Frequently Asked Questions
Our Mission
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Our care model is built for that. We offer longer visits, real space to listen, and a multidisciplinary clinical team with expertise across menopause, hormone therapy, medical weight management, sexual and gynecologic health, preventive cardiology, thyroid care, internal medicine, and nutrition.
We look at the whole picture and use shared decision-making to build a plan around your health, goals, values, and lifestyle.
This is thoughtful, evidence-based care for women in midlife — designed to help you feel heard, understand your options, and feel like yourself again.
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At Kultivate Women’s Health, we combine evidence-based medicine with thoughtful, individualized care. We look beyond a single symptom or lab result to understand the bigger picture — including hormones, metabolism, lifestyle, medical history, and what matters most to you.
Our clinicians bring different areas of expertise and different perspectives. Some lean more traditional, while others incorporate functional medicine principles. What we share is a commitment to current evidence, careful evaluation, and shared decision-making.
We’ll explain your options, talk through the benefits and risks, and build a plan together that is personalized, practical, and grounded in science.
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If you have several concerns or simply don’t feel like yourself and aren’t sure why, book a Comprehensive Women’s Health visit. We’ll look at the bigger picture, help you prioritize what matters most, and build a plan for where to start.
If weight loss is your primary goal, you can book directly into our Medical Weight Loss visit.
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Yes. We complement, not replace, your primary care provider.
At Kultivate, we provide comprehensive midlife care and can help manage many ongoing health concerns, order recommended screenings and testing, and coordinate specialty care when needed.
You should still maintain a relationship with a primary care provider for routine primary care, acute illnesses, and urgent medical needs.
Think of us as an additional layer of care focused deeply on the health issues that matter to women in midlife.
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Absolutely. Women’s health in midlife often involves more than one specialist, and we’re happy to work alongside your existing healthcare team.
When you need care outside our scope, we can also help connect you with trusted specialists and healthcare resources throughout the Cleveland area. Our team has developed relationships with clinicians across a wide range of specialties, and we’re happy to help you figure out where to go next.
Our goal is to help you connect the dots so you’re not left trying to navigate everything on your own.
Insurance & Payments
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No. Kultivate Women’s Health is a private-pay practice.
Our model allows us to offer longer visits, highly personalized care, and the time to look at the whole picture rather than structuring your care around what an insurance plan will cover during a traditional visit.
While we don’t bill insurance for our visits, you may still be able to use insurance for labs, imaging, medications, and other services depending on your individual plan.
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Yes. You can pay with your HSA or FSA card at checkout.
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Absolutely. After your visit, we can provide a detailed superbill with the information you need to submit a claim to your insurance company for possible out-of-network reimbursement.
Reimbursement varies by insurance plan, so we recommend checking your out-of-network benefits directly with your insurer. Even if your plan does not reimburse the visit, you may be able to apply the expense toward your deductible.
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No. Kultivate Women’s Health does not bill Medicare, Medicare Advantage, Medicaid, or other insurance plans for office visits.
Ann Konkoly, Holly DeWalt, and Jean Marino have formally opted out of Medicare. Medicare patients who see these clinicians pay privately for their care and agree not to submit Kultivate office visits to Medicare for reimbursement.
Insurance may still be used for labs, imaging, prescriptions, and care received outside of Kultivate, depending on your individual plan and coverage.
Labs & Testing
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Yes. We can send lab orders through your insurance. However, every insurance plan is different, and we cannot guarantee what your plan will cover or what you may owe.
Before having labs drawn, we recommend checking your coverage, network, deductible, and potential out-of-pocket costs directly with your insurance company. Kultivate is not responsible for charges from the laboratory or your insurer.
We also offer cash-pay lab options that can provide more predictable pricing, especially for patients with high-deductible plans or limited lab coverage. We’re happy to help you understand your options, but your insurance company is the best source for confirming your individual benefits.
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Yes. We offer self-pay lab options with upfront, discounted pricing through our lab partner. This can be a great option if you have a high-deductible plan, limited lab coverage, or simply want to know exactly what your labs will cost before having them drawn.
You’ll have access to convenient blood-draw locations, and HSA/FSA cards can be used to purchase labs.
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Absolutely. If you’d like to complete labs before your first visit, we offer curated self-pay lab panels with transparent, upfront pricing.
Many patients choose our Comprehensive Baseline panel so we can review the results together and make the most of your first visit.
➡️ Click here for our customized lab packages.
Labs before your visit are completely optional. We can also discuss which testing makes sense for you during your appointment and order labs afterward.
Please note: Pre-visit lab packages are self-pay and are not billed through insurance. If you prefer to use insurance for labs, you’ll need to meet with your clinician first so we can determine the appropriate testing and diagnoses.
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Great — bring them! If you’ve had recent bloodwork or other testing, you do not need to automatically repeat it before your visit.
Upload your results to the patient portal before your appointment so your clinician can review what has already been done. We’ll use what’s helpful and recommend additional testing only when it makes sense for your care.
More testing isn’t always better. Our goal is to get the information we actually need to make thoughtful decisions with you.
Hormone & Midlife Care
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Yes. We specialize in bioidentical hormone therapy, including estradiol, progesterone, and testosterone when clinically appropriate.
We primarily use FDA-approved hormone therapies and may use carefully selected compounded medications when an individualized formulation or dose is appropriate.
We do not place hormone pellets, but we can care for women who are currently using pellets and would like to transition to other forms of hormone therapy.
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Yes. Jean Marino, WHNP-BC, provides gynecologic care including pelvic and breast exams, evaluation of vulvar and vaginal concerns, IUD insertion and removal, and select in-office procedures.
We also offer nitrous oxide when appropriate to help make certain procedures more comfortable.
If you’re not sure whether your concern requires an exam or procedure, just reach out to our team and we’ll help you book the right visit.
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We provide comprehensive care for women in midlife, including perimenopause and menopause, hormone therapy, thyroid conditions, medical weight management, metabolic health, sexual health, vulvar and vaginal conditions, preventive cardiology, nutrition, and healthy aging.
We also provide gynecologic exams, IUD care, preventive screenings, and select in-office procedures, as well as internal medicine support for many of the health concerns that become more important in midlife.
Not sure where your concern fits? That’s okay. You don’t have to figure it out before you get here. We’ll help you determine the right place to start.
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Yes. Men are welcome at Kultivate for testosterone therapy and medical weight management with Holly DeWalt APRN-CNP and Shay Romano APRN-CNP.
Holly provides personalized, evidence-based care focused on hormone health, weight, and metabolic health for both men and women.
Ann Konkoly and Jean Marino specialize exclusively in women’s health and do not see male patients. If your husband or partner needs support with testosterone or weight management, Holly and Shay are happy to see him.
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Absolutely not. Coming to Kultivate does not mean you’re committing to hormone therapy.
We’ll talk about your symptoms, health history, goals, and concerns, then review the options that may make sense for you. Depending on your needs, that could include hormone therapy, non-hormonal treatments, lifestyle changes, nutrition support, medications, additional testing — or sometimes simply education and a plan for what to watch.
Our job is to help you understand your options so you can make an informed decision about your body and your health.
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Absolutely. Many of our patients continue seeing their gynecologist or primary care provider while coming to Kultivate for more focused midlife care.
You don’t have to choose one or the other. We can complement the care you already receive by spending more time on concerns like perimenopause and menopause, hormone therapy, sexual health, weight and metabolic health, thyroid concerns, cardiovascular prevention, and healthy aging.
And when helpful, we’re happy to coordinate with the other clinicians involved in your care.
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You can still feel terrible even when your labs fall within a “normal” range.
In midlife, symptoms matter. Perimenopause in particular is often identified based on your age, menstrual changes, symptoms, and health history — not a single hormone level.
We’ll listen to what has changed, review testing that is actually relevant, and look at the bigger picture rather than dismissing how you feel because one number is “normal.”
Sometimes the most important clue is simply: “I don’t feel like myself.”
Appointments
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You can book online anytime through our Book a Visit page.
New patients will complete an intake form before their appointment so your clinician can review your history, understand your concerns, and make the most of your time together.
Payment is collected when you book to reserve your appointment.
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Initial visits are up to 55 minutes, and follow-up visits are typically 25 minutes.
We intentionally allow more time than a traditional office visit so there’s space to listen, educate, answer questions, and make decisions together without feeling rushed.
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Yes. Many visits can be completed by telehealth or phone, depending on the type of appointment and your clinical needs.
Visits that require a physical exam, testing, or procedure are completed in our Beachwood office. Your clinician can help determine when an in-person visit is appropriate.
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Because we reserve significant time for each patient, we ask for 48 hours’ notice to cancel or reschedule. Late cancellations or no-shows may incur a fee. Please text the office at 216-877-8879 for cancellations.
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Yes. We offer memberships for patients who need ongoing support with medical weight management and testosterone therapy.
Depending on the program, memberships may include medication, follow-up visits, InBody body composition assessments, nutrition support, supplies, and ongoing communication with our team.
We’ll review the available options with you and help determine which program best fits your needs.
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At Kultivate, we believe your time — and ours — is valuable. Payment is collected when you book to reserve dedicated time with your clinician.
This policy has helped us keep no-shows and last-minute cancellations to less than 5%, allowing us to maintain reliable availability, stay on schedule, and give each patient the time their visit deserves.
As a private-pay practice, we don’t double-book or shorten appointments to compensate for cancellations. Your appointment time is reserved for you.
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That’s the goal. Your first visit is designed to move you from “I know something feels off” to having a clearer understanding of what may be going on and what we can do next.
We’ll review your history, symptoms, goals, previous treatments, and available labs or testing, then build a personalized plan with clear next steps.
Sometimes treatment can begin right away. Other times, we may recommend additional labs, imaging, records, or evaluation before making a treatment decision. Either way, you should leave knowing what we’re working on and what happens next.