and at least finish it while I had the school brain on. And also because I do want to integrate medicine, like Eastern Western medicine. And I feel like there's As much as it shouldn't be, there is much more of a s what I'm looking for. Credibility maybe between like introducing myself as Dr. Angelique Britt to another doctor in the Western world versus just myself with my, you know, L I C A C title. Yeah.
Toby: I think that's really reasonable. What about your doctorate program? Are you gonna be able to apply a lot of that to your clinical work? I
Angelique: Hoped to. I hadn't so you studied with Jeffrey when for many, many years. And this was my first exposure to him specifically. And I chose the school based on more of the spiritual leaning toward Chinese medicine and classical Chinese medicine, as well as because they have an in-person component to their coursework, which I felt was important considering this is a clinical doctorate. And so I thought being in person to do more clinical work was important. And so there are a lot of principles and things that I know I've got eons worth of continuing education material that I can go through. Just the way that the Taoist perspective of looking at Chinese medicine and life is just completely different than what my very TCM focused masters was about. So there's some things I've started to look at through the lens of what I've learned so far, but I think I need to take a deeper dive before I can completely extract what I've learned to actual clinical practice.
Toby: That seems really fair. What about if someone was thinking about that program, the doctorate program on Taoist traditions? What would you recommend that you really got that you the you know, the top two things you really liked about it?
Angelique: The two things that I really liked about it. First was the sense of community, the sense of community there. So the cohort of people that I was placed into was a remarkable group of people. Like we were on a group thread the entire time and we all got to meet each other. Sadly not twice, but one time. We just really meshed and melded. And there's very much a spirit of generosity and wanting to learn and wanting to do the very best you can amongst these people, as well as just going with the flow. Like there was just, you know, following the Tao the entire time. And the other was seriously, and the other thing that I really enjoyed about it was the very much different leaning toward looking more at the spirit, more at the heart, more at the Xin, you know, aspect and the shen of Chinese medicine from a classical point of view. Like there's a very cool and different set of channel treatments that are done through classical Chinese medicine. There it was just a completely different perspective. So it was very much a yin and yang experience for me coming out of the New England School of Acupuncture and then going to Taoist traditions. So I enjoyed both of those aspects very much.
Toby: Yeah, that sounds really complimentary, right? The two aspects. One more focused on the like the clinical aspect, you know, your master's degree, and then more like the philosophical aspect that you could probably apply to your clinical work. Does that seem fair?
Angelique: Yeah, that's fair.
Toby: I was gonna check in with you, how's everything going with you in clinic? Any really memorable cases difficult or amazing?
Angelique: I feel like there is always something to talk about in that regard. Sure. So I'm I'm growing a little bit more. So I'm at about half my capacity now on more regular basis. So that's nice. And the number of insurance patients has gone up and people are finding me more through their insurance searches. At some point I want to address the insurance piece today, but we won't do it yet. And in terms of cases, so yeah, there was a I've had an interesting one recently. Older gentlemen. Came in. His wife actually had him come in. And he's the kind of person, like very, very tall guy and kind of, you know, on the bigger side, like not necessarily heavier set, but just like a bigger kind of guy and very gruff and kind of grumpy. And those have been my favorite type of patients like since I was a nurse, of just like the grumpy older men. I don't know why, but I always just vibed with that kind of patient. So I was like nice. All right, we're gonna, we're gonna crack this egg. And he basically told me that he would never have come to acupuncture had it not been for his wife's coercion, essentially, and that he was desperate. And that's why he's here. And I was like, join the club. It's like you and everybody else that comes to get acupuncture. So his main issue was that about three years ago, he developed sudden onset vertigo, where he felt like somebody pushed him over. And then he was essentially in bed for four hours. And he took dreamamine, he said, and was just spinning and feeling like he was gonna throw up and he never threw up. And then he had three of those episodes in the last three years, the most recent of which was about two months ago. And then residually he has this motion sick feeling a lot of the time. Detail wise, when he's driving, he's fine because he's focusing ahead and he can he can, you know, look down the road and focus on one point. He says he feels his best when he's driving, which, you know, when I think of somebody with motion sickness, that's sort of counterintuitive, right? Yeah. But with things are going across his visual field, you know, from left to right or up down. Like if he's scrolling on his phone or if he's, you know, surfing the internet and reading web pages, he gets emotion sickness feeling. And he's just he's it has impacted his life to the point where he and his wife don't go on trips. They don't go very far from home because they don't know if this is gonna hit and where it's gonna hit and what's gonna happen. So it's created an instability in his life. I was like, all right. So we went down the whole chain of diagnostics. So things that were interesting about him, his diet was primarily. Carbs and dairy and sometimes meat. He had a colonoscopy that had gone wrong, where he ended up, it's I think he had to have a bowel resection. He had some wound infection happen. And as such, he had some abdominal issues since then. So he was having more trouble digesting meat and his bowel movements really irregular and he had a lot of abdominal pain that he had to actually like massage sometimes when he after he ate to like move things through, which sounded awful. And from his perspective, like the Western medical world had not served him well. So he brought in his MRIs and his tests and all the things, and there was some discussion of meniers, but not a definitive diagnosis. So he had a lot of left-sided symptoms. So his left nostril had been plugged for years, and his left eye, he said he had blocked tear duct. He hadn't had tears out of that eye for years using eye drops. No urinary complaints, very dry skin. So bowel movements were variable. Trying to remember other details. I think that was about it. And so I did a, you know, basic TCM treatment the first time because I'm still scared to do some for my first treatment. I'll get there, but I'm still scared. And since this guy was basically like, I'm here essentially under duress and out of desperation, I felt like scared. So just being real about that.
Toby: That's the time for jingwells, Angelique. I was saying that's the time for jingwell treatments. Yes. Okay. All right.
Angelique: It's a little Yeah, the time for Jing Wells. Yes. I got there, but it took me a k it took me a few treatments. So he did the first treatment, he came back and was kind of like, And I was like, so I adjusted my treatment, still stayed with TCM. And then the second time he came back, his nostril was completely unblocked. He his wife said he stopped snoring. He'd been snoring for years. He could breathe out of his left nostril for the first time in years, and his eye started tearing. What was interesting is on the table, his eye started tearing like during the treatment. So I thought that was super cool. And that's probably one of the most dramatic immediate effects from acupuncture that I've seen, like ever. So that was neat. And then I carried on. I he told me I had four to six treatments. And then his wife was like, You actually have six. And I said, Okay. So I knew I had six. And so I treated him once more with regular TCM. And I had treated done his ears, like his face and his ears locally. Cause the other thing that was important to know is that his left ear was completely blocked and he had. Pretty significant hearing loss in that ear. And then the right ear was blocked, but his hearing would come and go. So there's very much a fluid component, like a windy, phlegmy, dampy component to what was going on with him. So I tried local needling and that's what freed up his orifices. But his ears never became fully unblocked. And so I was like, okay, because we're getting down to the wires coming up on visit four. I knew like I had to get something going or this guy was gonna quit on me. So I was like, I'm gonna break out some. So I didn't I didn't say a whole lot about it. I just said I'm gonna try a different style of acupuncture with you. It's like okay, it's only four needles. All right. He's like, fine, whatever. Very clipped and short. And I didn't pick up on his gallbladder excess till after talking to you. But he was very much a gallbladder excess type person. But he also had, I feel like he had some stomach excess stuff. He was dry on the inside. And I how did I get to the stomach excess? I don't remember. I told you about it. He had a lot of ascending symptoms. I feel like he was. Dry on the inside and at the time of the visit, his skin wasn't so dry and he was also like leaking out of his face a lot. So I like counted that as external wetness. I don't know if that counts or if that's cheating. I know his blood pressure ran on the high side. He definitely gets angry and things rise. What else? I think he'd had some heartburn. He'd had some other like very like, okay, this could be a stomach. And so I did the stomach channel. And then I talked to
Toby: Wait, hold on one second. Wait, so y you diagnose them have as having a stomach excess, so you counterbalance by supplementing the lung or r vice versa?
Angelique: No, I had a he had a hold on. He was a lung excess. He was he was wet on the inside, dry on the outside. That's where I was seeing myself. So he was a he was a lung excess. Also had like the barrel chest. His phenars were on the flatter side, which doesn't bode for the lung excess, but he had enough symptoms of lung excess that I was like, okay, we're gonna do because he was damp on the inside. Well, I decided to try some and I knew I was coming to the end of my sequence of treatments with him, and so I didn't warn him. I just said, you know, I'm going to do this treatment. It's four needles and I want to try something different. It's a pretty powerful form of acupuncture and I think it's indicated. And so because he was damp on the inside, dry on the outside, primarily, I diagnosed with a lung excess. Because I thought like all of the things coming up to his head, the dizziness and all of that. I was like, okay, let's try it. So I did that. And then I wasn't sure how it was going to work. He got off the table feeling a little bit better. Like he's like he felt a little bit less dizzy, but he was also one of these people like, I don't know if this is working. I don't know if this is working. I mean, who knows if this is working? Of note, I had spoken to him about some dietary changes. So I talked about how his condition is a damp condition and foods that create dampness. And so he agreed to try gluten-free for a while. And so he's like, I don't know if this is working. I don't know if it's the diet. I don't know if it's this. So I'm like, okay. So I called you and we talked about this. And you pointed out some really important things. One, you mentioned his gallbladder excess as I gave you the case history. Because he was very clipped, very like very short, you know, very gruff, just felt angry, you know. And I talked to you a little bit about intuition and using one's intuition about somebody. He just felt very angry to me. And so gallbladder excess became the next channel I tried with him the following week. And that worked fairly well. He said he had the best week that he'd had in a while. But who knows if that's because of acupuncture? Who knows if that's because of the diet? Sometimes this just happens. So he's very much noncommittal to any of this actually doing anything for him. And so I was like, okay, so today was the last day. It was it. He walked in the door, he sat down, he's like, This is it. This is all I'm doing. And I said, All right. And I said so. He's like, Maybe I'll come back if I'm in like the midst of an episode. I was like, That would be a great time to come back. I was like, if I may, I would suggest acupuncture. On a fairly regular basis, doesn't have to be every week, but maybe every month or every six weeks. I was like, if we can keep you tuned up, so to speak, like an automobile, you'll have less likelihood of breaking down because acupuncture is cumulative and we are making progress. And he was like, Yeah, but I mean, I don't know if this is working. So I was like, All right. So I busted out my medical record, went to his first visit, and I started asking him questions. I was like, When you first came in, you're so I said, when you first came in, your left eye wasn't tearing. Is your eye tearing now? He said, Yes. And I said, and you were really snoring a lot at night. He's like, I don't snore anymore at night. And my no your nose is blocked on the left side, like for years. And he's Yeah. And I was like, is it blocked? He's no, that's still open. I said, All right. And I was like, and you've had your bowels. How are your bowel movements doing? He hated talking about bowel movements. He would shut me down all the time and I'd be like, I know, I know it's gross, man, but we have to talk about it. Bowel movements got regular, so they went from being really like irregular. Sometimes he'd go multiple times a day, sometimes there'd be multiple days in between bowel movements, sometimes it'd be really hard, sometimes it would be completely loose, sometimes he'd have a lot of abdominal pain. So you had no abdominal pain. Bowel movements were regular. And so I was just like pointing all of these things out to him. And I said, you know, I think part of it is dietary change for sure. I was like, and the reason the dietary change is important is because I can do acupuncture on you all the time. And if you're still putting things in your food, in your body that are creating dampness and your digestion is not strong enough to handle it, we're just gonna be, you know. Kicking a can down the road a little bit, not making any real progress. And so he kind of like nodded. And so today I supplemented small intestine because that is your go-to for windy conditions, correct? Correct. And so that was and it made sense. He also had the cracked medial heels. So I did small intestine today.
Toby: Cracked medial heel is a reason to supplement small intestine. Cracked medial heel is a reason to not supplement small intestine. Usually pretty smooth even heel, that's the one you supplement small intestine for 'cause that's a kidney excess sign.
Angelique: I let it go again. You okay. I'm gonna see if I heard you correctly because things got a little choppy. So you're saying that you use small intestine even if there is a smooth medial heel?
Toby: Smooth medial heel is an indication to supplement small intestine. A cracked medial heel is a reason not to supplement small intestine.
Angelique: That's right. So he had a cracked medial heel. So one would think maybe supplement kidney.
Toby: Yes. I if that's the only indication. But for f severe vertigo like this guy was having, then I would definitely, you know, you have to factor that in. So a cracked meal heel, that's not a for sure you can't supplement small intestine, but it's just a caution to do that. That's a reason not to g to consider not supplementing small intestine, but especially with that severe vertigo. What about his facial symmetry? Did he have a little bit of symmetry?
Angelique: I no, but he wasn't a not handsome guy.
Toby: Okay, so medium handsome with vertigo, plus the cracked heel, especially with a severe vertigo and the that being the chief complaint, I would still I would consider supplementing small intestine for a case like that. Because it is my go to try and drive wind conditions off the body, itchy, dizziness, things like that, to drive it off the body. That's my go to so especially maybe your last treatment for him, right? So I think it's really good to swing for the fences on that and then try and knock out completely his chief complaint.
Angelique: Okay. Yeah, so that's what I did today. And then what was pretty amazing is when I came so interestingly, he didn't feel as angry when he came in today as he usually presents. Like there was more smiling happening. I mean, definitely still on the gruffness spectrum, but not as high. So that was kind of neat to see after supplementing pericardium. And at the end of his treatment today, he said, you know, I've been thinking, I mean, what else am I gonna do lay in here? Right. And I was like, Yeah, you could relax, you know, and he just started laughing. And he's like, I was thinking about what you were saying, and I think it's reasonable to come back, you know, like maybe once a month. Like I could do that. And I said, All right. I was like, Great. So we'll do that. He said, Do you want me to call his wife? 'Cause I was talking to him about, you know, potentially looking at some dairy. He really loves dairy. I was like, you know, only if it feels right to you. I'm not saying that you have to do it because patients don't love the dietary changes, right? But I was like, maybe, you know. So he's like, Call my wife. And so I talked to her and she could not believe that he agreed to come back. Again, she was she thought it was great, like his results were good so far. But I explained to him, I was like, I feel like we're picking up some momentum with this. And so to just drop the ball would kind of go to a reset. And I was like, plus, I can kind of help guide you in the rest of your life in that way too, if you're seeing me periodically. So that was that was a neat experience.
Toby: That's great. And then also, you know, based on research, that's that's one of the stronger indications for acupuncture to work is frequency of treatment, right? There's there's all kinds of like kind of gray areas, but that's one of the clear things coming out of the research. Frequency of acupuncture seems to really you know, bode well for clinical results. And that's my sense too, you get that momentum going and then you can really get things going. Otherwise you see you know, acupuncture once every month and a half, once every three months or something like that, you're not gonna really be able to make some good progress. If the patient's already fine, you know, just to kind of tune up and they just want to feel great, I think once every couple of months is no problem. But to really get into pathology, I think frequent treatments is you know, that's what the research says and that matches my clinical experience too.
Angelique: Great. How do you how do you set people up for that? Like what's your language that you use with patients in terms of like, well, what do you how long do I have to come for? What do you how many times?
Toby: Yeah, I mean i it's it's always case by case, but let's say severe pathology like that, I say I like to work in sets of three. So if possible I like to see them three times in one week and then evaluate after the end of those three to see and then usually
Angelique: You do it in one week's time.
Toby: For severe pathology, yes. This a little bit matches what my teacher the monk would do. We'd be in a like a little village and we'd treat people every day for, you know, two or three days and then we would go. It would make some really big impact for people. So that's that's mostly what I do. I know here in the West a lot of people do once every week, once every two weeks or something like that. But s for severe pathology in China and then from my teacher's experience, right, it's every day or every other day to really make some good progress. Again, data you know, the research data supports that too. Frequent acupuncture visits are the ones associated with the greatest clinical outcomes. So yeah, so I think you can do that. And I just always tell th this is the phrasing I like to use for that for patients. I say this is what I recommend clinically, and that's up to you if you want to devote the time and the finances to that, but that's my clinical recommendation. So it sort of separates the two, right? I don't have to make that decision for them, you know, how's their finances, how's their time and things like that. That's my clinical recommendation. And then do with what you want of that. So it's nice and clean that way. That way they get to buy in. Some patients just refuse to do that or they can't do that financially or something like that. Then you can spread it out, but j just the impact is not as strong.
Angelique: So what do you so then if you have somebody who's like, you know, master negotiator patient, they're like, Okay, yeah, I hear you, Toby. So you want me to come three times in a week, I don't want to do that, but would it be as effective if I came once a week for three weeks? If that's all I can do, do you think it would still work?
Toby: I would agree. Yeah. Once a week for three weeks is much better than zero times a week for three weeks. But the biggest bang for your buck is three times a week.
Angelique: And you generally will do I mean, I know it's case I know the answer to Chinese medicine questions is one hundred percent of the time it depends, but in the context of that, you tend to not repeat a channel during those three.
Toby: Yes, I really try not to be speaking. Yeah, I really try not to. Okay. If at all possible, right? Because again, I really want to see what happens in those three times so I can give them a good evaluation going forward. You know, based on those response to those three treatments, that really gives me a good sense about how I think things will go. So ideally I w I want to take my top three ideas and then use one of my top three ideas for those three visits and then and then and then and then evaluate based on that.
Angelique: Have to roll around in my head how I can present that to people. One of the things that I'm working on in myself personally is like my relationship with money and how I am not responsible for other people's relationship with money and how I'm watching those things interact with each other. You know, because like hearing you say that like three times a week, like I'm thinking like, okay, so my return visit's $105. And so I'm like, that's three hundred and fifteen dollars in a week. And my immediate response is, but that doesn't have to be that way. Like I can be open and expansive. And if people want that and they want the critical result, then it is up to them to decide. Like I should have to geek keep myself and what I think because I am fearful of wasting their money, you know? 'Cause I know I'm gonna give it my best effort. It's just who I am.
Toby: And th this is one of the few things where you can say this is like fundamentally changing the patient's life. If th if you can increase their health by a significant amount, that's so much better than little trinkets that they might buy or something else they might get, right? I mean fundamentally changing their health is one of the best investments they can make. So you just lay out what you'd like to do for them and then they can decide if they agree with your idea that's one of the best things they can do for their
Angelique: I think one of the things as a new provider, especially, is the, I don't know, the imposter syndrome to some degree, but also just knowing that I am beginning, I am just starting out. And so I don't have the lens that you have, for example, or the lens that people have been in the profession for, you know, 20, 30, 40 years have. And making my peace with that, that's okay. And that what I have to offer is still a value, even though it might not be at master level yet that I'm gonna get there. And so that new person, that's that's the other piece that plays into that part of it. You know, for me that I'm working through and just going, going for. And I think that's part of the reason why I feel comfortable, more comfortable, I don't love it, but more comfortable accepting insurance because there's co-pays. So it's like less of an investment for people in that way. And it's like, okay. So I it's okay. It's like almost gives me permission to be not that I shouldn't be free with patients who are paying cash, but do you know what I'm saying? Like there's almost like the less of a pressure. Like the documentation is more, but they're using their insurance benefit. And so yeah, sure, they're investing their time, which is the most important asset that we have. But I'm feeling like I'm not gambling so much with folks that may not have the resources while also arguing with myself. See the prior argument about relationship with money. So just kind of working through those things.
Toby: But I don't have a perfect relationship with that either. But yeah, it's it's gotten better over the decades. It's gotten better. But yeah, I still feel uncomfortable like that. But that's what I mean. Give it to them. 'Cause and again you'll never have perfect knowledge about the patient's finances. You'll have like an inkling about it. But then just give it to them and they can decide. Yeah, I've had, you know, multimillionaires think, you know, three times a week is not that's I'm not doing that right. And then people that have to like you know, borrow money from somebody else or tap in other resources to get it. A lot of times especially younger people maybe don't have money, so they get a little bit of money, p change their health and then they can go back to work or whatever they need to do. So again, I really like to give it to them and have them decide and be again, they're I'm there to a hundred percent help them in any way I can and I can just give up my clinical recommendations rather than demanding that they, you know, Pay this money at this time or something like that. It's much better if I can just cleanly say this of my clinical recommendations and then now it's up to you how you want to interact with that. That took me a long time to come around to that. So yeah, like I said, it's not even perfect now. I still feel a little twinge of something when I when I go to recommend that to patients that they give me money. One another angle on insurance though too, I don't take insurance and I kinda like it. I like the pressure from the patient. It's directly one on one. They're saying I'm giving you a big chunk of money. And I would like some clinical results. I feel like that's clean and I don't know. I sort of like that more direct relationship.
Angelique: Yeah, I can see that. Working with insurance isn't easy. And it's it's it's fraught, I guess one could say. It's fraught. I just for me where I am now, especially being new, it's nice to have the mix and I feel like it I think it brings access. Like people that there are people that I'm seeing here now that would absolutely never spend money on acupuncture if their insurance wasn't kicking in part of it. Like absolutely never. And I'm helping those people. People that come in with back pain and knee pain and menstrual irregularities and things like that. It's like they would never otherwise have come to acupuncture if their insurance wasn't kicking in something. So I have I've got a lot to think about as the insurance contracts expire, if I want to continue or if I just want to do what I think you had suggested in months past, which is have a community day or a community evening. That's, you know, sliding scale and affordable, and then just do some for a group of people. Have people sign up in advance? And do it that way, you know, as I get my feet a little more wet, that might be a way to not deal with insurance as much. But just sort of letting the experience unfold before me and seeing what happens so far. Thank God for that biller, let me tell ya.
Toby: Yes. I think that's a clean way of doing it. Again, you maybe work w at a quicker pace for, you know, sliding scale patients, right? Then no herbs, no dietary recommendations or something like that. And just go quickly, even community style or something like that. I think I think that's really reasonable. You can still serve that population. And then again, you don't have to have insurance involved. So I think that's how I that's how I went around insurance all the way. What about yeah, we just have a few more minutes here today. Do you wanna say anything in just a couple of minutes about your ex experience with insurance or is that a bigger topic for us next time?
Angelique: Sure. Yeah. So with the insurance. So I think in episode three we talked a little bit about it and you had asked me how much the bill or costs and I was like, I don't know if I can talk about that. Yes. And I absolutely hate gatekeeping information. It is the worst feeling. I think it happens a little too much in our profession a little bit with certain things and I don't like it, but I also didn't want to get busted in from violating a contract. So I reached out to them and they were f totally cool about me telling people. So they charge ten percent of your claim. So whether that's, you know, 70 bucks or 144, they take 10%. And I can tell you it's the best ten percent that I have ever parted with in my entire life. Just because like they verify the insurance flawlessly. I know going in, I can provide a like a little, there's like a document that they provide that's printable or emailable to a patient that I send to them, let them know what their benefit is. They I know what the copay, it's just simple. And if there's a problem, they go after it for me. So I don't ever have to chase claims. They do that. So it's just I submit the charges, they ask questions if they have them. I ask questions of them. They're super responsive. And so Dr. Ian Gregory from Family Billing Solutions says he'd be willing to be a guest on the show to kind of answer questions that we have about insurance billing. They're the small to moderate sized clinic biller that's commonly used through the majority of the people that I know from school and the practices that they're in. Use these folks and they're great.
Toby: Okay, great. Yeah. Again, that would be great to have you know, based on the it's nice that you share your experience, but maybe from the billing side, all that work that they have to do to get that ten percent, that might be nice to hear from
Angelique: Yeah, absolutely. And I think that one of their I don't know if it's a rule necessarily, but a guideline they follow is that they want to ensure that whoever they're working with has had either a course in billing for insurance or they've tried it on their own for a while so they can actually understand the work that goes into billing. And I can tell you that I probably would not have appreciated them as much as I currently do had I not tried to do it myself for a while. Like I wouldn't be I know it to be true because you don't know what you don't know. You know what I mean? And then I spent a couple of months trying to do it myself and was like, absolutely not. I started dreading coming to work and I was like, I don't want that to happen. I don't it's too early for that. Too early for that.
Toby: It's such a different hat though, right? Clinical provider and then the billing aspect, right? I feel like it is two different hats. So th that's great to outsource that.
Angelique: Yeah, so happy to outsource it. So happy to. And insurance, I mean, without naming particular insurance companies, like there's a pretty variable range that you get paid. And so one of the things that they helped to do, and I'm I'm gonna use the wrong term, but it's like they use Medicare uses this to establish its billing, and it's some sort of unit, some sort of I don't know, each code that you use has a certain number of. Payable units and they follow the Medicare guideline for that. And then depending on the insurance company, the insurance company pays the codes differently. So there's one insurance company that a visit that I might reimburse visits if I don't use Electro is like 70 bucks. And that same visit from another insurance company is 140. So there's a wide range. And so what I'm what I'm seeing happen is that there's a bit of balancing out of happening. So I have a pretty even number I've got a like nice little mix of insurance people. So I've got Pretty even number of the ones that pay on the higher side to compensate for the ones on the lower side. So I seem to be breaking kind of even in that way of coming out right around my cash price ish. So that's fine. I'm all right with that. But if it were to go the other way, it might be a little more challenging.
Toby: Okay. Okay, yeah. The more you talk about the more I'm just so happy I just do cash only. So but it would be great to know a little bit more. Especially we can get your bill around. Okay. Yeah, totally. Let's wrap it up for today. Yeah, there's so much more I wanted to talk to you about today, but we really got going. So I'll save it for next time and I look forward to continuing this conversation with you. Okay. Take care everyone. Signing off for Toby and Dr. Britt. Bye everybody.
Angelique: Yeah, take care. Bye.
