Frequently Asked Questions

Find answers to the most pressing questions about pain management, our practice, and living with chronic pain.

  • How do I become a patient?
  • Why do I have to be seen every month to get my medications?
  • When can I expect my test results?
  • I have insurance. Why do I have a bill?
  • Can I still get medicine from my family doctor?
  • My prescription needs a prior authorization. What does that mean?
  • Why was I denied care?
  • Do you accept Medicare/Medicaid?
How do I become a patient?
Our physicians are specialists, so our facility requires a referral from any doctor currently treating you for pain. Your doctor will need to include what we will be treating you for, his/her last 3 office notes, and any diagnostic reports related to your pain (i.e. MRI, CT, X-Ray, Lab work, etc.). Please do not send diagnostic films or discs.
Once this information has been received, we can begin the process to consider you for becoming a patient. The New Patient Coordinator will contact you with our determination and/or to schedule your appointment.
Why do I have to be seen every month to get my medications?

Many of the medications we prescribe are heavily regulated by the DEA, which requires we prescribe medication in the safest manner possible. As a result, Oklahoma laws now prohibit many medications from being refilled without monitoring. Therefore, we require you to be seen monthly so we can closely monitor your health and any effects your treatment may have.

When can I expect my test results?

Depending on the test, we generally receive results back between 1-2 weeks. However, once we receive the results, your doctor must review and sign them before they are able to be disclosed. Therefore, all test results will be discussed at your next appointment. If we receive a critical result for any test, we will contact you immediately.

I have insurance. Why do I have a bill?

Most insurance plans do not cover 100% of your visit. Balances often reflect your percentage (co-insurance) and/or unmet deductible. Your balance includes only services with an unpaid balance.

Can I still get medicine from my family doctor?

Because we are specialists, we only prescribe medication for your pain. All other medications will have to be prescribed by your family doctor or another physician (i.e. cardiologist, psychiatrist, etc.). However, due to the strict regulation of medications by the DEA, you cannot be prescribed ANY controlled medication by these doctors. This includes medications for day to day living that may have a narcotic element such as cough syrup with codeine. If you receive a prescription and are not sure if it has a controlled substance in it, please call our office at (405) 752-9600 for clarification BEFORE you fill the prescription.

My prescription needs a prior authorization. What does that mean?
Insurance companies sometimes require prior authorization before they are willing to pay for a prescription. This simply means they are requesting information about your treatment to determine if a medication, its quantity, or a specific brand is necessary to your care.

Due to formulary changes made by many insurance companies, certain co-pays have increased this year. If your co-pay has increased significantly, please contact your insurance company to confirm if your payment portion has increased or if your prescription needs a prior authorization.

If you need a prior authorization, please have your pharmacy fax the appropriate form to our prior authorization department at (405) 752-9650. You must leave your prescription at the pharmacy in order for the pharmacist to fax this request. Our office is only made aware your prescription needs a prior authorization by receiving this form. Once this form has been received, we will complete the form, attach any necessary medical records, and submit all information to your insurance company. Due to high volume during the months of January and February, this process may take up to 5 business days. This information is NOT sent to your pharmacy.
Once your insurance company has received this information, it may take up to 72 hours for them to process it and make a determination. Appeals can take up to 1 month to be processed. After a determination has been made, your insurance company will call or mail you a letter to inform you of their decision. Most insurance companies will not cover the medication Buprenorphine for pain management. Please contact your insurance company to check your prior authorization status. If a prior authorization is denied, it is the patient’s responsibility to pay for the prescription out of pocket.
Prior authorization is valid for up to 1 year, depending on your insurance, and cannot be initiated until your prescription has been denied by the insurance company.
Why was I denied care?

As specialists, our doctors require potential patients to undergo rigorous scrutiny before being accepted at our clinic. This process is our first step in complying with various laws and regulations. This process includes a background check and reviewing the person’s prescription history through the DEA prescription database. As a result, patients may be denied care at our facility for many reasons, including: having a large number of criminal charges, filling prescriptions by a large number of different doctors, or filling excessively large amounts of medication in a short period of time. Other reasons someone might be denied as a patient include: having an open case for workers comp or a motor vehicle accident, non-contracted insurance, or being pregnant. Of course, each potential new patient is considered individually on a case by case basis.

Do you accept Medicare/Medicaid?

Yes, we accept both Medicare and Medicaid. However, we only accept Medicaid as a secondary insurance. We do NOT accept Medicaid as a primary insurance.

© 2024 Oklahoma Pain Center. All rights reserved.