Policies

Prescription Refill Policy

Please try to keep your prescriptions up to date at your office visits. This is the best time to double check that what we think is being prescribed agrees with what is actually being prescribed.  It is also the best time to discuss any issues with access to your medication or change in cost of medications.  Sometimes there is a more readily available or less expensive alternative available.

Keep in mind that you must keep your office visits current in order for us to honor your prescription request. It could be very dangerous for us to fill your medication if you have not had a recent office visit.

Prescriptions are not called in after hours.  We need access to your medical record to ascertain whether the refill request is safe and appropriate.  Calling in prescriptions after hours is potentially dangerous to your health.  If an after hours refill request is in your opinion so urgent that waiting until the next business day might put your health at risk we suggest going to an acute care clinic or emergency room.  In those settings a history and physical can be performed and if needed lab work done to make sure that the medication can be safely refilled.

Monitor your refills and please allow us at least 5 working days to honor your refill requests. If a refill is needed between visits YOU need to contact us directly.  Pharmacies often send their requests using e-prescribing.  We do not participate in such programs and as a result pharmacy requests routinely do not reach us.  If you call, then you know that we have been notified.

Please specify the medication, duration to be filled (eg one month at a time or three months at a time) and which pharmacy to use.  Often there is more than one pharmacy listed on a chart and your prescription might be sent to the wrong facility.  We send prescriptions by fax only.

Insurance Prior Authorizations for Medications

Insurance prior authorizations can often be very time consuming for the nurses and providers.   During the day our first priority is seeing the patients who are in the office that day.  Activities such as prior-authorization requests are done in between seeing scheduled patients. Unfortunately it often takes several attempts to obtain a prior authorization.  Please allow at least 2 weeks for prior authorizations to be completed.

Occasionally your insurance will request that your medication be changed to a “preferred” drug to help with cost. If you are told that there may be a preferred medication, please obtain from your insurance company the list of approved alternatives.  We are very sympathetic to the goal of saving money but these decisions must be made at an office visit when the prescriber can review your chart, obtain any needed supplemental history, perform any needed examination and discuss with you the pros and cons of changes in your medications. We typically will not agree with this type of request between office visits for the following reasons:

 

We usually approve of generic medication if they are truly comparable. We do not prescribe generic thyroid hormone since such formulations lead to excessively variable thyroid hormone levels that can be potentially harmful.  If you look at your office visit handouts, you will usually find a discussion about this.

Insurance Prior Authorizations for Medications

Insurance prior authorizations can often be very time consuming for the nurses and providers.   During the day our first priority is seeing the patients who are in the office that day.  Activities such as prior-authorization requests are done in between seeing scheduled patients. Unfortunately it often takes several attempts to obtain a prior authorization.  Please allow at least 2 weeks for prior authorizations to be completed.

Occasionally your insurance will request that your medication be changed to a “preferred” drug to help with cost. If you are told that there may be a preferred medication, please obtain from your insurance company the list of approved alternatives.  We are very sympathetic to the goal of saving money but these decisions must be made at an office visit when the prescriber can review your chart, obtain any needed supplemental history, perform any needed examination and discuss with you the pros and cons of changes in your medications. We typically will not agree with this type of request between office visits for the following reasons:

 

We usually approve of generic medication if they are truly comparable. We do not prescribe generic thyroid hormone since such formulations lead to excessively variable thyroid hormone levels that can be potentially harmful.  If you look at your office visit handouts, you will usually find a discussion about this.

 

Insurance

Insurance coverage for care is a constant source of frustration and confusion for you as well as your physicians and their staff. The insurance rules change so fast that you cannot expect us to be "right" all the time. Our goal is to help as much as possible, but it is your responsibility to inform us any time your insurance coverage has changed. Some things such as appeals or certain coverage must be handled only by the insured and cannot be handled by the office due to HIPAA regulations.

If you need a referral for your primary care physician for payment for your visit, please understand that obtaining the referral is your responsiblity, not ours. If you arrive without a referral, you may pay "out of pocket" or be rescheduled.

More and more insurance companies are requiring "preauthorization" for tests and medications that we order. While we are very sympathetic to financial concerns, we do not consider it our mission to apportion costs between our patients and third-party payers (insurance companies). In fact, such efforts distract us from our true mission -- that of providing high quality medical care to our patients.

Because of the ongoing changes in medical econmics, some services are not covered by your insurance and we cannot provide these services free of charge. There will likely be charges for document preparation, medication preauthorization, and duplicate prescriptions.

We participate in most insurance plans. To verify participation in your plan, please call (409) 835-9834.

We do not accept:

New Patients

New patients must be referred to our office by another physician. This applies even when your insurance does not require a referral. Once your referral is received from your physician, it will be reviewed and we will verify the insurance. When this is completed, you will be contacted regarding the date and time of your appointment.

To expedite your visit and get the most from your first visit with the physcian: