_" a -i i i I I ( WELCOME to the office of Edward Manougian, M,D., for chrouic pain management. Certification of a clu'onic pain condition is necessary ftl'r i, all treatrnent it trri. office. To facilitate the process of certification, please brirfS pertinent rnedical records you have in your i possession. I It is expected that you have one of the following conditions: I i I . the ustial 0( 1 ) persistenr severe pain, that is, pain at a level of 5 to 1 0 on 10 scale, for at least 3 (2)Persistent moderate pain, that is, pain at ievel 2 or above on the 0;10 i scale, for at least 6 (3) Intermittent severe pain enough to prevent you frorn per{ormine ['o"r activities, such as migraine months- | months' headaches I I This program only relies on oral medications. The goal is to enable Rfsons to return to alroductive life. At other rnedical facilities, rnedications may pe -by routes other than oral. This includes injections ofvarious t,rues,. administered for example, intravenous injection, epidural block, sympatbetic block, Reripheral nbrve block, intrathecal injection I ( Many other fomrs of pain numagement exist, most of which are complernentary to orai medication. Exarnples are sufgery, acupuncture, phiysical [ electrical stimutati on, magnetiJneta stim"lation, traclion' acupressure! massage, heat, cold cornpresses: balms, medical devices, ;;;;ffi;ffiu"ti", - I I etc. persons coming to this office are expected to have undergone some pf the i .! i;i ,r., j,'t i; ii.: (r Office Hours and Fees Days: Friday only Addless: 1617 Canyon Drive #l\L,Pinole, cA94564 Closed for Lunch: Hours: 9A.M. to 5 P.M. Voice Mail: 510 964 i2 htroon to 1:00 P'M' g2O0 ernail: emanougaian@.comcast'net hour for new Visits are scheduled at 20 minutes for established patients, ffid one patients. two methods are preferred' Fees: Payment by cash, credit card, or check' the latler New patient-$3O0 $100 (Bring your medical records) Established Patient prescriptions for patients unable to corne ro the office due to illness, or unexpected n-ot notified prior eve.ts i"*"rrr" in'rvriting needed)-$50. Miss.ed appointments checks will be io uppoi.r*ent day-$25- Your next visit will be $125' Bounced an additional $20- C you through your insurance' You should be aware of the medications available to prior to coming for your appointment contact your insurance for a formularycare your pharmaci.t oUtain tiis information, too. You should have a primary "* to make rnatLers as sirnple fnyri.i* and a pharmacy, recognized by your insurance Dr' Manougian the list will provide as possible. Bring your formulary u'ith you. It of drugs readilY available to You' must initiate the process by If prior authorization is needed, your phannacistusing the information on the obtaining the necesrory for*, filling out the form and fax to the insurance' pres"riptlon, and faxini the form to ttt" doctor to certify, the conectness of the If the doctor needs to do more with the form than certiffthe doctor is required to If form, and fax it to the insurance company the fe-e- is $25' fees are to be paid by credit phone the insurance comPany, the fee is $50. These proper phone number card before the doctor rvill proceed with the request. The the photle, the keys the doctor needs is to be provided by the pharmacist' \\hen on difference in successful outcome' to use differ from ytu.r,i.uding to a possible per page' Payment must be in Forms not related to medication are $15 advance. NOTTCE REGARDING PRIOR AUTI{ORIZATION OF MEDICATIONS ( If vour pharmacist finds that lrour medication is not covered by your inswance, you have two choices: - 1) Ask the phannacist to see if a comparable medication is available. notifli the doctor' If available, 2) Seek a prior authorization- This involves the following action by the must pharmacist; The pharmacist 1) Obtain the necessary prior authorization form, 2) Fill in the form, a) Using your insurance information G.D., your address, phone number, etc.), \_ - b) And using the inforrnation available fiorn your prescription. 3) Then, fax the nearly complete form to Dr. Manougian to sign, and fax to your insurance company using the fax nurnber provided by the pharmacist. The pharmacy rnakes money selling you the rnedication- Dr. Manougian does notGenerally, a phannacist workilg in his/irer phannacy will help you get your rnedication. That, is how phannacies profit. Unfortunately, sorne phannacies, usually run by salaried pharmacists, could care Iess about you obtaining )rour rnedication because tkrey are paid in any case. Obtaining prior authorization is extra wolk for them. Deaiing with schedule II medications frightens them. This is the sort of pharrnacy you should avoid. Your insurance has a list of preferred pbarmacies. You can get this ljst frorn your insurance. That can be a starting point, if you don't already have a satisfactory PharmacY. i \ - number being provided by the phannacy, then the fee is $50. Fees are payable in advance. Youi credit card may be used to pay by phone, If the pharmacist refuses to proceed in this fashion but faxes the form to the doctor io fill, then the fee is $25. If the doctor is to call the insurance, the