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New Patient Packet

Anthem Waiver for Non-Medically Necessary Service



Initial Consultation and Physical Exam

To schedule your initial consultation, call us (858) 794-9192 or send us an e-mail at

The initial consultation is focused on getting to know a new patient. It includes a face-to-face patient-to-physician conversation regarding your complaints, medical and family history, previous therapies and diagnostic test results.

Please bring the following to your appointment:

  1. Your available medical records
  2. Laboratory test results
  3. Original radiographic images
  4. Current medications (or list) with doses and frequency

The next step of the initial consultation is a comprehensive physical examination oriented on your problems.  In addition to the traditional hands-on physical examination, we analyze joints and soft tissues with high-resolution ultrasound which, allows us to gain valuable diagnostic information while in the office. If necessary, an extended physical examination may include thermography, EKG, an instrumental assessment of autonomic nervous system.

Based on results of the initial assessment, we select appropriate diagnostic tests which are performed within several days or weeks following the consultation. These may include customized outsourced (LabCorp & Quest) biochemical, genetic and immunologic tests, radiographic imaging procedures, stool and saliva testing, food intolerance testing, etc.

Typically, the first follow up appointment is scheduled three - four weeks after your initial consultation. The standard length of the initial consultation is one hour.

Follow-up Appointments

Follow-up appointments are focused on discussion of the diagnostic test results, administration of additional diagnostic tests, if necessary, and selection of initial therapy. Based on results of the initial consultation and diagnostic findings, we offer patients several highly individualized therapeutic choices, which include traditional therapy, alternative therapy, when appropriate, or the integrative approach combining both therapies under one umbrella.

Further follow-up appointments are focused on assessment of the treatment efficacy and medical maintenance issues. Based on the selected therapeutic protocols, during follow-up appointments we perform all the necessary procedures and additional diagnostic tests.

Depending on the complexity of the problem, the length of the follow-up appointment varies from 15 to 20 minutes.

Participating Insurance Plans

The Institute for Specialized Medicine participates with Medicare (not accepting new Medicare patients), Tricare and most PPO insurance plans. Participation varies as changes occur within the insurance industry. Please check with our receptionists to find out if we participate with your insurance plan.

For your convenience, we will file your primary insurance claims if you provide us with the correct billing information. We ask you to pay the deductible, co-insurance, or co-payment at the time of service. We accept cash, Visa, Mastercard, American Express and Discover cards.

Certain services provided by the Institute for Specialized Medicine are fee-for-service only. They include (but are not limited to): acupuncture, shock-wave therapy, laser therapy, prolotherapy, focused dietary consultations, and optimization of exercises.

GLUTEN-FREE REMEDIES™ are food supplements and herbs selected by Dr. Shikhman and specially manufactured for the Institute for Specialized Medicine. Learn more.

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