Understanding Your Clinical Care
Understanding Your Clinical Care at Midwest Spine & Brain Institute
How Do I Make An Appointment to See a Midwest Spine & Brain Institute Provider?
You may schedule an appointment by calling our office at 1.651.430.3800 (1.800.353.7720) M-F 8:00am - 5:00pm. You may want to verify with your insurance company to determine if you need a primary care referral to see one of our spine providers.
Referral From Another Provider: Your primary care provider may recommend you see one of our providers and he/she may complete a referral form that will be sent to our office to schedule an appointment.
Your Pre-Visit History: Your care begins with understanding your spinal condition and lifestyle concerns. When you schedule your initial appointment we will also schedule your pre-visit history appointment.
Our Historian will call you to collect your medical history. We do not charge you for this call. You also have the benefit of not having to complete a very lengthy health history form on your own.
What Do I Bring With Me to My Visit?
It is essential that you bring along the following items:
- X-rays, CT scans and MRI scans, CDs, films and/or reports.
- Medical Records of previous tests or treatments
- (EMG, Physical Therapy, Chiropractic treatment, Acupuncture, etc.)
- Any brace or support you are using
- Current Insurance card
- Photo Identification – to protect your identity
- Payment for your initial visit (co-pay or co-insurance)
Care Team Approach: The care teams at Midwest Spine & Brain Institute include orthopaedic spine and neurospine surgeons, interventional pain physicians, certified physician assistants, certified nurse practitioners, licensed physical therapists, registered nurses and clinical support staff. Typically you will begin your care with our midlevel provider who will meet with you and evaluate your health concerns. The RN and clinical support staff are members of your care team who are available for telephone communications regarding your clinical care. The RN works together with clinical support staff in communicating with your provider to assist you in getting answers to your questions.
At Each Visit
Check-in: Upon check-in you will need to provide a photo ID as well as your insurance card to proceed with your visit. We require your photo ID to be sure that we are protecting your private medical record. We require your insurance card to be sure that your private health care claims are sent only to your insurance carrier. We want to help protect your identity.
You will complete some important forms including:
- Privacy Notice Acknowledgement
- Financial Agreement
- You may need to make a partial or full payment for your services depending on your insurance coverage.
- Verification of demographic information and authorization for treatment.
- Health History form (at your first visit or pre-visit history appointment).
-Clinical: It is important for your provider to understand how you view your current level of pain, function and overall quality of life. The following forms are part of your evaluation and useful tools to help you and your provider decide on options for care and treatment that become a part of your medical record. Some of these forms may be required by your insurance company.
Entering the Spine Clinic Exam Room: Our patient coordinators are helpful members of our care team. We will measure and record your vitals. We will review your history and clinical forms with you to be sure they are complete and verify the reason for your visit today.
Entering the Procedure Suite: If you are scheduled for an injection or other procedure, a member of our care team will meet you in the reception area and accompany you to a procedure suite prep room. We will measure and record your vital signs. We will review your health history, explain your planned procedure and answer any questions you may have. Before your procedure begins we will measure your blood pressure and heart rate and ask you to sign a consent form for your procedure.
Check out: Before you leave the office you will receive a summary of your care plan. The process for scheduling additional services for you, such as physical therapy, imaging, injections, and/or surgery may include obtaining prior authorization from your insurance company as well as a pre-determination of your benefit level.
Surgical Care Teams: If your plan of care includes surgery, your care before and after surgery will be supported by a care team comprised of your surgeon, his/her midlevel provider(s), a registered nurse and clinical support staff. The midlevel providers assist during surgery, make hospital rounds, see patients for their 1st post-operative visit, follow patients during their recheck visits and manage clinical care questions including addressing prescription refill requests. The RN will contact you after your discharge from the hospital and is available for telephone communications regarding your clinical care. The RN works together with clinical support staff to assist you in getting answers to your questions.
Shared Decision-Making: We encourage you to ask questions so you can better understand your condition and participate in shared decisions for your plan of care. Shared decision making is a collaborative process that allows you and your providers to make health care decisions together, taking into account the best scientific evidence available, as well as your values and preferences.
Prior Authorization and Medical Necessity: For diagnostic tests such as MRI or CT imaging, treatments such as physical therapy and procedures such as injections or surgery, your insurance may require a prior authorization and a determination of medical necessity in order to approve your requested procedure. We will assist you by requesting the authorization. There are situations where you may choose to pay cash at the time of service if you wish to forego requesting a prior authorization and filing a claim to your insurance company unless your insurance policy states that additional medical necessity requirements must be completed and documented prior to authorization.
What If I Need Forms Completed By My Provider?(such as a disability or FMLA form) Please alert your clinical coordinator if you have forms to be completed. Some forms such as work ability can be completed during your visit. Other forms such as disability forms or FMLA may require additional time for review and completion. If your form is not able to be completed during your visit, your clinical coordinator will send those forms to the medical/legal department so they may be completed and returned.
Understanding Prescription Medication Therapy
Your First Visit: Understanding your medication history is an important part of your care. At your visit, we will review your medication history and confirm medications that you are currently taking. You will need to work with your current prescribing provider to continue any existing prescriptions. We will not manage or take over a prescription ordered by another provider.
Before and After Surgery: If you are currently taking prescription pain medication it may be necessary to taper or decrease the amount of pain medicine you are taking before you have your surgery in order for you to have a successful post-surgery recovery.
We will assist you with managing post-operative pain with pain medicines for a period of time that is appropriate to the procedure performed. This typically does not exceed 3-6 months after surgery. Your provider will work with you to make a plan to decrease or taper your use of pain medicines or will refer you to a provider with expertise in medical management of chronic pain.
Medication Contract/Agreement and Therapeutic Monitoring:
Your plan of care may include a medication contract or agreement. As part of the therapeutic monitoring process, patients prescribed prescription pain medicines may expect a random urine analysis at any visit. Depending on your insurance this could be at your own expense
Important Responsibilities Regarding Controlled Substances: Because prescription pain medicines (controlled substances) have potential for abuse, strict accountability is necessary.
- Prescription pain medicines need to be taken exactly as prescribed by your Midwest Spine & Brain Institute provider.
- They should come from only one provider care team and be filled at the same pharmacy.
- Taking more medicine than is prescribed, misuse or abuse of these medications will necessitate stopping prescribing altogether.
- Strict adherence to treatment program and attendance at follow-up appointments is required. Non-compliance will necessitate stopping prescribing altogether.
- These medicines may be hazardous to someone who is not tolerant to their effects, especially a child, and it is important that you keep your prescription pain medicines secure. If your medications are lost, stolen or destroyed they will not be replaced.
Medication Refills: All prescription refill requests require three business days to process. Use the Patient Portal or call your pharmacy to request a refill.
- Any prescription that is permitted to be sent electronically will be submitted directly to your pharmacy.
- Controlled substances may require an original signature from your care team.
- If your prescription requires original review and signature you may arrange to pick up at one of our main locations where your care team sees patients or it will be mailed directly to your pharmacy.
- Any patient, or person authorized on behalf of a patient, to pick up a prescription will be required to show photo ID and sign for the prescription.
- We do not accommodate medication refills on a walk-in basis.
- We do not accommodate weekend or after-hours refills or new prescriptions for pain medications.
If you are experiencing unacceptable side effects or your medicines are not working in the manner you expect please contact our office at 651-430-3800.