Music City Peds’ Policies and Procedures

Dear Clients of Music City Peds,

As founder and owner of Music City Peds, I would like to express my gratitude for your decision to entrust your care to us. We are passionate about what we do and strive to provide exceptional care to our clients and their families.

Please review our policies and procedures in order to be informed about essential clinical and logistical aspects of your care with Music City Peds. In our experience, we’ve found that that clear expectations promote optimal communication and satisfaction as we work together.

Sincerely,

Caitlin Rissler, owner and nurse practitioner

Payment Information:

  • We are out-of-network with insurance, and payment is collected at the time of the appointment. If you’d like to submit a superbill to insurance to request reimbursement, we can generate one for you. Just let us know.
  • We encourage clients to communicate with us between appointments as necessary and do not want to deter anyone from corresponding with us due to cost concerns. We do not charge for letters, forms, phone messages (including brief phone calls), or portal messages. If you require a phone call that exceeds 15 minutes, your clinician may discuss charging an appropriate fee.
  • During the intake process, our clinic coordinator can offer information to potential new clients regarding fees for different types of initial visits.
  • Our follow up appointments range from $165-$275 and are based on length of appointment, typically 25, 40, or 55 minutes, and rarely 15 minutes.
  • In accordance with our no show/late cancellation policy, a current card on file is required. A $100 fee will be charged if client does not show up to appointment or cancels within 24 hours of the appointment time. This is because we know that time slot could be filled by a client on our wait list if we had been given notice, and our providers’ time is valuable. Essentially, if that slot was reserved for you, we require that you pay a portion ($100) of the appointment fee.
  • However, we understand that things come up last minute and can interfere with your appointment time. As a courtesy, IF you are able to reschedule (and keep) your appointment for another slot within 5 business days with one of our available providers, we will apply the $100 late cancellation or no show fee to that kept appointment!

Appointment Information:

  • Our nurse practitioners are licensed to practice in the state of TN. This means that the client must be in TN at the time of each appointment, regardless of whether the appointment is in-person or via telemedicine.
  • While we offer telemedicine often, we may sometimes recommend an in-person appointment for optimal care in some cases. We also require an in-person appointment once per year.
  • If client is being prescribed medication by a MCP provider, client must have appt at least every 3 months! This is how we ensure optimal care, adhere to standard of care protocols, and monitor clients on medication.
  • If MCP provider expresses need to see client sooner than 3 months for an appointment because of need for closer monitoring, a dose adjustment or medication change, etc., please note that refills cannot be provided until that appointment requirement is fulfilled.
  • Our nurse practitioners work as a team. Our electronic medical record system allows us to document care which is accessible to all Music City Peds providers. If you see a particular provider for one appointment, that does not necessarily mean you will follow up with the same provider. We take availability in schedule, client preferences, and areas of experience and expertise into account when determining which provider clients should schedule with.
  • After-school appointments fill up fast! Reserve your spot in advance to meet your scheduling or preference needs. We provide school excuse forms if needed.
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Prescription Information:

  • We can only prescribe medications to TN or mail order pharmacies, with the rare exception of sending a non-controlled substance to a different state due to the client being out of state temporarily (such as a vacation). We are no longer able to prescribe controlled substances (stimulant medications for ADHD) to pharmacies outside of TN. However, for non-controlled substances, the patient can call pharmacy to transfer prescription to a different pharmacy location within the same company (ex: from one Walgreens to another).
  • Stimulant medications for ADHD (methylphenidate or amphetamine products) are schedule II controlled substances which means that our nurse practitioners can only send 30-day supply prescriptions without refills (although we can send 3 consecutive 30-day prescriptions once a client reaches a maintenance dose), and pharmacies can only fill these prescriptions every 30 days.
  • If 3 consecutive 30-day prescriptions have been sent to the pharmacy for a maintenance dose of a stimulant medication, the bottle will still say “no refills”, but clients can ask pharmacy to fill the next prescription “on hold” as long as it has been 30 days since the last fill.
  • Because stimulant medications are tightly regulated due to risk for misuse, prescriptions that are lost or stolen cannot be replaced early. Therefore, we urge clients to keep stimulant medication in a secure and private location to prevent a lapse in treatment.
  • Plan in advance! IF you will be out of TN when you are due to fill a stimulant medication and you will NEED your medication while out of town, please let us know in advance so that we can attempt to authorize an early fill of your medication. We will try to accommodate these requests as best we can. 

Transition to Adult Care Provider:

  • Our cut off age based on our pediatric certification and practice policy is 23yo. This means we cannot prescribe medication or provide care after clients turn 23yo.
  • As clients approach 23yo, we will discuss whether to refer to an adult primary care provider or specialist and help bridge that transition by sending medical records once that appointment is scheduled and a release is signed by the client.

College Students and Young Adults:

  • We are happy to continue care for young adults until they turn 23yo and will then transfer care to adult provider. 
  • Clients must be in TN during appointments, whether they are in person or virtual.
  • Clients must have appointments every 3 months to receive medication refills. 
  • We must see clients in person at least once per year.
  • If you live, work, or attend school in TN, the below info should not apply to you.

IMPORTANT Updated Policies:

  • We can only prescribe medications to TN pharmacies. Most medications (stimulant medications being an exception) can be transferred from a TN pharmacy to another state (if within same company – like from one CVS to another)
  • IF you are prescribed a stimulant medication for ADHD, you cannot transfer prescriptions to another pharmacy. This means that the stimulant medication prescription must be picked up from TN pharmacy.
  • Some mail order pharmacies can send controlled substances to your out of state address. But, know that you may have to be present to sign for the medication at delivery.
  • IF you are prescribed a stimulant medication and cannot return to TN for appointments every 3 months OR need your prescription sent outside TN, you will need to find a local provider in your state to see you for follow up and to prescribe. We are happy to send medical records and collaborate, and we can care for you when you are back in TN.