CALL CENTER GUIDELINE
Expectations of the call center:
Answer calls in a timely manner
Never spend more than 10 minutes on a call with a patient
If you are unsure of a call
o First refer to this guideline
o Second send me an email to assist
Greeting:
Incoming calls- Hi, this is _______ with paincareflorida, how may I assist you today?
Outgoing calls- Hi, this is ________________ with paincareflorida returning your call. How may I assist
you?
If a patient is calling regarding a prior authorization for medication- Advise the patient:
1. We have a 72-hour policy to submit the prior authorization and we will only submit a PA for
medications greater than $50.00 and we encourage patients to utilize the Goodrx card.
2. If the medication is over $50.00, create a case and send to Cindi West (Clinical Triage).
3. Any pharmacy or clinical calls send to Cindi West.
If a patient is calling inquiring if their blood thinner clearance has been received for one of the
ambulatory surgical centers- please send the request to Debbie Blair.
If the request is for an office injection- you will send the request to the location fluoro MA.
1. SPO- Sarah Wilson
2. PSL- Ericka Bourdier/Carla louis Pierre
3. PBG- Heather Saltalamacchia/ Sherry Rainsburg
4. Okeechobee- Katelynn Schaeffer/Rylee martin
Peer to Peer request: Follow the steps below: Once the information below is received, you will send an
email to the designated office managers to schedule. Refer to the call list.
REASON:
PERSON CALLING:
PHONE and EXTENSION FOR CALL BACK:
DATE OF SERVICE:
LOCATION FOR PT'S NEXT VISIT:
CAN EITHER OUR PHYSICIAN OR PA DO THE PEER TO PEER, OR DOES IT
HAVE TO BE A PHYSICIAN?
TIME NEEDED:
Incoming new patient call:
All new patients call should be transferred to the new patient reps along with an email
to the new patient email address. If a new patient calls and want to reschedule or cancel
an appointment, follow the same protocol as above.
Scheduling Patients-
There are multiple ways the patients can request an appointment.
1. Calls directly into the call center.
2. Via portal request through Athena.
3. Appointments requested via AI marketing platformed – housed in outlook.
4. Voicemails- housed in outlook.
First thing - obtain the patient’s name (correct spelling) and date of birth. If the
patient has a duplicate account- notify the location office manager to correct.
Verify the patient address, phone number, insurance and primary care physician.
If none of the above is listed in the chart please obtain and load- be sure to ask
the patient to read the insurance member ID to you directly from the card, also
be sure to load the insurance in the proper format.
Once the information is uploaded make sure to verify the eligibility is correct and
if an authorization is required, send an email to designees below.
If the patient has an HMO insurance, schedule the patient at least 2 weeks out to
obtain the authorization for the visit(s).
Always look for the authorization for the visit that requires it.
If a patient is calling for an appointment due to being out of medications or if
their medications weren’t sent to the pharmacy.
o Look in Athena to see when they were last seen. If there are no
appointments on file within 30 days the patient will require an
appointment to be seen.
o Look to see if a script was sent to the pharmacy. Below indicates that the
script was sent. If you see below, you can advise the patient the script was
sent, and they need to check with the pharmacy.
Encourage all patients to utilize the patient portal as a form on communication to
the office. If they have not accessed the portal- walk them through the process.
Appointment types:
Follow- up # 1 indicates the patient must be seen when a physician is
available in the office- those appointments are colored yellow.
o What constitutes a #1 visit?
Must be seen every 3 months when the doctor is in the office
to send the prescriptions to the pharmacy. See example:
o Follow up #2 and #3
These appointments are made after the patient is seen as a
#1 and the provider has sent the subsequent scripts to the
pharmacy for month two and three. These appointments can
be seen without the physician in the office. However, if the
patient MCR the patient can only be scheduled with a APRN
not a PA. A PA always requires supervision from a physician.
See the list Physician Assistants:
Brent Sanders, PA
Justina Sanders, PA
Cheryl Spragg, PA
o Extensive evaluation
These appointments are made for patient who either have
not been seen in the office 6 months or greater or at the
request of the provider to make a patient an extensive eval.
These appointments are 30 mins long.
o PIFU (post injection follow-up)
These appointments are for patient who have a follow up
with the practitioner after a procedure and they are 15 mins
long.
NONE OF THE APPOITMENTS ABOVE ARE TO BE SCHEDULED ONTO THE
PHYSICIAN SCHEDULE UNLESS APPROVED.
Our physicians:
Marc Levine, M.D.
Ramon Alvarez, M.D
Loel Warsch, M.D.
Jay Kuchera, M.D/Addictionologist
Our locations:
111 SE Osceola st. ste 100 Stuart, Fl. 34994 (Corporate)
10244 US1, Port St. Lucie, Fl 34952
4510 Donald Ross rd. Palm Beach Gardens, Fl 33418
208 19th drive, Okeechobee, Fl. 34972
Authorization calls:
If a patient is calling inquiring about authorizations for office visits or injections, co-
insurance, co-pays. For immediate attention please send an email to the following for
now:
SPO- Joy Jackson
PSL- Fisher/Kristal
Okeechobee- Katelynn
PBG- Fisher
You will send an email for now to any additional request to billing@paincareflorida.com
Billing questions:
If a patient calls in asking to speak to someone in billing- send an email to
billing@paincareflorida.com
West Palm patient calls- New Patient and Established
Forward all to Marisol Cole
Medical Records
Refer to the handout.
FAX No.:
772-337-7876
