NEW PATIENT CONSULTATIONS
EVALUATION OF NEED
Prior to scheduling, you will be screened with your required information and a detailed survey. The results of these will be reviewed by Dr. Alarcio to determine the type of appointment you will need. If it is unclear, we may need to have a
short call with you or request medical records for a better understanding of your needs and medical issues. We will provide a good faith estimate of the cost for your planned consultation.
COMPLEX NEW PATIENT APPOINTMENT WITH DR. ALARCIO
The consultation includes 1 to 1.5 hours of face-to-face time with Dr. Alarcio. (If out -of-state this can be Telemed or Video/ZOOM) additional time for her to review outside records, review your history, symptoms (another 1.5-2 hours) and perform a detailed or more limited physical examination (Depending on your circumstances).
Initial recommendations for additional testing and imaging will be presented at the end of the appointment and via orders either given at time of appointment or emailed to you.
The second appointment (post consult) will be 1-1.5 hours to go over the results of ordered labs, imaging and any other studies or testing. This is a very detailed appointment and Plan of Treatment; impressions and recommendations will be sent following this visit.
RE-ESTABLISH APPOINTMENT
If it has been two years or longer since the last appointment and you want to re-establish care with ANTIC, it will then be considered a new consultation. A longer visit and going over information that has transpired since your last visit will require extra time. Dr. Alarcio will review the last visit with the clinic and determine an estimate of the time that will be required to go forward with the visit. If it has been 2 years a lesser charge than 3 or more years will be considered and discussed.
Referrals, scripts, lab orders, school notes, etc. will not be facilitated without first having a visit if it has been 2 years or longer. NO exceptions will be made.
PREPARE FOR A SUCCESSFUL VISIT
You are encouraged to organize and provide the most pertinent medical records to improve the efficiency and effectiveness of the record review process.
Things we would like to have for the visit:
- Laboratory tests: both positive and negative
- Genetic testing
- Specialty lab or stool testing: i.e., Mold testing, Gl Maps, Cunningham panel
- All Neurology records: including EEG, EMG, NCV, Sleep studies, Evoked potentials, Cognitive Testing, Autonomic Testing, Spinal tap and results, other neurological pathology reports (nerve and muscle biopsy) Radiology imaging: MRI of Brain, CT of Brain, Spine imaging. CD of imaging would be helpful.
- Rheumatology Records: including laboratory tests, diagnostic tests and clinical evaluations and current treatments and treatments that have been tried.
- Any infusions currently on or tried: IVIg, Antibiotics, Rituxan etc. Infusion company currently with.
- Current medication and supplement list
To make the most of your consultation time, we recommend you organize your thoughts ahead of time to allow a focused review of your medical history and concerns.
VISIT FEES AND TYPES
Our current fees are based on those of practices across the country that care for similar patient populations. We offer different levels of care based upon your personal medical needs and the amount of provider time we anticipate you will need. If your appointment takes longer than expected, you may be charged at the provider’s hourly rate.
Please note that payment in full at time of visit is expected. Please let us know within 24 hours if you do not anticipate keeping your appointment. There is a charge for same day cancellations as visits cannot be filled.
FEES
*Pricing Subject to Change
| New Patient visit | $1000 |
| Follow-up visit 45 minutes or less | $250 |
| Follow up visit more than 45 minutes. (Super Bill Provided Upon Request) | $400 |
| FMLA paperwork | $50 |
| School Notes for determination of Homeschooling, EOS, Homebound | $30 |
| Disability Forms | $50 |
| Court Papers | $50 |
| Letters for any Legal, Flight reimbursement and Guardianship matters | $30 |
| Letters for Home or apartment regarding mold | $30 |
| Letters regarding exemption from vaccines | $20 |
| Records that are to be printed not emailed (depending on number of records being printed) | $25-$75 |
| Nasal or buccal swabs in office to be sent out | $10 for patients $15 for family members that are not a patient. |
| Seizure action plans | $20 |
| Any other forms | *Price will be determined by the amount of work required. |
CARE AGREEMENT
We understand that you or your child may have many symptoms that are severe and disabling, but please understand that chronic, complex illnesses such as yours or your child’s, require time to assess and treat. It is not uncommon for our patients to require several iterations of treatment with us to find what works best. Treatments are over time and there will not be an immediate recovery of health when treatments begin.
Our practice is designed to provide chronic disease management, not acute care. If you have a new symptom(s), you should be evaluated by your primary care provider to be sure that you do not have a new unrelated problem. If you have worsening and/or acute symptoms you are concerned about, you should call 911 or be evaluated by the nearest Urgent Care or Emergency Department.
If discussion between your provider and Dr. Alarcio is required, please provide us with your Dr’s name and phone number so we can arrange a Peer to Peer between your Dr and Dr. Alarcio during clinic hours. Please note* if your provider leaves a general phone number such as the hospital emergency department line or their clinic’s mainline, their call will not be returned. Dr. Alarcio offers this as a free service when she is able, but it is not a guaranteed service.
If you or your child is having an exacerbation of your illness that cannot wait until your next scheduled appointment, please contact the office and leave a message or email the office notate Urgent and office staff will call you. Once we review your message with the Dr, we will schedule you for the next available appointment or add you to the cancellation list. If applicable, you will be called by staff with new medication or change in treatment. Otherwise, medication changes and initiation of new medication will be made during scheduled office visits.
TEST RESULTS
We are happy to provide you with medical records and test results in electronic format as required by 21st Century CURES Act.
We appreciate that you are anxious to get your test results and to understand their significance. Please keep in mind that results on the tests we order are not always simple as “normal” or “abnormal” and often require the provider to analyze them in the context of the larger picture. Therefore, explaining the significance of the results often requires a conversation with the provider.
We ask your patience in waiting until your next appointment to discuss test results. Be assured that if anything serious is found we will contact you immediately and move your appointment up accordingly.
Routine monitoring labs (CBC and CMP) for patients on infusion therapy or certain oral medications do not require an appointment if they are normal. If there are important laboratory abnormalities, however, a follow up appointment must be scheduled, even a brief telephone appointment, so that these results and their potential implications may be properly communicated with you. Due to the complexity of the syndromes and diseases we manage, analysis of the labs requires an appointment.
Please note* If labs are in preliminary status in the lab portal and the patient or parent asks for a copy to be sent regardless of status, staff will only do it once prior to completion.
We do not guarantee that recommended laboratory studies, Imaging or procedures will be reimbursed by your insurance company. It is your responsibility to ensure that laboratory tests, procedures or other tests ordered by ANTIC are covered by your insurance policy prior to these studies being completed. If your insurance company requires different diagnosis code(s), we are happy to change or add codes if necessary or appropriate, to improve the insurance company reimbursement. If you request more extensive staff involvement to facilitate getting tests covered after the fact, you will be billed $50.00 because the office staff is very small and not equipped to spend large amounts of time on these insurance issues.
INSURANCE
In April of 2021, Arizona Neuro Recovery Treatment Innovation Center (ANTIC) was removed from all Insurance contracts and is no longer contracted with insurance of any kind. We deeply regret the impact this will have on patients, but caring for a complex population using the insurance model as it currently exists is not sustainable.
We do not submit medical claims on your behalf; however, we will provide you with a superbill that you may submit to your insurance company for possible reimbursement. For some insurances a partial or half reimbursement may be possible if you have out-of-network coverage (this depends on your insurance and having a conversation with the prior authorization department of your insurance carrier will determine this.) We cannot request or accept single case agreements.
Dr. Alarcio no longer participates in Medicare or Medicaid programs. If you are a Medicare, Medicaid or AHCCCS member and wish to become a patient of ANTIC, you are required to accept the terms and conditions set forth in a private contract between you and ANTIC for services provided by ANTIC, even if such services are covered by Medicare or Medicaid. Under this private contract, you acknowledge that you accept full responsibility for all charges and for services provided by ANTIC and that payment is due in full at the time care is provided.
Laboratory, imaging, other diagnostic tests, as well as medications and infusion therapies and treatments in the office that are ordered by the provider at our Clinic should be covered by most insurance companies and Medicare, but it is your responsibility to verify whether this is the case for your specific plan.
A federal law called CURES Act prohibits anything ordered by a provider who is not registered with AHCCCS or Medicaid from being covered. So, if you have AHCCCS or Medicaid, you will need a primary care provider or other specialty provider willing to order tests or Radiology imaging as we will not be able to do that.
MEDICAL RECORDS RELEASE
You are responsible for obtaining your or your child’s medical records from other healthcare providers /facilities. Medical records from another physician or office can only be released to us with your authorization by completing a Request for Medical Records form. Please contact your other healthcare providers to obtain the records that we have identified as pertinent to your ANTIC evaluation.
Your ANTIC records are available upon request via email. We will be happy to send electronic records to you at no cost and to the providers of your choice. If you ask to have them printed for you instead, a printing fee will be charged depending on the size of the chart and quantity of records involved. We follow the guidelines for the State of Arizona for fees charged should you request to have us print out your medical records. These guidelines from AZ State Statute 12-2295:
per page
| Pages 1-50 | $1.25 per page |
| Pages 51-100 | $0.96 per page |
| Pages 101 and above | $0.62 per page |
Mailing and shipping are determined by the actual cost.
The medical provider may charge the actual postage and electronic media cost, if applicable and any applicable taxes.
Laboratory and other study results can be obtained directly from the testing facility.
PRIOR AUTHORIZATIONS
There are no FDA approved treatments for Autoimmune encephalitis, Lyme, Mold, dysautonomia, mast cell activation syndrome or Ehlers-Danlos syndromes. These conditions are poorly understood by insurance companies. As a result, insurance companies often request extensive and time-consuming documentation to consider approval of many of the treatments used and testing for these conditions. The number of these requests for our patient population far exceeds that of most other practices and we must now charge for this service.
If your insurance company requires ANTIC to obtain a “prior authorization”, provide a letter of medical necessity, assist in an “appeal” or conduct a “peer-to-peer”, physician consultation for medications, infusion therapy, imaging, laboratory testing, procedures, or other care, you will be charged a fee for this service. The fee for prior authorizations or other insurance company issues involving only administrative staff will be charged $25- $75, per medication, other treatment or service depending on complexity.
An active credit card must be on file prior to ANTIC acting on the insurance company request(s) and you will be contacted first to be sure you would like us to move forward.
There is no guarantee that your insurance company will decide in our favor as a result of our actions, but we will make every effort to get the care you need approved.
PRESCRIPTION REFILLS
Prescriptions are best ordered during your scheduled office visit. We will order enough refills to last until your next recommended follow-up visit. The frequency of recommended follow-up visits depends on the stability of your condition and the medication(s) prescribed. No medications will be prescribed longer than 6 months out except for seizure medications.
Certain controlled medications may need to be ordered on a monthly basis due to controlled substance regulations. ANTIC does not automatically provide refills. You must reach out via phone or email at least 3 business days in advance of running out. We recommend that you request them 7 days in advance, as these prescriptions require the provider to review, approve and personally order the controlled medications. Some controlled substances require visits at least every 3-4 months to be renewed.
Prescriptions initiated by another provider should be refilled by that provider unless discussed at a visit and the provider agrees to take over prescribing the medication. It is your responsibility to be sure you do not run out of your medication by scheduling office visits at appropriate intervals and requesting refills in a timely manner.
A new prescription or one recommended by another physician requires an office visit or telemedicine visit.
CONTROLLED SUBSTANCES
We do NOT prescribe Narcotics
Prescription for other controlled substances (tranquilizers, non-opioid analgesics, and stimulants), required visits every 3-4 months.
If authorization is required by insurance, it may take longer to get refilled.