What to
Expect

Comprehensive Arthritis Care in Sumner County

Patient Attendance, Compliance, and Prescription Policy

New Patients
As a new patient, please plan to arrive 30 minutes prior to your appointment time. To save time you can download and fill out the new patient registration form available on the website. Please bring your health insurance card and a picture I.D. with you.
 
Follow Up Visits
Follow up appointments are the key for continuity of care. During this visit your most recent lab results are discussed and your medication and dosage is adjusted appropriately. If you miss your follow up appointment, test results will NOT be discussed over the phone. To continue receiving services, patient account information must be current.
 
Appointment Time
In an effort to keep appointments on time, please understand that if you are 15 minutes late for your appointment, you would need to reschedule. Same applies if outside tests are not received prior to appointment time. We do our best to accommodate emergency situations. It is your responsibility to make this office aware of any changes to your address, phone number, insurance, and pharmacy. We require two working phone numbers at all times for our records.

Missed Appointments
No Show appointments are discouraged and perceived as a total lack of respect for the Physician’s valuable time. It is also discourteous to your fellow patients who could have been seen in that allotted time. We work diligently on our cancellation list. With your help we can eliminate No Show appointments and reduce wait time for our patients. In the event that you need to cancel/reschedule your appointment please contact the office 48 hours prior
to your appointment time and we will accommodate your request. However, if you accrue several missed appointments without prior notice, we reserve the right to discharge you from the practice. For your convenience we routinely make reminder phone calls for upcoming appointments.

We value you as a patient and expect you to value our time and policies. Please help us in helping patients fight pain. We look forward to a great professional relationship and truly appreciate the trust you have demonstrated in us.
 
Narcotics Policy
In order to comply with new DEA guidelines and State laws CAC does not prescribe narcotics. If you feel these medications are beneficial in treating your illness, please contact your primary care provider. If your PCP holds the same policy as we do regarding narcotics then it is the responsibility of your PCP to refer you to a Pain Management Specialist (due to insurance regulations).

Prescription Refills
Please do not wait until you run out of the medication. We need 48-hour notice to get authorization to process refill requests. This office will NOT refill any prescription that was originally given by your PCP or any other physician. In an event that you need a prescription and have not been seen for more than 6 months, you will have to make an appointment to be seen.

Thank you for your understanding and cooperation. Caring for you is our privilege.

Specialty Pharmacy Prescriptions and Prior Authorization

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What is a prior authorization?

A prior authorization is an extra step that insurance companies require before they decide if they want to pay for your medicine. Imaging procedures, for instance MRI and CT Scans also require PA. Once a PA is done, this process may need to be renewed each year or possibly every month depending on your benefits with your insurance company.

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What kind of pharmacy will this go through?

There are two types of pharmacies. Regular pharmacies like Walgreens and a Specialty pharmacy like Briova/ Accredoetc. It also depends which specialty pharmacy your insurance will allow you to use. All different specialty pharmacies have different forms and protocols that they want our office to follow. It is your responsibility to make this office aware of any changes to your address, phone number, insurance and pharmacy. We require two working phone numbers for our records at all times.

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What should I do if my medicine needs a prior authorization?

Familiarize yourself with the prior authorization process. If you get a call from a toll-free number, please answer it immediately. Please read the benefits of your health insurance plan. Some drugs are covered under the pharmacy part of your insurance and some are covered under the medical part of your insurance. Allow the doctor’s office enough time to complete our end of the process. Please do not call the office multiple times on a daily basis. Take comfort in knowing that this office is already dedicating a lot of time in obtaining PA. You may check with the specialty pharmacy to see if additional documentation is needed and have your pharmacy contact the office. It may take anywhere from three to six weeks to obtain PA depending on the response time from your insurance company. The Physician’s office has no control over the timeline or the outcome.

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What happens if PA is denied?

Please understand, not all medicines will be approved. Even if we do everything right, the insurance company may still refuse to cover your medicine. We will re submit the request and appeal the decision. At times your insurance company may want you to try and fail another drug before they approve. In any case, we will diligently work with your insurance to get approval. In the end, the insurance company is the one making the decision. Please be patient and know that on your behalf we are persistent. The Physician’s office has no control over the timeline or the outcome.