Office Information for American Pain and Wellness in Plano, TX & Allen, TX
Call one of our locations for more information.

Office Info / Office Procedures
Welcome to American Pain & Wellness. Our main office is located at 6020 W. Parker Rd., Suite #300 on the 3rd floor in Plano. Our office hours are Monday through Thursday, 8:00 AM to 5:00 PM, and Friday, 8:00 AM to 12:00 PM.

PRIOR MEDICAL RECORDS
If you schedule an appointment with one of the doctors at American Pain & Wellness, we ask that you bring any medical records from other doctors who have treated you for your pain symptoms. Please include any MRI reports, X-rays, or CAT scans. Bringing these records will help us avoid ordering duplicate tests and may also speed up your treatment plan.

INSURANCE INFORMATION
Please fax a copy of your insurance card to (469) 326-5101 before your appointment. This allows us to verify your insurance benefits prior to your first visit. We will bill your insurance company for the services provided. All co-payments are due at the time of the visit. We accept cash, personal checks, Visa, MasterCard, Discover, and American Express. A $25.00 service fee will be charged for returned checks.

MEDICARE PATIENTS
If you have Medicare coverage, your family physician should be aware of any medical treatment you receive from other doctors. Please provide us with the name and address of your family physician.

WORKER’S COMPENSATION INSURANCE
If your pain problem is due to a work-related injury, we will bill your worker’s compensation carrier. To do so, we must have the name and address of the carrier, the name and phone number of your adjuster, the date of your injury, and the name and address of your employer at the time of the injury. You will need to be referred to American Pain & Wellness by your treating doctor. If you do not currently have a treating doctor, we will consider becoming your treating doctor. Your adjuster or case manager must authorize your initial consultation with American Pain & Wellness.

REFERRALS
If you are a member of an HMO, you must obtain a referral from your primary care physician. Your primary care physician’s name should be listed on your insurance card. The referral must come from your primary care physician and not another specialist, even if the specialist is the one recommending you see us. You are responsible for obtaining your referral and keeping it current for all future appointments. If you arrive without a referral, you will need to either reschedule your appointment or pay for the visit at the time of service.

TREATMENT / PROCEDURES
If the physician at American Pain & Wellness determines that your treatment requires a procedure, we will contact your insurance company to obtain pre-certification. We must have this authorization before scheduling the procedure. It may take five to seven business days to obtain approval. Pre-certification for HMO patients may take longer, as the primary care physician must issue additional referrals for all procedures, diagnostic testing, and physical therapy.

Most procedures are performed on an outpatient basis at Presbyterian Hospital of Plano or Parker Road Surgery Center, which is located on our campus. The doctor will bill your insurance carrier for professional fees, and the hospital or surgery center will bill the facility fee. Payment to the facility does not include payment of the doctor’s professional fees.

MEDICATION
If your treatment plan includes prescription medication, we will ask you to read, sign, and comply with a Medication Agreement.

Medication Agreement – Microsoft Word
FACTS ABOUT INSURANCE

Health insurance plays a large role in helping people obtain pain management treatment. In an effort to help you understand your health coverage, we would like to share some facts about healthcare insurance.

You may receive a letter from your insurance company stating that medical fees are higher than usual and customary. An insurance company surveys a geographic area, finds the average fee, then takes 90% of that fee and considers it “customary.” Included in the fee survey are discount clinics, which can bring down the average fee. Many doctors in private practice have fees that are considered higher than the average.

If you have insurance, we will be happy to help you determine the coverage you have available. Your insurance policy, however, is a contract between you and your insurance company. We cannot guarantee payment of your claims or accept responsibility for negotiating claims with insurance companies or any other party. If your insurance company pays only a portion of the bill or rejects your claim, you are responsible for full payment of the services rendered. If payment from your insurance carrier is not received within forty-five (45) days, we reserve the right to seek full payment from you. Balances that are delayed or denied by your insurance company due to Coordination of Benefits information become your responsibility after thirty (30) days. We encourage you to become familiar with your insurance benefit plan and the philosophy of its administration.

If there are any changes in your insurance status (such as a new company, deductible, co-pay amount, group number, or mailing address for claims), you must provide us with the new information within forty-eight (48) hours in advance of your next visit, or payment in full will be necessary.

Most of our procedures require precertification before the procedure can be scheduled. Our office staff works diligently on your behalf to obtain these precertifications. The process varies depending on the requirements set forth by your insurance carrier. Our insurance specialists are well trained in this area and will work to obtain authorizations as quickly as possible. This may take five (5) to seven (7) business days. Our schedulers will call you to schedule the procedure as soon as authorization is obtained.

Please be assured that our office staff are professionals in processing insurance issues. Patient calls on a daily or frequent basis asking for updates on the status of precertification overload the phone lines used for obtaining precerts and delay the staff’s ability to properly manage their time and communicate with your insurance company.

CANCELLATIONS
If you need to cancel or reschedule an appointment for an office visit or a procedure, we ask that you please call twenty-four (24) hours in advance.