Clinical Services

• Always take medications exactly as prescribed by your provider.
• Avoid self-medicating or adjusting dosages without consulting your provider to prevent harmful interactions or complications.
• Inform all healthcare providers (including specialists) of any medications, supplements, and over-the-counter drugs you are taking.
• Scope of Prescriptions: We only prescribe and refill medications within the scope of primary care. We do not prescribe Schedule II medications regulated by the FDA or specialty medications that require ongoing management by a specialist.
• Regular Monitoring and Surveillance: Medications require periodic lab testing and follow-up visits to check for side effects and ensure effectiveness. Side effects may not always be felt, making tests such as kidney or liver function essential for your safety.

• Chronic, stable medications prescribed for long-term conditions are reviewed and refilled during your annual preventive physical exam.
• In most cases, a year’s worth of refills is authorized at your preventive visit if you have completed all necessary follow-ups and testing. Before contacting our office for a refill, check with your pharmacist first—they often have refills on file from your last visit.
• Sometimes pharmacies file prescriptions as “not yet due,” leading to the appearance of no refills. Remind the pharmacist that the refills may have been provided during your last annual physical.
• If you require additional refills outside of your annual exam timeframe, you may have missed a scheduled physical or follow-up. Refills may be canceled if you are overdue for your recommended appointments or lab testing, as ongoing monitoring is necessary to ensure safety and effectiveness

• We reconcile (update and confirm) your medication list at every office visit.
• You can access your current medication list and recent refill history via the patient portal.

• Submit refill requests at least 72 hours (3 business days) before your medication runs out.
• Preferred Methods of Refill Requests:
  • Pharmacy: Request refills directly through your pharmacy when possible.
  • Patient Portal: Log in, select the medication, and request a refill.
  • Phone: Call our office and leave a detailed voicemail including your full name, date of birth, medication name, dosage/strength, and preferred pharmacy name/phone number.
• Important: If recommended follow-ups or lab tests are incomplete, your refill request may be denied until you schedule and complete these essential evaluations.

• Keep your preferred pharmacy information current and inform us promptly of any changes.
• Remove pharmacies you no longer use from your profile.

• You will receive a text notification when your medication refill has been approved and sent electronically to your pharmacy.

• Coordinate with your pharmacy to dispense medications simultaneously for convenience and better management.
• We typically refill medications annually during your preventive visit to streamline this process.

• Sugarloaf Medical P.C. does not prescribe or refill controlled substances, including chronic pain medications, sleep medications, tranquilizers, or ADD/ADHD medications.
• This includes all Schedule II medications regulated by the FDA.
• Patients requiring these prescriptions will be referred to specialists who manage them.

• Medications prescribed by specialists must be managed and refilled by the prescribing specialist.
• Contact your specialist directly for refills.

• Any change in medication type, dosage, or strength requires evaluation by your provider.
• All medication questions and change requests must be addressed during a scheduled office visit to ensure safe and appropriate care.

• Some medications require prior authorization, which may extend processing time.
• Certain prior authorizations involve significant physician effort and may incur additional charges.

• Check for manufacturer coupons or discounts when possible.
• Consider self-pay options through discount services (e.g., GoodRx).
• Ask about more affordable alternatives that offer equivalent therapeutic benefits.

• Short-term medications (e.g., antibiotics) are not refillable.
• If an acute illness symptoms persist or worsen, schedule a follow-up visit for further evaluation.

• Emergency refills outside regular business hours are reserved for critical medications only.
• Non-critical medications must follow the standard refill procedures.

• LabCorp is our primary in-office laboratory service. The phlebotomists drawing your labs are employed by LabCorp.

• If your insurance requires or you prefer Quest Diagnostics, please inform our staff or the phlebotomist before your blood draw so we can accommodate your needs.

• Typical Process: We generally order and draw labs at the time of your scheduled office visit, allowing your provider to determine which tests are needed based on your current health concerns. 

• Pre-Visit Labs: If you prefer to have labs drawn prior to your appointment, we can accommodate you. However, additional labs may still be required on the day of your visit if your provider deems more testing necessary.

• Why We Recommend Same-Day Labs: Each visit and patient is unique, and lab tests are not standardized in advance. Drawing labs at the time of your visit helps ensure we capture all necessary tests.

• Coordinating with Specialists: We encourage having most labs drawn in our office unless a specialist explicitly requires a specialty lab. If a specialist orders labs, these must be entered into our system to ensure accurate recordkeeping and result-sharing.

• Office or Nurse Visit Charge: In certain cases, coordinating external lab orders may require a brief office or nurse visit, which could incur a charge.

• Avoiding Duplicates: Inform your specialist if you have already had labs drawn at Sugarloaf Medical P.C.. Most specialists can access your results electronically; if not, we can fax them to their office.

• Routine Results: Generally available within 3–7 business days. Some specialized tests may require more time.

• Immediate Portal Posting: Your lab results appear in your patient portal as soon as the lab reports them—before your provider’s review.

• Contact Us if Delayed: If you do not see your lab results after 7–10 business days, please contact our office for an update.

• Provider Interpretation: Allow at least 3 business days after results are posted for your provider to review, interpret, and add any comments or instructions.

• Normal Results: Normal lab results may simply appear in the portal without provider comments. If your provider has additional instructions, they will include them.

• Abnormal or Critical Results: Our staff will contact you to schedule a follow-up visit or advise on urgent care if needed. Some abnormalities require repeat testing, additional labs, or further evaluation.

• Nurse’s Lab Visits for Minor Retesting: Occasionally, a minor lab abnormality (e.g., urine showing blood likely due to menstruation) may be repeated in a nurse’s lab visit to confirm it has resolved. Standard charges may apply.

• Chronic Disease Monitoring: Conditions like diabetes or hypertension often require routine lab tests to check medication effectiveness and detect any potential side effects.

• Routine Follow-Ups: Many conditions need periodic office visits to review labs, ensure medication effectiveness, and address new or ongoing concerns.

• Callback Visits: If unexpected or concerning results arise, our office will reach out to schedule an appointment, as outlined in our Appointments and Scheduling Policy.

• Preventive Visits: Annual preventive exams typically include lab orders relevant to your overall health status.

• Check Your Portal: Review new lab results and provider notes promptly.

• Do Not Direct Result Questions to Staff: All questions, clarifications, or concerns about lab results require a scheduled follow-up visit with your provider. Our office staff and nurses cannot interpret or comment on your results.

• Complete Recommended Care: If additional tests or visits are advised, please schedule and complete them to ensure safe, continuous care. Failure to follow recommended testing or appointments may affect medication refills or treatment.

• Billing & Insurance:

  • Self-Pay Patients: Lab charges are due at the time of service.
  • Insured Patients: Some tests (such as reflex or add-on testing) may incur additional costs. Contact your insurance or the lab directly with questions.

• HIPAA Compliance: Your lab results and medical information are managed under strict privacy regulations.

• Authorized Sharing Only: Results are shared via your patient portal and, if needed, faxed to specialists or care teams with your permission.

These appointments are typically scheduled during your check-out. If that is not possible, please call our office as soon as you can. Diagnostic appointments are booked by phone only, not through the patient portal, to ensure the proper setup and preparation for each specific test. For accurate results and your safety—especially for critical tests—it's essential to follow preparation instructions carefully and arrive on time.

Ambulatory Blood Pressure Monitoring (ABPM) This test records your blood pressure throughout a full 24-hour period during your normal daily routine and sleep. It helps diagnose high blood pressure patterns that may not be detected during a standard office visit, such as white-coat or masked hypertension. You’ll wear a cuff on your arm connected to a small monitor. The device inflates periodically throughout the day and night. It is important to return at your scheduled time the following day so the device can be prepared for other patients. Please handle the equipment with care and avoid exposing it to water or impact. Your results will be reviewed by your physician and discussed at your next visit.

Home Sleep Study This overnight study is used to evaluate for sleep apnea and other breathing disorders during sleep. You will receive a small device with sensors that track breathing, oxygen levels, and heart rate while you sleep in your own bed. A short questionnaire must be completed prior to the study—please complete this via your check-in link. The device must be returned the next morning at your scheduled time, as it is used by other patients. Handle the equipment gently, keep it clean and dry, and store it in a safe location when not in use. Results are interpreted by a third-party sleep specialist and discussed during your follow-up visit.

DEXA Scan (Bone Density Test) DEXA (dual-energy X-ray absorptiometry) scans measure bone density and assess your risk of fractures or osteoporosis. This test is recommended for postmenopausal women, men over 70, or individuals with risk factors such as long-term steroid use, smoking, or prior fractures. You’ll lie on a table while a scanner moves over your hips and spine. There is no pain or preparation involved. A brief questionnaire must be completed before the scan—please use your check-in link. Results are interpreted by your physician and discussed during a follow-up.

Spirometry (Pulmonary Function Test) Spirometry measures how well your lungs work by assessing airflow and lung volume. It helps diagnose asthma, COPD, and other lung conditions. During the test, you’ll be asked to take a deep breath and blow forcefully into a mouthpiece. It’s simple, safe, and quick. Some patients may be asked to avoid inhalers prior to the test; follow your physician’s instructions. Your doctor will explain the results in detail.

Electrocardiogram (ECG or EKG) An ECG is a painless test that records your heart’s electrical activity. It helps detect irregular heart rhythms, heart attacks, and other cardiac issues. Small sensors are placed on your chest, arms, and legs to monitor your heartbeat. The test takes about 5–10 minutes and does not require any preparation. Your physician will review and explain the results.

Certain advanced imaging procedures—including CT scans, MRIs, nuclear studies, and mammograms—must be completed at an external radiology facility. Your provider will recommend the appropriate test and provide you with a referral. You may schedule this at a facility of your choice.

Important notes:

• Check with the radiology facility to confirm insurance coverage and whether the test requires prior authorization.
• Some authorizations can take several business days to process.
• If your test was completed and you do not see results posted to your portal within 7–10 days, please contact us or the imaging facility. This usually indicates that we have not yet received the report.
• If your test is a follow-up for monitoring a prior abnormal finding (e.g., a lung nodule or an abnormal mammogram), it is best to complete it at the same facility for consistency. If you must switch facilities, please bring a CD or copy of the prior images to the new location to ensure an accurate comparison.

We are here to support you through every step of the testing process. If you have questions about referrals, preparation, or follow-up, our team is happy to help.

• To ensure timely care and coordination, all in-house diagnostic and ultrasound testing must be scheduled in advance by phone. These appointments cannot be scheduled through the patient portal to ensure appropriate preparation. If you are unable to keep your appointment, please notify us at least 72 hours in advance so we may offer the slot to another patient. Testing is an essential part of your medical care, and being prepared allows us to deliver the best results possible.

  Home sleep study devices and ambulatory blood pressure monitors must be returned on time the following day as scheduled. These devices are shared between patients and need to be sanitized and prepared for the next use. Please protect these machines from water, drops, or extreme temperatures. Any damage to the equipment may delay your results and incur replacement costs.

  For outside diagnostic testing, our office will provide guidance on the recommended facility and assist with any required insurance authorizations. However, it is ultimately the patient's responsibility to:

  • Confirm their insurance network coverage.
  • Ensure prior authorization is obtained (when needed).
  • Notify us or the imaging facility if results have not appeared in the patient portal within 7–10 business days.
  • When possible, return to the same imaging center for follow-up tests requiring comparison with prior studies, or request a copy of prior imaging on CD to share with a new facility.

  Following preparation instructions and attending scheduled tests on time helps ensure accurate, timely diagnoses and improves the safety and quality of your care.

Referrals are given only at the time of an in-person office visit after evaluation by one of our physicians or nurse practitioners. This ensures that all referrals are medically appropriate and well-documented.

Once a referral is issued, the information — including the specialist’s name and contact details — is available on the patient portal at any time for your reference.

While we may recommend a subspecialist, you are free to choose your own provider.

As a patient, you are responsible for:

• Scheduling your own appointment with the specialist.
• Ensuring the specialist is in-network with your insurance.
• Confirming your benefits and obtaining prior authorization if required by your plan.
• Coordinating billing and payment directly with the specialist’s office

If you are unable to schedule with the referred specialist or have difficulty reaching their office, please notify us so we can assist or update the referral as needed.

If you wish to see a different specialist, let us know so we can send the referral and your medical records to the provider of your choice.

If your insurance requires a referral or prior authorization:

1. First, schedule your appointment with the specialist.
   
2. Then call our office so we can initiate the referral.
   Please allow adequate time for processing.

We send the referral and relevant notes directly to the specialist. We are also connected to the Care quality interoperability network, which allows many specialists to view your records electronically.

• Always bring important documents (including CDs of imaging done elsewhere) to your specialist visit.
• Inform the specialist that Sugarloaf Medical is your primary care provider, so they can send us their progress notes.
• Make sure any lab work or testing performed by the specialist is sent to our office before your next appointment so we can review the results with you in person.

Please let us know about any other specialists or providers involved in your care. Keeping your medical team informed helps ensure safe, comprehensive, and well-coordinated care.

• Mayo Clinic – Trusted medical information on diseases, symptoms, tests, and treatments.
• MedlinePlus – Health information from the National Library of Medicine.
• WebMD – Health articles, symptom checker, and general medical advice.
• UpToDate – Evidence-based medical information on conditions and treatments.

• American Diabetes Association – Diabetes education, management tips, and resources.
• American Heart Association – Information on heart disease, stroke prevention, and cardiovascular health.
• National Kidney Foundation – Kidney disease management and prevention information.
• American Cancer Society – Cancer education, prevention strategies, and treatment resources.
• Breast Cancer Risk Calculator – Assess your risk for breast cancer.

• Drugs.com – Drug interaction checker, side effects, and medication guides.
• RxList – Prescription medication details and side-effect profiles.
• FDA Drug Database – Information on FDA-approved medications.

• LabCorp Patient Information – Help understanding laboratory test results.
• RadiologyInfo – Information about radiological procedures and diagnostic tests.

• CDC Vaccines – Immunization schedules, vaccine safety, and recommendations.
• Vaccine Information – Comprehensive vaccine education and resources.
• ChooseMyPlate – Nutrition, dietary guidelines, and healthy eating tips.
• Physical Activity Guidelines – Recommendations for general physical activity and exercise.
• Your Guide to Lowering Blood Pressure – Practical advice for hypertension management.
• Your Guide to Lowering Cholesterol and Triglycerides – Strategies for managing cholesterol and triglycerides.
• Smokefree.gov – Resources and support for quitting smoking.

• CDC Infectious Diseases – Updates and information on public health and infectious diseases.

• National Alliance on Mental Illness (NAMI) – Mental health education, advocacy, and resources.
• Psychology Today – Directory to find therapists and mental health articles.
• Substance Abuse and Mental Health Services Administration (SAMHSA) – Resources for mental health support and substance abuse treatment.

• American Red Cross – First aid instructions and emergency preparedness resources.
• Poison Control – Guidance on poison emergencies and immediate response.
• CDC Emergency Preparedness – Public health emergency response resources and guidance.