Controlled Substances Policy

At Metro Behavioral Consultants PLLC, the safety and well-being of our patients are our utmost priority. As a psychiatric clinic, we understand the importance of adhering to strict guidelines and regulations regarding controlled substances. This policy outlines our commitment to maintaining a safe and responsible environment for the prescribing, dispensing, and monitoring controlled substances within our clinic.

Legal Compliance

1. Our clinic strictly complies with all federal, state, and local laws and regulations governing the use of controlled substances, including the Controlled Substances Act and relevant licensing and registration requirements.
2. All practitioners authorized to prescribe controlled substances hold valid licenses and registrations and stay updated on any changes in laws and regulations.

Prescribing Practices:

1. Controlled substances are prescribed only when medically necessary and by evidence-based guidelines and best practices.
2. Prescriptions are based on a comprehensive assessment of the patient's condition, medical history, and treatment goals.
3. Our practitioners employ a multimodal approach to treatment, considering non-controlled alternatives and adjunct therapies whenever appropriate.

Monitoring and Documentation:

1. Patient information and medical records are maintained in Compliance with privacy laws and regulations, including the Health Insurance Portability and Accountability Act (HIPAA).
2. Strict documentation procedures are followed for all controlled substance prescriptions, including accurate and complete records of the medication, dosage, frequency, and duration of treatment.
3. Patients receiving controlled substances undergo regular monitoring to evaluate treatment effectiveness, assess any potential side effects, and detect signs of misuse or diversion.

Patient Education and Informed Consent:

1. Patients prescribed controlled substances are provided comprehensive information about their medications, including potential risks, benefits, and alternatives.
2. Informed consent is obtained from patients before initiating any controlled substance treatment, ensuring they understand the nature of the medication, its potential side effects, and the importance of adhering to prescribed guidelines.

Safeguarding Controlled Substances

1. Controlled substances are stored securely in Compliance with applicable regulations and best practices, ensuring restricted access and preventing unauthorized use or theft.
2. Our clinic maintains accurate inventory records, performs regular audits, and reports any discrepancies or suspected incidents of diversion to the appropriate authorities.

Collaboration and Communication:

1. Our practitioners engage in ongoing Communication and collaboration with patients, other healthcare providers, and pharmacies to ensure safe and coordinated care.
2. We maintain open lines of Communication with regulatory agencies and comply with any requests for information or inspections related to controlled substances.

Staff Training and Education:

1. All staff members involved in the management of controlled substances receive comprehensive training on applicable laws, regulations, and clinic policies.
2. Regular education and updates are provided to ensure staff members stay informed about emerging best practices and any changes in regulatory requirements.

We are committed to upholding the highest ethical and responsible practice standards regarding controlled substances. By adhering to this policy, we aim to safeguard our patients' well-being, prevent misuse or diversion, and contribute to the overall safety of our community. This policy is subject to periodic review and revision to ensure ongoing Compliance with changing regulations and evolving best practices.

Prescription Refill Policy

ALL Refills for controlled substances, following federal and state regulations, may have additional requirements and restrictions. Controlled substance prescriptions may limit the number of refills allowed or require a physical visit to our clinic before a refill can be authorized. It is essential to plan and schedule appointments accordingly.

Prior Authorizations for Prescriptions

At Metro Behavioral Consultants PLLC, we understand that certain medications may require prior authorization from insurance providers before they can be prescribed and dispensed to our patients. Our prior authorization policy is designed to streamline the process while ensuring patients have timely access to the medications they need for their mental health treatment. We are committed to supporting our patients in navigating the prior authorization process to ensure they receive the most appropriate and effective medications for their mental health treatment. If you have any questions or concerns regarding prior authorizations or your medication access, please do not hesitate to contact our clinic.

Please review the following guidelines regarding prior authorizations:

1. Identification of Medications Requiring Prior Authorization: Our clinic maintains an updated list of medications that commonly require prior authorization based on insurance coverage policies. The prescribing provider will identify if a medication falls under the prior authorization requirement during the treatment planning.
2. Communication and Collaboration: Our clinic will initiate the prior authorization process by contacting the patient's insurance provider to determine the specific requirements for authorization. We will work closely with the patient, their insurance company, and the pharmacy to gather all necessary information and accurately complete the prior authorization request.
3. Documentation and Information Submission: The prescribing provider and our clinic staff will gather and submit all relevant medical documentation required for the prior authorization process, including diagnosis, treatment history, and medication-specific information. We will ensure that all necessary forms, supporting documentation, and clinical justifications are completed accurately and submitted promptly.
4. Timeliness and Follow-Up: Our clinic is committed to initiating the prior authorization process as soon as possible to minimize any delay in medication access. We will closely monitor the progress of the prior authorization request and follow up with the insurance provider as needed to expedite the approval process.
5. Patient Communication: Patients will be informed if their prescribed medication requires prior authorization. We will provide patients with clear instructions regarding the steps involved in the prior authorization process, including any information or documentation they must provide. c. Patients will be kept informed of the progress of their prior authorization request, including any updates or additional requirements.
6. Appeals Process: If a prior authorization request is denied, our clinic will assist patients in navigating the appeals process. We will work with the patient, their insurance provider, and any necessary third parties to provide additional documentation or clinical justifications to support the appeal.
7. Patient Responsibilities: Patients are responsible for providing accurate and complete information necessary for the initial authorization process, including insurance information and supporting documentation. Patients should promptly respond to requests for additional information or documentation related to the prior authorization request

Requesting Forms or Letters from Your Provider

If you need any forms filled out by your provider or any letter written by your provider, you will need to schedule an appointment with your provider for completion of these forms and/or letters. You will need to bring these forms to your appointment, with all patient sections already filled out. For letters, you will need to bring the name and contact information of any person and/or department to send the letter, as well as addresses, emails, and/or fax numbers for sending the letter.

For a Diagnostic Assessment to be completed, make a 15 minute appointment with case manager, patient and provider present to go over and complete any medical/diagnostic questions and sign the forms. Please have your case worker complete the forms to the best of their knowledge before coming to the appointment.

Payments and Insurance

Payment is due at the time services are rendered. Your payment may consist of an insurance deductible, a co-payment, co-insurance, or full payment for uninsured patients or those services not covered by an insurance plan. Please be prepared to show your insurance card at every visit. Keeping your records up to date helps us expedite referrals and authorizations necessary for your care and ensures we have the information needed to bill your insurance company accurately and timely.

Controlled Substances Policy

At Metro Behavioral Consultants PLLC, we are dedicated to providing safe and effective care to our patients. Our Controlled Substances Policy ensures responsible prescribing practices and promotes patient safety. Please review the following guidelines:

1. Maximum Dosing Guidelines: Our providers adhere to the Metro Behavioral Consultants PLLC maximum dosing guidelines for controlled medications for treating anxiety, ADHD, and insomnia.
2. Random Toxicology Screens: Patients prescribed controlled substances must be aware that they may be subject to random toxicology screens as a condition for receiving ongoing prescriptions.
3. Medical Records Request: Before prescribing any psychiatric medications, our prescribers may request medical records from recent prescribers to better understand the patient's medical history and treatment.
4. In-person Appointments: Controlled substance medications will only be prescribed with an in-person appointment with one of our prescribers. Please refer to the list of controlled substances.
5. Medication Adherence: Patients must strictly adhere to the prescribed regimen for controlled substances. Any misuse or deviation from prescribed instructions may result in termination of care.
6. Positive Toxicology Screens: A positive toxicology screen may result in the termination of care. Patients need to be honest and transparent regarding their medication usage and compliance.

We are committed to providing comprehensive care while maintaining the highest standards of safety and professionalism. By adhering to this policy, we ensure the responsible use of controlled substances and promote the well-being of our patients.