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Clinical Procedures for Hormone Replacement Therapy

Each patient starting HRT is provided our Clinical Procedures & Treatment Consent to be reviewed and signed prior to their first appointment. You may request a copy of your signed consent at any time.

Some of the common questions we receive regarding Hormone Replacement Therapy procedures are further clarified below.

Using Insurance: Defy Medical does not accept any form of insurance. Most health insurance companies do not recognize our style of practice nor do they adequately reimburse for the type of care we provide. Defy Medical strives to provide both quality concierge medical care along with affordable access to compounded medications, blood tests, and nutritional supplements. In order to accomplish this, we do not accept any form of insurance. Many of the formulations we use in our therapies are not covered by insurance, although the cost of overall treatment is often less than when using insurance.

All compounding pharmacies used by Defy Medical do not accept insurance. On case by case basis, some insurance companies may reimburse for Hormone Replacement Therapy after the treatment has been paid for. Defy Medical provides claim assistance by completing the standard claim form (CMS-1500) for the patient to submit to their insurance company. It is each patient's responsibility to contact their own insurance company to confirm reimbursement. Defy Medical will not contact your insurance company nor will take any responsibility for any additional forms your insurance requires. If you would like to receive Claim Assistance, please contact patient services at [email protected]

Required Hormone (HRT) Follow Up Evaluations:

One of the purposes behind drawing blood for analysis is to provide our physician a means to compare how you are responding to therapy with your hormone blood levels and other important health indicators. This information allows our medical providers to make appropriate adjustments to your regimen that not only improve how you are feeling but minimize any side effects and risks with treatment. The laboratory analysis of your blood will also provide a comparison with initial blood work and provide data that will aid in the development of your treatment plan.

HRT Follow-up blood work:

We strive to go beyond the minimum recommendations for monitoring every type of hormone replacement. All important tests needed to monitor men and women being prescribed hormones are completed at least twice per year and as needed based upon the individual’s response to treatment.

Pharmacy & Prescription Hormone Medication:

All compounded Hormone Replacement Therapy medications are included in the overall cost of therapy and must be ordered at Defy Medical using one of our approved national compounding pharmacies.

  1. Compounded medications are custom formulated by the prescribing doctor and adjusted based upon a patient’s needs. Therefore, continual communication between the doctor and compounding pharmacist is an important part of our patient’s care. Our relationship with the compounding pharmacy provides an additional level of service while also enhancing the triad-of-care between the pharmacist, doctor, and patient. The experts on our team have dedicated over 10 years working with compounding pharmacies to develop the best hormone and nutrient formulas. We consistently monitor any use of preservatives along with the Ph level and the type of carrier in order to ensure the best absorption with a reduced risk of irritation after application or injection.

  2. Due to our standards of care for our patients, Defy Medical will not send or call in prescriptions to other compounding pharmacies. All compounded Hormone Replacement Therapy medications are included in the overall cost of therapy and must be ordered at Defy Medical using one of our approved national compounding pharmacies. Approved pharmacy partners are fully vetted to ensure they meet the high standards required and follow USP and Good Manufacturing Practices. USP 797 and USP 800 are important Federal standards that regulate the compounding of sterile injectables and handling of specific medications like testosterone, estrogen, and progesterone. We ensure that every compounding pharmacy we use is USP 797 and USP 800 compliant by personally visiting each pharmacy prior to sending the first prescription.

  3. Defy Medical uses both 503a and 503b pharmacies who compound sterile and non-sterile pharmaceutical products. 503b facilities are the preferred source for sterile medications due to the FDA required stability studies and much higher standard of manufacturing that a 503b must follow. Typically, medication prescribed by Defy Medical practitioners will be produced by dual-licensed 503B and 503A compounding pharmacies who acquire the FDA-approved active ingredients necessary to manufacture testosterone in a variety of dosage forms.

  4. Defy Medical does not send prescriptions for controlled substances across state lines (i.e. fax or call in prescriptions for testosterone to retail pharmacies in other states.) Controlled substances require additional steps to be taken by the doctor when prescribing to patients located in a different state. All forms of Testosterone are a controlled substance in every US state.

    Human Chorionic Gonadotropin (HCG) is now a controlled substance in many US states. Additional time will be spent prescribing these medications; however, we will process the prescription in a timely manner.

  5. Federal and State laws can often change resulting in the sudden inability for a compounding pharmacy to provide a medication or ship medicine to another state. Raw ingredients can also be on backorder at a particular pharmacy also limiting access to needed medications. Our team manages your prescriptions while maintaining constant communication with multiple compounding pharmacies to mitigate a disruption to your treatment. If one pharmacy cannot provide a medication we will use an alternative pharmacy who can provide the medication for the same price. Sometimes there can be an ingredient shortage that can affect all pharmacies, when this rare event occurs we will immediately notify patients and prescribe an alternative treatment when needed.

In order to keep the fees affordable and to avoid charging a monthly fee all HRT monitoring & management fees are included in the cost of the HRT medications. Collectively, these fees go towards the cost of maintaining a full-time practice dedicated to serving patients while providing optimal concierge care.