MEDICAL PROVIDER VISITS
NO REFILLS OF SUBOXONE WILL BE MADE FOR ANY REASON WITHOUT A PROVIDER ENCOUNTER/VISIT.
WHEN YOU START YOUR TREATMENT YOU WILL HAVE MORE FREQUENT VISITS USUALLY WEEKLY FOR ~ 5 VISITS, THEN BIWEEKLY, THEN EVENTUALLY MONTHLY.
You will be contacted on the day of your appointment.
Provider will E-prescribe Suboxone to your local pharmacy of choice.
Have the address of the pharmacy you would like to use.
Medical Provider appointments will either be by Telehealth or Telephonics.
Follow-Up Appointments will be at least monthly and will be scheduled with your provider prior to the end of each visit.
Regular Visits: Visits are focused on evaluating compliance and possibility of relapse. They include: Urine or Oral Saliva drug screen to test for drug abuse, pill counts, an interim history of any new medical problems or social stressors, prescription of medication. Appointments do not include evaluation or care for other problems. More frequent visits will be necessary for not following Drug Screen or Counseling Requirements.
DRUG SCREENS
DRUG SCREENS (Oral Saliva and Urine) and PREGNANCY Tests (for females) WILL BE MAILED TO YOUR ADDRESS. FURTHER DETAILED INSTRUCTIONS CONCERNING HOW TO CONDUCT DRUG SCREENS WILL BE TEXTED TO YOU. DO NOT OPEN DRUG SCREEN PACKAGES PRIOR TO VISIT.
OBSERVED DRUG SCREENS ARE REQUIRED FOR EVERY VISIT. FAILING TO SUBMIT YOUR DRUG SCREEN ON TIME CAN RESULT IN MORE FREQUENT VISITS, TAPERING OF MEDICATION, AND POSSIBLY OTHER DISCIPLINE TO ENCOURAGE COMPLIANCE. OBSERVED DRUG SCREEN RESULTS ARE NOT USED AS THE SOLE BASIS FOR TREATMENT DECISIONS AND/OR TERMINATION FROM TREATMENT.
ZOOM COUNSELING
Regular counseling has shown patients are more likely to succeed in full recovery from opioid addiction. FAILURE TO COMPLY WITH COUNSELING CAN RESULT IN MORE FREQUENT VISITS, TAPERING OF MEDICATION, AND POSSIBLY OTHER DISCIPLINE TO ENCOURAGE COMPLIANCE.
ALL IN CENTRAL TIME
CONTROLLED SUBSTANCE MONITORING DATABASE/PRESCRIPTION DRUG MONITORING PROGRAM POLICY
General: Controlled Substance Monitoring Database (CSMD) shall be checked prior to initiating Buprenorphine for all prospective patients either by National Addiction Specialists Staff or Provider (s).
CSMD Checks: Controlled Substance Monitoring Database (CSMD) shall be checked prior to or with each visit for all patients either by National Addiction Specialists Staff or Provider (s).
Abnormalities: If abnormalities are seen in CSMD, these will be discussed with patients during their visit and appropriate measures or changes in medications or frequency of visits will be considered based on the abnormality found.
DANGEROUS BEHAVIOR RED FLAGS
(Treatment may be discontinued if these behaviors occur)
Continually changing your phone number.
Frequent, urgent, inappropriate phone calls, texts, or angry/agitated outbursts and behavior
Use of opioids, xanax, or controlled medications not approved by your provider.
Lost/stolen meds, running out of meds too soon, taking medication not as prescribed.
Refusing drug screens (oral or urine).
Inability to perform with the technology required for telehealth visits. (Must be able to text, receive and make phone calls, open web links, and send and receive photos and videos.)
Inappropriately contacting other NAS providers if you are unable to reach your own. (Your provider will contact you as soon as they are available.)
Frequently missing appointments, non-payment of bills as agreed, or cancellations within 24 hours of appointment.
FINANCIAL INFORMATION
Payment Requirements: Payment for all services is due prior to services being rendered and the account must be paid in full prior to medication being prescribed. Payment may be made in the form of credit or debit card. Personal checks will not be accepted. NAS does not accept partial payments and upon entering into this program, you are responsible for ensuring that you have the full payment at the time of your visit.
Medicaid: NAS has contracted with the state of Tennessee and Virginia’s Medicaid providers for reimbursement of services to those insured. Medicaid will pay for the required visits and for medication. We currently accept Tennessee Medicaid (Bluecare, Amerigroup, United Healthcare Community Plan) and Virginia Medicaid (Molina, Sentara and Anthem Healthkeepers)
Medicare: NAS has contracted with the state of Tennessee and Virginia’s Medicare for reimbursement of services to those insured. Medicare will pay for the required visits and for medication.
Commercial Insurance: We accept ATENA, BlueCross BlueShield, CIGNA and Ambetter. PLEASE TEXT our biller at (615) 994- 8888 IF YOUR INSURANCE CHANGES PRIOR TO YOUR APPOINTMENT.
MAJORITY OF COMMERCIAL INSURANCES HAVE COPAYS OR YEARLY DEDUCTIBLES THAT HAVE TO BE MET PRIOR TO PAYING FOR PROVIDER VISITS.
Check with your private carrier to determine if you have a copay or deductible associated with your policy.
Delinquent Payments: If a patient cannot pay for service, they will be dealt with on an individual basis. If a patient is consistently not able to pay, options may include: referral to another provider or medical facility or medical detox depending on patient circumstances.
Refund Policy: If you do not show up to your appointment, your deposit will not be refunded. Refunds are available if the appointment is canceled prior to 24 hours.
Other Fees/Information
Labs may be billed separately. Cost of labs is the patient’s responsibility if insurance does not cover it. Drug screens are provided for each patient encounter, but drug screens done by outside companies such as Labcorp or Quest Diagnostics are the patient’s/patient’s insurance companies responsibility.
Financial Assistance – financial assistance is available on an individual basis and may offer lower fees based on need. Please inquire with the Office Manager for more information.
Suboxone price varies among pharmacies. Medicaid pays for generic forms of Buprenorphine/naloxone medication. Medicaid may only pay for one prescription per month, so if you are being seen more frequently than monthly, you may have to pay for the additional prescriptions.
MAJORITY OF COMMERCIAL INSURANCES HAVE COPAYS OR YEARLY DEDUCTIBLES THAT HAVE TO BE MET PRIOR TO PAYING FOR PROVIDER VISITS.
PRIOR AUTHORIZATION PROCESSING
TEXT 615-994-9000 FOR INFORMATION RELATED TO PRIOR AUTHORIZATIONS
Prior authorizations (PA) may be required by insurance companies to pay for your Suboxone and will be completed by National Addiction Specialists. Sometimes processing of these by insurance companies can delay obtaining your medication.
It is the INSURANCE COMPANY, NOT YOUR PRESCRIBER, that has final say on the PA BEING APPROVED for your medication to be paid for.
If your insurance company denies your PA, this DOES NOT MEAN that you can’t get the medication at the pharmacy. However, it does mean that YOU, and not your insurance company, will be responsible for paying for the medication. PA’s usually get approved within 24 hours by insurance companies,but they can take up to 72 hours. PA’ s last for 6 -12 months, but can vary.
