SILVA PSYCHIATRIC CARE
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PRIOR
​AUTHORIZATION
​for medications


Medication Prior Authorization: $25.00

Most medications I use are available in a generic, cost-saving preparation. Occasionally, however, I may recommend certain newer, brand-name only medications that are costly enough that your insurance company--if you are using medical insurance at the pharmacy--will require prior authorization before agreeing to pay for it.

This involves explaining to the insurer why the medication is being prescribed, including justifying the amount; there are often limits as to the quantity of pills that can be dispensed over a certain period of time. It is a purely financial concern on the part of your insurance company, but in addition to your identifying information and basic demographics, the diagnosis/indication must be verified and approved, and other details about your treatment at SPC are released. In many cases, the insurance company requires documentation of outcomes of prior trials using other, less expensive FDA-approved medications.

The prior authorization protocol is a time-consuming process that involves registering the request, submitting and resubmitting forms, and answering surveys. It can take several business days to process and be approved (sometimes with automatic expiration/review dates, for periods of one year at a time), unless an expedited review is requested, but delays of 1-2 days are commonplace, and there is always the remote possibility that your insurance company will reject the prior authorization request altogether.

There is a nominal, one-time $25.00 surcharge for this service; if it has to be reviewed annually, you will not be charged again the following year. Additionally, if you pay this surcharge and we switch medications and another prior authorization is required by your insurance company within the same calendar year, you will not be charged again; you will only be charged, at most, once per calendar year for any and all prior authorization requests.

Please bear in mind that you might get a better price on your refills using GoodRx or the Kroger Prescription Savings Program, or similar grocery-store pharmacy discount programs, compared to obtaining prior authorization and then paying your top-tier pharmacy insurance copay. Many grocery stores offer free prescription discount programs, or everyday low prices on medications, and prices at HEB, Walmart, Target, Kroger, etc. are always much more reasonable than prices at franchise convenience-store pharmacies like CVS and Walgreen's. The best prices are often found using the free GoodRx app, which provides price listings for medications from stores in your area which you can easily compare.

See Dr. Silva's profile on Healthgrades.

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​SPC

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SERVICES

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  • Comprehensive Psychiatric Evaluations
  • Psychotropic Medication Management
  • Brief Counseling Sessions
  • Competency/Guardianship determinations
  • Pre-Surgical Clearances (elective bariatric and plastic surgery procedures)​
  • DOT Clearances
  • + other fitness-for-duty and focused psychiatric evaluations
  • Emotional Support Animal Documentation
  • + other medical endorsements

ABOUT SPC

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  • Dr. Silva, M.D.​
  • Résumé
  • ​Areas of Expertise
  • ​Treatment Cost
  • Patient Reviews
  • Payment Policy
  • No-Show Policy
  • Refill Requests
  • Refill Policy
  • Privacy Practices

SUPPORT/FAQS

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  • Contact Me
  • Set Up/How To
  • Telemed App
  • ZOOM Download
  • GoodRx/$4.00 Meds
  • Medical Record Copies
  • Medication Prior Authorizations
  • Patient Portal
  • FORMS
  • FAQ

OTHER RESOURCES

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  • COVID-19
  • American Psychiatric Association (APA)
  • Alcoholics Anonymous
  • Centers For Disease Control
  • La Hacienda Treatment Center
  • NAMI (National Alliance on Mental Illness)
  • Narcotics Anonymous
  • NutritionFacts.org
  • Physician's Desk Reference​
  • SPC Blog (2009)
  • Talbott Recovery Center
  • ​Texas PMP AwaRxe

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  • MEET DR. SILVA
  • NEW PATIENTS
    • COST OF TREATMENT >
      • STUDENTS
    • Patient Reviews
    • AREAS OF EXPERTISE
    • Frequently Asked Questions
    • ADULT ADD/ADHD?
    • REQUEST AN APPOINTMENT
    • STUDENTS
  • THE CONCIERGE MODEL
    • WHAT IT IS
    • PATIENT REVIEWS
  • TELEMEDICINE
    • WHAT IT IS
    • HOW IT WORKS
    • PATIENT REVIEWS
  • PATIENT REVIEWS
    • HEALTHGRADES: DR. SERGIO SILVA
    • TELEHEALTH REVIEWS
    • THE CONCIERGE EXPERIENCE
    • Midland Awards Program
  • TREATMENT PHILOSOPHY
    • INFORMATION FOR PATIENTS & FAMILIES
    • ARCHIVES
  • CONTACT: TEXT ME NOW
  • ABOUT
    • PAYMENTS
    • REFILL POLICY
    • Frequency of Visits
    • CANCEL/NO-SHOW
    • PRIVACY
    • HYPERTENSION SCREENING PROTOCOL
    • FORMS
    • Texas Rx Monitoring Program
  • RECOMMENDED
    • COVID-19 VACCINATION
    • BEST PRODUCTS
    • READING
    • Apps
    • Decks
  • SPOTLIGHT
    • DIALECTICAL BEHAVIOR THERAPY
    • NEW YouTube CHANNEL
    • NOTICES & NEWSLETTER ARCHIVE