Patient Rescources
About: Your New Patient Appointment:
I’ve completed the new patient packet of paperwork, and submitted it. Now, what do I need to bring to the actual appointment?
Thank you for completing the registration process. Within two –three business days (keeping in mind our office is closed on Fridays) we will contact you, at the number provided on the packet, to schedule your first appointment. If you do not hear from us, please contact the office. Modern technology is great, but remember nothing is perfect.
When scheduling the appointment, please keep in mind if you are scheduling for a minor (17 years and younger) they must be accompanied to the first appointment by a parent or legal guardian.
What do I need to bring to the actual appointment?
By completing the previously discussed registration process ahead of time, the appointment can be focused on your care. Therefore, all you need to bring to the appointment is:
- Your physical insurance card. If you do not have one, go ahead and just email our office the electronic card from your insurance provider. The card may be sent to phcr4u@icloud.com
- Prepare for your appointment. Bring a list of questions you have, a log of headaches / migraines you may have had leading up to the appointment. If you want, include what you were doing when the headache began, how it felt and what treatments you have tried.
Will you remind me about my appointment?
Absolutely! We utilize two methods to remind you. A few days prior you will receive an email reminder to the address provided in your intake packet. We will also do our best to contact you by phone, two days prior, as a reminder of the date, time and our address.
What should I expect at my first appointment?
As a new patient, we will have you come to our office 15 minutes prior to when Dr. Alford will meet with you. This is built-in to the time we have provided to you. It will allow for finishing paperwork and check-in before the visit starts so you will be on time.
Upon your arrival, our office will review anything requiring clarification from the intake packet you had previously sent us. We will collect any payment due such as copay, co-insurance, or percentage of a high deductible plan which are assigned by your insurance. Then we will gather some vital signs (height, weight, and blood-pressure). Finally, we make sure you activated your portal (See Patient Portal Section).
Dr. Alford is extremely thorough with all her patients, especially as she is getting to learn about you. If you need to plan, it is always best to allow more time then less. Therefore, we recommend 60 – 90 minutes for your first appointment. Remember, every patient is different, therefore some require a little more or less time with Dr. Alford then others might.
About: Your Established Patient Appointment
Why do I need a follow-up appointment?
You are strongly encouraged to make your next appointment before leaving the office. Dr. Alford’s book fills very quickly. It’s better to have an appointment and not need it, then need it and not be able to get it.
These appointments are crucial to evaluate how the patient is doing, how the medication is working, and how optimal is the treatment plan. Also, it is important to follow up regularly to monitor for any side effects while on prescription-level medications. Most of all, if you are on preventative or acute medication, Dr. Alford can only refill requests with regular check-in appointments.
Do I need to arrive early to a follow-up appointment?
We appreciate when patients arrive about 5 minutes prior to the scheduled appointment time. This allows for the small amount of paperwork to be completed (done at every appointment) by the patient, and all the fun stuff like payments, vital signs, etc. to be completed and be ready for your appointment.
What if I’m late to my appointment?
Should the patient be 10 minutes, or more, delayed; the appointment will be rescheduled. Understand, this is in the best interest of the patient and all the patients to follow (one day it could be you). There are many “behind the scenes” components that go into your appointment. We strive to be on time so that each patient can be afforded the time to adequately discuss their concerns with Dr. Alford. When you are not on time for your appointment it is that time with Dr. Alford that is drastically impacted. This is not beneficial to anyone. We will do our best to reschedule you for another date / time as soon as possible.
About: Where is my prescription(s)?
How did you know what pharmacy I use?
As part of the new patient packet, we collected your preference in the pharmacy. You are always welcome to confirm this information with us upon check-in/check-out. Prescriptions, unless otherwise discussed will be sent to the pharmacy provided to us in the packet.
My pharmacy hasn’t sent me a text, did it not get sent to the pharmacy?
On a typical day at Pediatric Headache Center of Richmond, we tell patients not to expect the prescription to be sent to the pharmacy until Dr. Alford has completed clinic (seeing all her patients that day).
If you are told your medication is not available for pick up, please inquire with your pharmacy if a prior authorization was required. Until this is completed, your insurance will not cover (or pay for) the medication making it unavailable. Usually, we are notified if this step is required, but not always. If you do not receive an update in a few days from your pharmacy, you might want to call our office to make sure the prior authorization is underway.
If for some reason your pharmacy does not have the electronic prescription, please call the office and let us know to resend it. Technology is great but sometimes it fails us. So, while prescriptions are always sent the day of your visit, they do not always get to their destination effectively.
What’s a PA and why do I care?
PA (short for Prior Authorization) is a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service / medication is dispensed to the patient to qualify for coverage.
Once our office is notified by the pharmacy of a PA being required by insurance, we submit the information and documentation required, on average, the same day. Every insurance carrier varies, but we anticipate to have a determination within 72 -120 hours. Our office will be notified as will your pharmacy.
Helpful Hint: your pharmacy will know before we do if it was approved, by re-running the prescription.
What do I do if insurance denies the medication request?
If your insurance provider did not approve the choice in medication discussed with Dr. Alford, don’t fret! We have options. We will have a better idea of our choices once our office is notified in writing by the insurance company of the denial and the criteria the insurance has set forth to obtain the preferred medication (this may be referred to as Step Therapy). Depending on a number of different factors, Dr. Alford will decide with you the best way to move forward. Sometimes she will turn to an alternative medication option, and other times we appeal. It all really depends on the explanation and options in the denial letter.
What the heck is an appeal?
When the insurance company needs to be convinced the patient needs this specific medication and there is no suitable alternative, we will write a very persuasive, detailed letter, requesting a reconsideration. Due to the in-depth nature, and extremely personalized letter this appeal is, our turn-around time can be a few business days. Once we have sent off the appeal, on average the insurance company will respond in writing in 30 – 45 days. Again, this varies by insurance plan. Please be patient, we promise to let you know the outcome when we find out.
About: School:
How do I request an absence note?
If you know an absence note will be needed, just let us know at check-in. We will ask if the patient is returning the same day or the next day. Should you forget to ask, you are welcome to utilize your portal to request a note. Please understand, we can only provide an absence note if the patient was seen in the office by Dr. Alford, on the date you are requesting. There are no exceptions.
How can I have access to my medications at school?
Each school has its own rules that we must follow on such matters. Typically, we need to complete a form to be kept on file with the school nurse for the medication, prescription or over the counter. You can ask for this form while you are in the office, by calling, or contacting us via your portal. We have most school systems forms on file. If you provide us the school district, and the medication name, we will gladly complete the necessary form. We can send the form to the parent via the portal or if the parent completes their portion prior to send it to us, we’d be happy to send it to the school nurse directly on the patient’s behalf. You will need to provide us the fax number.
Also, you will need an unopened package of the medication to take to school. If this is a prescription be sure to have the pharmacist put the original fill in two labeled bottles so you have one for home and one to take to school. The insurance will not allow you to fill it twice.
About: Letters, Homebound, 504, Disability Services?
What is the process to request a letter?
Should you need a specific type of letter related to your academics, renew a homebound or are seeking 504 accommodations / disability services an appointment is required with Dr. Alford. This is office policy and non-negotiable. The appointment will focus on your current condition, what you are requesting, and why. We must have this documented to support our requests on your behalf. If your school / college has forms to be completed by the doctor, they must be provided to the office with your portion already completed.
We work diligently to get these completed and sent where they are needed as soon as possible. Understand, these documents are patient-specific. For planning purposes, allow the documents to be completed a week from the appointment.