ReLACS Health exists for those that are looking for a more personalized relationship with their sleep doctor. As desired by patients who struggle with short visits, we offer longer, detail-oriented appointments to provide not only comprehensive assessment but also education about your sleep health to reach a deeper understanding of the condition and its treatment. For members, we provide responsive, flexible communications regarding your questions and concerns. You work directly with Dr. Berkowski.

Additionally, visits to insurance-based clinics may be “covered” by insurance but still lead to significant out-of-pocket expenses. Many of you have high-deductible plans and have not met your deductible; others may be enrolled in a health sharing plan. Sometimes there are surprise costs at a fee-for-service insurance-based clinic. Everything you pay at ReLACS Health is transparent so you can make an informed decision regarding your treatment. Dr. Berkowski has extensive skill and experience in managing complex sleep conditions including severe restless legs syndrome and insomnia so the combination of the personalized doctor-patient relationship along with clinical acumen is something you may not be able to get through insurance.

It is an acronym for the Restless Legs and Advanced Consultants for Sleep. The words in the acronym may seem out of the correct order, because “we put restless legs first!” Insurance-based sleep clinics focus almost exclusively on sleep conditions that lead to sleep studies, which net the most profit from insurance, leaving the others like RLS, insomnia, and daytime sleepiness as an afterthought. We treat all sleep conditions—whether they are financial winners or losers in the insurance-based system.

If we said “it’s like direct primary care (DPC),” would that help? Direct specialty care is a rapidly growing practice model that strives to provide patients with excellence in specialty care through a personalized relationship with their doctor. By having patients pay their doctor directly for treatment—a practice common in numerous other fields and businesses outside of medicine—direct specialty care enables patients access to an unmatched doctor-patient relationship that incorporates time with the physician and greater flexibility in communication. This system can provide you more ideal treatment without interference from third parties who may have other business interests that can impede your quality of care.

All patients start with an initial Comprehensive Consultation, during which long-term treatment and management goals will be discussed. Some of you may require ongoing medications and regular follow-up through ReLACS Health, which would necessitate a monthly membership. Others may get all you need from the consultation and can take your assessment back to your regular sleep provider or primary care physician as clear guidance for ongoing treatment. You may just need expert guidance and direction in your care and would be fine returning for consultation in six months to a year later without the need for a membership.

Payment is by credit or debit card only, including HSA or FSA cards, through the secure third party platform Stripe. You will be charged a non-refundable chart preparation fee prior to your Comprehensive Consultation. The full consultation fee is due at the conclusion of the consultation. If you proceed to a monthly membership, your membership would start immediately and the fee will be billed after each month of membership, with first monthly payment one month from the date of the initial visit. Membership continues on a month-to-month basis, including for the specialty memberships. You may cancel at any time and would just owe for the portion of the month since the last payment. However, if you are receiving medications from ReLACS Health, you should give sufficient notice to find another provider and coordinate to take over management and prescription refills.

Though many patients improve significantly before the end of the RLS or CBT-I Programs, the idea behind the length of the specialty programs is for you to purchase a treatment “package” without having an up front payment. These programs divide the payments over 5 and 2 months, respectively with payment due after each month. This allows you to know up front how much you may have to pay with the option to cancel at any time if you wish to end treatment through ReLACS Health. Patients in the RLS Program often have front-loaded care over the five-month specialty program but the monthly fees attempt to reflect the total expertise, time, dedication, and personalized communication required, averaged over a five-month period.

ReLACS Health has chosen not to use a physician hourly fee model for two main reasons: first, with monthly membership fees of known length, you have certainty in how much you will be committing to the treatment. The amount of physician time required is unpredictable and would thus lead to uncertain costs. Second, you should get medical assistance when you need it and not hesitate because you will be running up the tab in hourly fees each time you need medical management.

As a pure direct care practice, ReLACS Health does not bill insurance. Reimbursement may be possible, if your insurance covers out-of-network expenses, or some of the costs may be credited toward an out-of-pocket deductible. Please refer to your insurance documents or contact your insurer to find out. ReLACS Health can provide a Superbill/Invoice for consultations and set up an ongoing membership structure and visits that are best suited for reimbursement through your insurance. Those with Medicare cannot submit for reimbursement due to Medicare restrictions, and Dr. Berkowski is opted out of the Medicare program. However, like any physician, ReLACS Health can order lab tests and prescriptions that can be paid for using your insurance including Medicare.

Possibly, some of the visits or membership fees may be considered medical expenses, but you should contact your FSA/HSA servicer for specific answers as it may vary. Some patients use an FSA/HSA card, whereas others submit a receipt to their servicer for reimbursement.

Yes, ReLACS Health can order lab tests or send prescriptions to pharmacies, which can then be obtained through typical insurance coverage. ReLACS Health also has special cash payment pricing through LabCorp and Quest.

Of note, an iron infusion is a medical procedure, not a prescription or medication, and ReLACS Health can order this at a few independent infusion centers directly, but larger medical centers generally require an order from one of their in-network providers to administer an infusion. We will help arrange to find a clinician with infusion center privileges near where you live if necessary.

We are currently licensed in Michigan, Ohio, and Florida. According to state medical board regulations on telemedicine, you must be within state lines at the time of your telemedicine consultation and verbally attest to such.

If you live close enough or are traveling to these states, you can be seen for your official visits there with follow-up care provided between visits with you being elsewhere.

Alternatively, some states have limited exemptions for physicians providing specialized telemedicine care. Details of each state’s telemedicine policies can be found on the Center for Connected Health Policy (CCHP) website.

ReLACS Health may expand to other states in the future if there is room for more memberships or consultations without compromising the care of those already served. Please let us know if you would be interested in receiving care in your state, as increased demand may help to prioritize licensure in states who are in need of our services.

Not currently, though state medical board regulations of telemedicine are in flux, after a temporary lifting of telehealth restrictions during COVID-19. These changes may necessitate that a small number of patients be seen in person eventually.

ReLACS Health is fundamentally a telemedicine practice. A hands-on physical examination is very low yield in sleep medicine and in-person visits are otherwise done primarily for financial reasons in an insurance-based system due to insurance reimbursement, not necessarily to your benefit. ReLACS Health can serve patients spanning the regions of Ohio, Michigan, and Florida and a single, in-person location is unlikely to be convenient for most patients. Virtual visits are, in some ways, the 21st century version of the doctor knocking on your door for a home visit, but without the black briefcase.

We ask that you cancel your appointment at least 16 hours prior to your appointment. For a Comprehensive Consultation for a new patient to the clinic, you must submit the non-refundable $100 chart preparation fee and sign the Patient Agreement prior to your appointment. You may cancel and reschedule if plans change without an additional fee. For your appointment, you will receive automated reminder emails or texts, which will include a cancellation link. Otherwise, contact ReLACS Health directly to cancel and/or reschedule.

Yes, ReLACS Health can perform home sleep apnea testing if we receive an order from a licensed clinician. Currently, these can only be performed if you are in Michigan or Ohio. Please see Home Sleep Apnea Testing for more information.

If you receive a home sleep apnea testing unit and decide not to do the test, a partial reimbursement can be given, sans $50 for the administrative costs and shipping. In most cases, the decision to do home testing was well thought-out in advance and it would be best to go through one night of testing, but certainly extenuating circumstances do occur.

The Florida department of health requires that we provide the following website for more information on Florida’s teleheath system:

https://flhealthsource.gov/telehealth/