Our practice focuses on the treatment of patients with mild to moderate pain. Some patients are in need of treatment for EXCRUCIATING/SEVERE PAIN. These patients may require large doses of DANGEROUS NARCOTICS. We feel that these patients are better served, by being treated by highly trained specialists that are affiliated with tertiary hospitals.
For that reason, we abstain from treating these very difficult cases. Because of this, we have a strict, inflexible policy of limiting the amount of narcotic medication prescribed to no more than Percocet 10/325 or Oxycodone 10 MG, 3 times per day. This is our MAXIMUM DOSAGE for any of our patients. Of course, a large percentage of our patients will be prescribed lower doses and quantities.
**In the past, some patients have been foolish enough to try to convince us to break this well entrenched policy. As you may have guessed, this has resulted in a wasting of OUR TIME and YOUR MONEY. If you feel that you may need more narcotic medication than our doctor will prescribe, then we implore you to seek another physicians who will be willing to write for these higher doses.**
MEDICATION COPAY RESPONSIBILITY INFORMATION
IN EFFECT STARTING January 1, 2017
1) Medication copay should be collected, in full, at the time of the visit. If the patient does not bring the full amount for the copay at the time of the visit, payment can be delayed to the next visit. If the patient fails to pay the co-pay at their next visit, they will NOT be seen. With any delay in payment, patients are required to sign a document stating they have been notified of our co-pay policy and the monies owed.
2) Co-pays can be paid for by cash, credit, or debit card.
3) Patients who have an open legal case may defer payment of co-pays until their settlement. Patients who choose to defer payment are required to sign a legal document that stipulates their desire to defer this payment until settlement. This legal document will and should be presented to their lawyer at settlement.
3) Should the patient be indigent (in extreme financial crisis), we have the legal option to "forgive" the medication copay. In order to qualify, patients are required to fill out the Financial Hardship form, which can be found on our website here or requested at the time of visit. The patient must fill this form out and return it to us either in person or by fax (Fax #: 215-947-6274), at which time our accountant will evaluate the form to determine if one does qualify for medication co-pay forgiveness.
ALL PATIENTS MUST COMPLETE A DRUG SCREEN BEFORE THEY ARE SEEN BY DR. BERKOWITZ. DRUG SCREENS ARE USED FOR SEVERAL REASONS:
To monitor the types of medications our patients are taking (Combining certain medications can cause dangerous health complications)
To assess compliance with our treatment regimen
To assure that patients are not using the medications for illegal purposes
Patients should be aware that inconsistent drug screens (presence of an illegal substance, presence of a substance not prescribed, and/or absence of medication Dr. Berkowitz prescribed you) are grounds for dismissal.
**We DO NOT submit these drug screens to any government institutions. This are soley for our practices internal purposes.**
**We do not test for Marijuana.**
When you are scheduled for an appointment at our office, you will receive an appointment card that has the time and date of your next office visit. We realize that sometimes these cards may be misplaced. Because of this, we have instituted a phone call reminder system in which patients will be notified 36 hours prior to their appointment. In addition to this our patients will receive a text reminder the day of your appointment.
In order to ensure the functionality of this system, you must provide our office with your cell and home phone number.
If you are not receiving these reminders this means that we do not have your correct phone number! Please ensure that our office always has your updated numbers.
If you miss or cancel your scheduled appointment without 48 hours notice, you will be charged a $25 fee
If you miss 2 or more appointments you must pay the fees upfront. by credit or debit card. in order for us to reschedule you.
What qualifies as a "missed or cancelled appointment"?
- Notifying our office of a cancellation with less than 48 hour notice.
- Not showing up at your scheduled appointment time.
- Coming to your appointment after our office has closed for the day.
- Not seeing the Doctor on your scheduled appointment date and time
- If you come late and the doctor is no longer there
If your appointment is scheduled within the last hour of our session times you must have your phone available.
Please make note and be aware of our office session hours. Sometimes we have a number of no-shows an We may call our patients to come in earlier than their scheduled appointment. If your phone IS NOT available, and there has been a change of your appointment for an earlier time, this may result in a missed appointment fee. I
**PATIENTS WHO ARE UNABLE TO URINATE WILL EXPERIENCE A DELAY TO SEE THE DOCTOR. YOU WILL HAVE TO TAKE AN ORAL SWAB TEST AND WILL BE CHARGED $20 FOR THE STAFF TO PERFORM THIS TEST.**
ACCEPTED PAYMENT METHODS
We accept the following forms of payment:
- Credit Card
- Debit Card
We do not accept personal checks.
Should you wish to pay with a credit or debit card, you must
- Call our office at (215) 947-6143, during regular business hours, several hours before your visit, in order to pay.
- Go to http://www.phillypaindoc.com/payment-methods to pay online.
**Please contact your insurance company for the specifics of your plan**
**Our office is OUT-OF-NETWORK with all insurance companies except for Medicare.**
When an office is out of network, the patient is normally responsible to submit their own receipts to the insurance company and get reimbursed directly. We on the other hand offer the courtesy of billing the insurance for you, and applying their payment towards your co-pay.
If your insurance does pay an amount towards your office visit, we will deduct that amount, and you will be required to pay the remaining balance.
Example: John Doe is coming for his third visit. His insurance pays $100 towards balance. Therefore Johns payment will be $65.
Here is a list of some of the more popular insurances that will often cover a portion of your visit, and have some out of network benefits.
Blue Cross Blue Shield
- Independence Blue Cross/ Personal Choice
- United Healthcare
HERE IS A LIST OF INSURANCES THAT WILL NOT COVER ANY PART OF THE OFFICE VISIT.
- Keystone First/Connect
- United Healthcare Community
- Health Partners
**IMPORTANT PLEASE READ**
The first Suboxone pre-authorization form submission is free. Every Prior - Authorization submitted after that is an additional $20 charge.
In order to get your prescription pre-authorized we need your cooperation to notify us within 24hours of you becoming aware that a prior authorization is necessary.
Your insurance company is not your friend. They are a business. Their primary goal is to make money. They will make more money if they can figure out a way to reject your Suboxone prescription. We have had countless patients tell us of some of the lies that the insurance company will tell them after we have already submitted your Prior-Authorization. Some of the lies include:
“We have not received your prior-authorization request”
“All you need to do is have the doctor call us”
“All you need to do is have the doctor’s office submit it again”
“We have not received anything from your doctor”
We, on the other hand, are very interested in you getting your prescription filled. When we become aware that you require a prior-authorization, our office will promptly complete it. Many insurance companies require us to do a lot of paperwork in order to get your prescription approved. We will do that. We are experts at beating the insurance companies at their own game but, we will need your cooperation to defeat them.
Please do ONE of the following to get your prior-authorization approved.
1. Call us ONE time within 24 hours of the time you become aware that you require a prior-authorization.
2. Submit ONE request through our Contact us page. In the “message” section put in “prior-authorization request” and for what medication you are prescribed by Dr. Berkowitz.
Once this request has been submitted, we will issue a prior-authorization within 24 hours during the normal business week.
In attempt to get your prior-authorization complete, DO NOT do the following:
-DO NOT Call Dr. Berkowitz’s Cell Phone
-DO NOT Call our office more than one time to request a prior-authorization
-DO NOT Call us outside of our normal Business Hours Monday-Friday 9:00am-4:30pm
(Precertifications, Verifications, and Record Requests)
Many insurance companies require extensive paperwork in order to process pre-certification. We are happy to fill out the paperwork they require, but $20 processing fee will be charged at the time of your next visit.