A Different Kind of Visit

Diagnostic Framework
Consultation

A focused intake, a written clinical summary, and a follow-up visit. Designed for patients who need a clear, documented diagnosis and roadmap — not necessarily a specialist who prescribes every medication that follows from it.

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The Process

Three steps, one clear picture

Most Long COVID patients have extensive records and no unified account of what those records mean. This consultation changes that.

1

Intake Visit (~60 min)

A comprehensive intake covering your full symptom history, prior diagnoses, test results, medication trials, and functional limitations. The goal is not to repeat what you've already told a dozen other providers — it's to read those accounts together and identify what has and hasn't been adequately explained. You'll be asked to send records in advance.

2

Written Clinical Summary

A written report documenting the diagnostic framework — which sub-syndromes are present, which have the strongest evidence base for your specific presentation, what treatment sequence is recommended, and which specialists or interventions should be pursued in what order. Written for you, but structured so your PCP can use it directly.

3

Follow-Up Visit (~30 min)

A review of the written summary with you — to answer questions, clarify recommendations, and help you understand how to present the framework to your existing care team. If adjustments to the summary are warranted based on your feedback or questions, they're made here.

Is This Right for Me?

Who benefits from this consultation

This consultation fits well if you…

  • Have an extensive workup but no coherent explanation for your symptoms
  • Have a primary care provider willing to work with a specialist's framework
  • Live outside Massachusetts, or don't have Aetna, BCBS, or Harvard Pilgrim
  • Need a documented diagnosis and treatment plan — but your PCP can manage the prescribing
  • Want a clear account of which sub-syndromes are present and in what order to address them
  • Are a caregiver trying to help a family member navigate a confusing clinical picture

This may not be the right fit if you…

  • Need ongoing specialist prescribing or frequent medication adjustments (ongoing care may be more appropriate — see care options)
  • Are in acute crisis or need urgent psychiatric or neurologic evaluation
  • Don't yet have a primary care provider — the written summary assumes someone will act on it
  • Are seeking a second opinion on an active inpatient admission or surgical decision

If you're uncertain, contact us before scheduling — we'd rather help you find the right fit than have you spend resources on the wrong service.

The Deliverable

What you and your providers receive

The written summary is the core output. It exists for two audiences simultaneously.

For You

Your clinical picture, explained

  • Plain-language explanation of which sub-syndromes are present and how they interact
  • Why certain symptoms occur in the pattern they do — not just that they occur
  • What your prior workup did and didn't establish
  • Which tests or evaluations, if any, are still worth pursuing
  • What foundational interventions to start regardless of prescriber
  • What the evidence actually supports for your presentation
For Your PCP and Care Team

A roadmap your providers can act on

  • Structured sub-syndrome diagnosis with clinical rationale
  • Recommended treatment sequence, including medications and behavioral interventions
  • Specialist referrals prioritized by clinical urgency
  • Guidance on monitoring and what to look for as treatment progresses
  • Notation of which interventions should be avoided or sequenced carefully (e.g., graded exercise before dysautonomia is addressed)
  • Written in language your providers can reference and build on
How to Prepare

What to send before your intake

The quality of the written summary depends on the quality of the records reviewed. The more organized and complete the records you send in advance, the more precise the output.

Diagnostic records (send if available)

  • Sleep study results (polysomnogram, MSLT, home sleep test)
  • Autonomic testing (tilt table, QSART, TST, thermoregulatory sweat test)
  • NASA Lean Test results if self-administered (heart rate log)
  • Echocardiogram, Holter monitor, or event monitor results
  • Relevant lab work: CBC, CMP, thyroid, ANA panel, B12, ferritin, inflammatory markers
  • Allergy and immunology workup if MCAS has been evaluated
  • Prior neurology, cardiology, rheumatology, or pulmonology notes
  • Neuropsychological or cognitive testing if completed

Clinical history

  • A timeline of symptom onset relative to acute COVID or viral illness
  • Medication history, including what has been tried and effects/side effects
  • Current medication and supplement list
  • Primary care summary or discharge summaries if available
Don't have all of this? Bring what you have. The goal is not to have a perfect record before scheduling — it is to provide the most complete picture possible so that the summary accurately reflects your presentation. If specific testing is needed to complete the evaluation, that will be noted in the summary.
Records can be sent to: practicalneuropsychiatry@gmail.com for non-HIPAA-protected documents, or via the patient portal for secure transmission. If you're unsure which to use, send a message to the email address and we'll direct you.
Coming soon: The Long COVID Tracker App will eventually support pre-consultation record organization — including symptom timelines, medication history, and a summary document you can share directly. For now, a written summary or organized record packet is the best preparation.
Not in a Licensed State?

Health consultation is still available

If you live in a state where Dr. Claunch is not licensed to practice medicine, a standard clinical consultation — including ordering tests, prescribing medications, or actively directing treatment — is not possible. Licensure exists for good reasons, and those constraints are not circumvented here.

What is available is a health education consultation: a review of your history, an explanation of the sub-syndrome model as it applies to your presentation, and a written summary framed around Long COVID as a condition — its known mechanisms, its commonly identified sub-syndromes, and the evidence base for each — that your existing providers can read and act on. The distinction matters: Dr. Claunch can explain what the literature supports and what patterns your history suggests, but will not name a specific diagnosis for you or direct specific medication choices. Your licensed providers retain that responsibility.

For many patients in unlicensed states, this is still meaningful — particularly those whose current providers are unfamiliar with the sub-syndrome model and would benefit from a clearly written educational framework. If you're uncertain whether this applies to you or whether a health education consultation would be useful, contact us before scheduling.

A Note on Experimental Treatments

The evidence landscape, honestly described

Many patients arrive having researched investigational treatments — low-dose naltrexone, plasmapheresis, anticoagulation protocols, IVIG, stellate ganglion block, and others that have appeared in the Long COVID community and press. These are worth discussing, and where data exist, they can be reviewed honestly.

This practice, however, focuses primarily on treatments with an established evidence base — drawn from ME/CFS, dysautonomia, migraine, chronic pain, and sleep medicine literature — because that list is long enough to occupy most patients meaningfully before experimental options become the most reasonable next step. Pursuing experimental treatments while foundational interventions remain unaddressed is rarely efficient, and often confounds the clinical picture further.

When investigational approaches are genuinely supported by emerging data and appropriate to a patient's specific presentation, they are discussed and appropriate referrals made. Patients interested in the current research landscape — including active clinical trials — will find a curated overview on the resources page (coming soon).

A Note on Insurance

Why this consultation is self-pay

Independent specialty practices face real structural constraints when working with large insurers. Prior authorization requirements, reimbursement rates that don't reflect the time required for complex cases, and administrative overhead that falls disproportionately on small practices without dedicated billing departments — these are the actual barriers, not indifference to patients who need coverage.

This consultation is not designed to exclude patients without resources. It is designed to create a service that can be delivered at a level of thoroughness the standard insurance encounter does not support. A 15-minute follow-up cannot produce a multi-page clinical summary. The Diagnostic Framework Consultation is structured around what a complex Long COVID presentation actually requires — and priced to reflect that honestly, with a superbill provided for out-of-network reimbursement requests.

If cost is a barrier and you have Aetna, Blue Cross Blue Shield, or Harvard Pilgrim — insurers that are common across New England and cover many patients in Massachusetts and neighboring states — standard insurance-based care may be more appropriate. See insurance options →

Pricing

What the consultation costs

$1,500
Flat fee · All-inclusive package · Self-pay
  • Chart review — prior records, test results, specialist notes reviewed before your visit
  • Intake visit (~60 min) — comprehensive history, sub-syndrome assessment, Four Pillars review
  • Written Diagnostic Framework Summary — structured document for you and your primary care provider
  • Follow-up visit (~30 min) — review findings, answer questions, finalize the summary
  • Provider phone discussion option — if your PCP or another provider needs clarification after receiving the summary
  • Available across all licensed states (MA, FL, MI, RI, CT, NY, PA, VT, NH, ME*)

If you choose to continue as an ongoing patient after the initial consultation, visits revert to $250 / 30 min. A superbill can be provided for out-of-network reimbursement requests.

*ME licensing pending. You will be informed before scheduling.

Request a Consultation →

We'll confirm fit before scheduling. Response within 2 business days.

See how this compares to other specialist options →