MEDICAL EVALUATION AND TREATMENT OF OPIOID DEPENDENCE - aka 'Apex Health Clinic Policies'
Providers at Apex Health are certified in Outpatient Treatment of Opioid Dependence. The providers have experience in primary care medicine, which includes experience in managing many psychiatric diagnoses such as anxiety, depression, alcohol dependence, and tobacco dependence. Apex Health providers are not Psychiatrists or Medical Psychologists. Some patients may require referral for further evaluation and treatment by specialists in those fields.
Evaluation and Management
For patients requiring medication assisted treatment of opioid dependence (eg Norco, Percocet, Oxycontin, Methadone, tramadol, etc.), we help guide the process of transition to other medications such as buprenorphine, Suboxone, Zubsolv, Bunavail, Sublocade, etc., then plan to continue to taper off of these medications with a goal of sober living. An initial visit averages 60-90 minutes and includes registration, drug testing, review of medical history, and time with your provider. Patients will be asked to complete a general health questionnaire prior to their visit, as well as customary registration forms. Patients may be required to obtain additional lab work prior to or during treatment by our clinic in order to monitor safety of medications prescribed. Please do not bring young children you your appointments as this may cause a distraction from your treatment discussion.
Follow-up visits will be approximately 15-30 minutes. Arrive 10 minutes early to complete a few simple forms to update us on your current treatment, make payment arrangements, and for a drug test. All medications should be brought to every appointment for accurate pill counts, especially if you have moved your appointment to an earlier date than originally scheduled.
Each Addiction Medicine treatment plan will be individually tailored. Subsequent visits are typically 4 weeks apart depending on dosing, progress, and other issues that may arise. Our goals are two-fold. For most patients, our goal is to help you taper off medication assisted treatment and not to keep you on it for several years. For some patients, long term maintenance therapy may be necessary to control ongoing opioid cravings. Apex Health is not a Pain Management clinic. We may suggest non-narcotic pain medications or work with your primary care provider if ongoing pain is limiting your ability to taper your medication.
Under this agreement, patients should understand that their visits are only to address problems related to treatment of opioid dependence. Other medical problems, such as high blood pressure, low testosterone, acute illnesses, etc., should be discussed with your primary care provider. Although our providers are trained in primary care, we require you to have a separate primary care provider to manage your other medical problems. Patients are also required to allow Apex Health providers to discuss your care with your primary care provider, pain management team, psychiatrist, or any other involved providers due to the complexities involved in managing treatment of opioid dependence.
Controlled Substance Agreement
All patients being treated for opioid dependence must sign a Controlled Substance Agreement. Violation of terms of this agreement may result in immediate termination of treatment. Buprenorphine products are a controlled substance, and as such it is your responsibility to store it in a safe location. Lost or stolen medications are not refilled, but you must notify us if this occurs.
Drug Testing will be performed onsite at each visit. Occasionally we may require you to come in for additional random testing between scheduled appointments. If your results are questionable for the presence of other substances, urine samples may be sent to another laboratory for confirmation testing, and you or your insurance will be billed directly by the laboratory.
Patients receiving medical treatment for opioid dependence are strongly encouraged to seek individual counseling as well as attend group meetings such as AA, NA, or other local support groups. MANY INSURANCE PLANS DO NOT COVER OFFICE VISITS OR PRESCRIPTIONS IF YOU ARE NOT ACTIVELY ATTENDING COUNSELING. Please routinely provide us with written documentation of your counseling in order to facilitate coverage of your medications. Another helpful resource can be found on www.addictionsurvivors.org.
Office Business hours are Monday-Thursday 8-4:30, Friday 8-3 . We are closed for lunch from 12-1.
Treatment received after 5pm Monday-Thursday, after 3 pm on Fridays, on Holidays or on Weekends may be assessed a $25 fee, due at next appointment. Exceptions include: a) you were specifically instructed to call outside business hours, b) if another treating physician calls to discuss your treatment plan (for example, an ER physician.)
Charges are listed below. Payment is due at beginning of appointment. Apex Health clinic does not participate in any insurance plans. Upon request, we can provide a billing form for you to submit to your insurance company, but we can not guarantee your insurance company will reimburse you for any portion of your visit. We accept Visa, MasterCard, debit cards, or cash. We do not accept checks.
Initial Visit Deposit: $60 Due to the amount of time blocked for a new patient appointment, a nonrefundable deposit of $60 is required before we schedule your first appointment. This will be applied towards your first visit. If you fail to keep your initial appointment with less than TWO full business days notice, you will lose your deposit. If you reschedule your appointment after losing your deposit, you will be required to pay an additional $60 nonrefundable deposit. If you were allowed schedule an appointment but were unable to provide the deposit, your appointment is not secured and may be given to another patient.
Initial Visit: ($160 - NOTE: On 3/18/2020, initial visit fee was reduced through 7/4/2020) $220 is our usual fee. (includes Drug Screen).
Follow up Visits: ($160 - NOTE: On 3/18/2020, follow up visits were reduced through 7/4/2020) $200 is our routine follow up visit fee.
We do not offer 'payment plans.' Patients are expected to pay in full at time of visit. There is no such thing as a "pay half today, get 2 weeks of medicine" or other similar policy at Apex Health.
SUBLOCADE INJECTIONS WILL NOT BE GIVEN UNLESS VISIT IS PAID IN FULL.
Random Drug Screen: $20 (as of 6/1/2019, the first drug screen within 30 days of your last visit is included but additional tests are charged $20)
No-Show / Missed appointment fee: $60 for the initial visit, $20 for follow up visits (to be collected prior to next visit)
After Hours Fee: $25 for calls after 4:30 pm, weekend calls, or Holidays
Insufficient Funds fee: $20 (We do not accept checks, but will apply this if we have to reverse credit card charges)
Telemedicine: Please refer to the separate Telemedicine agreement
Cancellations / Missed Appointments
In order to ensure other patients are able to utilize our office time effectively, we require ONE BUSINESS DAY notice for any appointment changes. You must contact us DURING office hours for changes.
Appointments are set at specific intervals to monitor your progress, as well as maintain compliance with DEA regulations. Rescheduling appointments because you have enough to last another week or two is not acceptable unless previously agreed upon with your provider.
We all have busy lives, and we respect that you have a schedule to keep. We do our best to stay on time throughout the day. If you arrive more than 10 minutes late, you may be charged $20 for a missed appointment and may be asked to reschedule your appointment.
Apex Health now offers Telemedicine visits with our physicians. A separate Telemedicine agreement is required for patients who choose to utilize this service.