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Office Policies

Dr. TJ Macari is a physician specializing in osteopathic manipulative medicine/ neuromusculoskeletal medicine. He is not a primary care physician. You should continue to see your primary care physician for annual check-ups and medication management.

Dr. Macari does not participate with any insurance plans, including Medicare. He is considered an “out of network” physician. Payment is required in full at the time of each visit. All patients will receive a “superbill” at the end of each visit to submit to insurance for reimbursement. Reimbursement varies from 0-100%, depending on your insurance plan. The doctor’s practice is based on cultivating personal relationships with his patients and their wellness. Treatment is individual and tailored to the unique needs of each patient. Each patient is evaluated on multiple levels.

Payment is due in full for all services and products at the time of service, unless other arrangements are made in advance. We accept all major credit cards, checks, or cash.

Tests will be ordered as necessary for good medical care. You will be provided with an order request, lab slip or kit, or prescription as appropriate for your care. It is your responsibility to determine insurance coverage for any testing or prescriptions, though in the case of some specialty labs our office manager can let you know what the cost will be. In some cases, it may be more cost-effective for you to request tests or prescriptions from your primary care provider, but it is your responsibility to make this determination. In other situations we will need to order labs or prescriptions through sources other than those available through your primary care provider. For specialty labs, payment will need to be made at the time the lab is ordered in the office. For labs ordered outside of the office, you will work directly with your insurance and the lab company to arrange payment. The office manager will be able to help you navigate through this process.

We require 24 hours notice for any appointment cancellation or rescheduling. If you are unable to give 24 hours notice there will be a fee assessed. 

We do not provide emergency care. This means we are not available during evening and weekend hours or when the office is closed. We do not provide in-patient care during hospitalization. All patients should maintain a relationship with a primary care provider or institution that provides emergency medical services. If you are receiving a prescription from the office, and have questions about what you are experiencing we are available by email and generally respond within 48 hours. New prescriptions usually require an appointment during business hours.

In order to receive hormone treatment you must have the certain lab and physical examinations done before receiving your prescription. Additionally, hormone levels are monitored every 6 months (or sooner if medically necessary). Please check with your insurance if they will cover the cost of these tests since some insurance plans may only cover them once a year. In order to refill prescriptions you must be current on lab testing. In some cases an appointment will be needed to refill prescriptions so please notify the office as soon as possible before you need the refill so that appropriate care can be arranged. Compounding pharmacies often take several days to prepare and ship a refill and the office is not open every day so be sure to call at least 7 working days before you need a refill to ensure there is no interruption in your prescription.

Annual physical exams with gynecologic exam are required when you are receiving hormone replacement therapy. In addition to an annual visit with me, you must provide a record of your examination with your gynecologist or primary care doctor, which includes lab results. If you prefer our office can order the labs but we do not do gynecologic examinations. This is done for your safety and in compliance with standards set by medical boards.

Often appointments include an osteopathic treatment. However, if you require advising about nutrition, hormones, or other health issues, or if examination or laboratory findings indicate a change in your prescription or healthcare is appropriate, you will need to come in for an appointment or schedule a phone appointment, which does not include a treatment. Also, if you would like an explanation of lab results or tests ordered by myself or other healthcare providers, you should also schedule an appointment for this purpose. An appointment scheduled for these purposes will generally not include an osteopathic treatment unless a long appointment is specifically requested. In the case of a long appointment or a phone appointment you will be billed at the hourly service rate prorated for the time spent. Please feel free to call the office for fees or other information.

Prescription refills will be called in to the pharmacy within 24 hours from the time it was requested. In the case of compounded prescriptions, the pharmacy often takes an additional 2-3 days to make up your prescription. Please plan ahead accordingly. New prescriptions generally require an evaluation by the doctor and an appointment should be scheduled. 

Due to the sensitive nature of some of our patients, please do not wear any perfumes, essential oils, after-shave, scented hair or other products in the office. If you have special needs please let us know.

Phone calls are usually returned by the end of the next business day. Though we do our best, we cannot ensure I will be able to return your call the same day. To decrease your wait time it is recommended that you send an email to and in the subject include "patient question." These emails will go directly to me. 

For information regarding fee and office policies, appointments or other questions you may also email You may also email with questions about the practice or my work. Please let me know in your email if you are not able to receive responses of a personal nature via email otherwise I will assume that your email is confidential and will respond accordingly.

If at any time you have a change in address or phone numbers please let us know so we can update our records.

Your first appointment is scheduled for a large block of time and will take usually one hour. Please notify us as soon as possible if you need to reschedule this appointment so that we can accommodate other patients.

Office Policies: Headliner
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