Overlapping diagnoses. A third biologic medication. Signs that don't add up. Complicated is our normal.
We specialize in complex autoimmune conditions: rheumatoid arthritis, lupus, psoriatic arthritis, ankylosing spondylitis, Sjögren's, vasculitis and dermatomyositis. We treat the disease and the person living with it.
Medicare and most major plans
“When a patient tells us they have a diagnosis, a prescription,
and no one has ever asked how they're sleeping?That's exactly who we're here for.”
Dr. Kromo, Founder
The full-picture rheumatology visit.
Your body doesn't see your disease and your stress as separate problems. Your doctor shouldn't either.
Our rheumatologists and nurse practitioners each bring their own training to an integrative approach developed by Dr. Kromo.
A biologic medication treats the disease.
Sleep, stress and nutrition shape how you live with it. We work on both.
We ask about your hormones, your sleep, your stress, your diet, and what you're already taking, including supplements and home remedies. The medicine gets our attention. So does the way you live.
Our whole team sits in one room. When one of us says “Hey, I have this patient...”, whoever is at their desk looks up and helps.
We focus on seven conditions that are complex, long-term, and often treated with biologic medications:
- Rheumatoid arthritis,
- Lupus,
- Psoriatic arthritis,
- Ankylosing spondylitis,
- Sjögren's,
- Vasculitis, and
- Dermatomyositis.
What to expect from your care
We plan for the long run.
Autoimmune disease changes over years. We plan for that, not just for the next visit. Some patients have been with Dr. Kromo for more than a decade. After that long, we know you, not just your labs.
Your care continues between visits.
We review labs and follow up on results that need attention, so important information doesn't sit in your chart waiting for the next appointment.
Your doctors talk to each other.
We send records, coordinate with your specialists, and keep everyone on the same page. After your first visit, we send a note to the doctor who referred you. You don't have to explain everything twice.
A narrow focus means deep experience with your condition.
Not sure what you have yet? Call anyway. We'll ask about your symptoms and tell you honestly whether we're the right practice for you.
The team
Four rheumatologists and two nurse practitioners, one chart, one office. Our doctors, nurses and front desk speak Spanish.
Olga Kromo, MD
Rheumatologist · Founder and Medical Director
Javier E. Rios, MD
Rheumatologist
Lorena A. Lopez, MD
Rheumatologist
Liliya Gandrabur, MD
Rheumatologist
Sophia Fontela, APRN
Nurse practitioner
Ernesto Ramos, APRN
Nurse practitioner
Your infusions happen here, not at a hospital.
Same practice, same chart, same physicians. Comfortable chairs and nurses who know you.
We handle prior authorization.
If your plan says no, we appeal.
We schedule your sessions.
In the same office where you see your doctor.
We monitor you during each infusion.
Your rheumatology team is right here.
Your first visit
Plan on up to 90 minutes.
We start by listening. Not scanning a chart while you talk. Listening. Your full history: when it started, what makes it worse, what other doctors said, what you've tried on your own. If something's worth going into, we go into it. If not, we keep moving.
Then a hands-on exam. We check joints you didn't know needed checking. We look at your skin, your nails, your eyes. Autoimmune diseases leave clues everywhere.
You leave with a plan. Not a "let's wait and see." A plan: what labs we're ordering, what we're looking for, what happens next, and when you'll hear from us.
We know your disease. We don’t know you yet.
Questions
Call us or request an appointment below, and ask your doctor's office to fax the referral and your recent labs to (305) 671-3739. You don't need a diagnosis yet. If you don't have a referral, some plans require one and others don't. We'll check and let you know.
Yes. We request your records when you schedule, and we ask you to bring what you have. Your diagnosis, your medications, and your history come with you. You don't start over. If you're on an infusion or a biologic medication, tell us when you call so we can plan your first visit around it.
No. We prescribe the same evidence-based medications as any rheumatologist. Integrative means we also look at what else is driving your disease: sleep, stress, nutrition, movement. That includes vitamins, herbs, teas, and home remedies. Tell us about them. We'd rather know than guess, because some of them change how your medications work. We may also recommend a few new supplements.
We do. Our team files the prior authorization for your biologic, whether it's infused or injected here in our office, or you inject it at home. If your plan says no, we push back. We appeal, and your rheumatologist makes the medical case for your treatment. We look for copay programs or foundation help you may qualify for, and we renew your approval before it runs out, to avoid a gap between doses. Before you start, we draw the screening labs most biologics need, here in the office. Your plan makes the final coverage decision.
Traditional Medicare, with or without a supplement plan (AARP and similar). Some Medicare Advantage plans, and most major commercial plans. Call with your plan name and we'll check. Your plan makes the final coverage decision.
New patients are typically seen within 2-4 weeks, sometimes sooner if there's a cancellation. If your doctor thinks you need to be seen sooner, ask their office to call us.
We recommend that you start with the rheumatologist who can see you soonest, because with autoimmune disease waiting has a cost: the sooner you're seen, the sooner your treatment plan starts. From that first visit you have your own rheumatologist: one doctor who knows your history and follows your care. Our doctors sit down with Dr. Kromo for regular case review. For less complex concerns and routine follow-ups you may also see a nurse practitioner, who works under your doctor's supervision. Dr. Kromo's own schedule has the longest wait, which is why new patients often choose to start with another rheumatologist.
Yes. You can see a doctor in Spanish, and our nurses and front desk speak Spanish too. Tell us when you call and we schedule you with a Spanish-speaking doctor.
Plan on up to 90 minutes in the office. Some of that is X-rays, if we order them. Some of it is waiting. We'd rather tell you that than surprise you. Your time with the doctor depends on your history. A complicated one gets more time.
Photo ID, your insurance card, and everything you take: prescriptions, vitamins, supplements, and anything you use at home. Bring prior lab work, imaging, or records if you have them. Fill out the new patient forms online before your visit. We use them to prepare, so your first appointment starts with you, not with paperwork.
Yes. Bring a family member or a friend. They're welcome in the exam room and in the infusion suite. If you want someone to call us about your care, there's a release form in the new patient paperwork. Once you sign it, they can.
Yes. We draw blood and take X-rays here in the office, so there's no separate trip. Blood work is sent to Quest or LabCorp for processing, and we go over the results with you.
Once you're a patient, yes. Follow-ups, lab reviews, and medication check-ins can often happen by video. Your first visit is in person so the doctor can do a full exam.
We're open Monday through Thursday, 8am to 6pm. Outside those hours, for non-urgent matters, leave a voicemail or send a message through the patient portal, and we'll reply the next day we're open. If it's an emergency, call 911 or go to the nearest emergency room.
Yes, and only if you want to participate. Nothing about your care depends on it. We run a large research program, with trials open across many of the conditions we treat. For some patients that means a new medication before it's widely available, usually at no cost to you. Ask what's enrolling for your condition.
Ready when you are.
Just the basics. We'll handle the rest.
This form is reviewed during business hours.
If you are having a medical emergency,
call 911 or go to the nearest emergency room.
We received your request.
We aim to call you within one business day.
Our office is open Monday through Thursday, 8am to 6pm.
Questions before then? (305) 671-3447