New Patient Questions
Q: As a new patient, what happens at the first appointment?
Your physician will take a complete history and order testing if necessary. Some appointments are purposefully set up to only accomplish a consultation and testing will be performed on a separate date. Testing may include skin testing, lung function testing or other various forms of testing needed to evaluate your symptoms. Once testing is complete, your doctor will review the results and recommended plan of treatment.
Q: What to do if I need a medication refill?
Please contact your pharmacy. Contacting your pharmacy will expedite the refill request and ensure that all prescription information received is accurate. All prescription refills are done as soon as possible, but at times it could take up to 48 hours. If you are overdue for an appointment we will schedule one for you and provide enough medication to cover you until your appointment.
Q: At what age can I bring my child in to get skin tested?
Limited skin testing can be done even on small infants. The best approach is to have a consultation visit with one of our physicians to discuss the child’s history and determine the best course of testing.
Q: Is there a charge for no-show appointments? How far in advance can I cancel or reschedule with no penalty?
In order to avoid a no-show fee, please call to reschedule or to cancel an appointment. If you change your appointment outside a 24 hour period, you will not be charged this fee. Please make every effort to cancel or reschedule your appointments as soon as possible to allow other patients to access those available appointment options.
Q: How fast can I be seen as a new patient?
Most often we can accommodate a new patient appointment within 48 hours. However, you must be off antihistamines at least 4 days prior to your appointment to have allergy skin testing.
Q: What kind of patient education is available at Bernstein Allergy Group?
At each visit patients are given extensive education and instructions regarding their treatment plan. Patient education is a major focus in accomplishing a successful treatment plan, and written and demonstration instructions are a high priority of our care.
Allergy Injection Questions
Q: How Do Allergy Shots Work?
Allergy is when your immune system mistakes a harmless substance for a dangerous one and triggers the release of chemicals into your body, thus creating symptoms like runny nose, sneezing, watery eyes, and itching. In some cases symptoms progress to include coughing, wheezing, swelling of the throat and tongue, and in the worst case anaphylaxis.
Allergy shots increase your tolerance to the harmful allergen. By injecting gradually increasing doses of the offending allergen extract, the immune system builds up a tolerance to that allergen. Allergy shots slow down and reduce the production of the IgE antibody.
Q: Who are the Best Candidates for Allergy Shots?
If you are able to avoid the trigger of your allergies or if usual doses of medications control your symptoms, then immunotherapy might not be needed. While allergy shots have been proven effective against inhalant allergies and stinging insect allergies, they are not used for food allergies. If any of the following applies to you, then you may be a candidate for allergy shots:
- If the medications to control your symptoms (i.e., antihistamines, nasal sprays) do not work.
- If the medication used to control your symptoms produces too many side effects.
- If complications (i.e., sinus infections, ear infections) develop.
- If you have asthma or eczema triggered by allergies.
- If you are at risk of developing anaphylaxis (a severe reaction that, in some cases, may be fatal) when exposed to an allergen.
- If medications control your symptoms, but your symptoms flare back up every time you try to reduce your medications.
- If you cannot effectively avoid things that trigger your allergies.
- If you would rather take a series of allergy shots than daily medications.
- If you would rather treat the actual problem rather than just use medications to control symptoms.
- If cost of the medications is a burden, allergy shots are very cost effective compared to the use of daily prescription medications over several years.
Q: How Often Do I Need Shots?
Allergy shots are typically started on a weekly schedule during the build-up phase. This can be accelerated under certain circumstances and this may be discussed with your allergist. Symptomatic improvement may occur within the first 3-6 months with full benefit usually seen with the first 12-18 months.
After a maintenance dose is reached, your allergist will determine when to decrease the interval between shots (for example, every 2 weeks, every 3 weeks, every 4 weeks). Most people will be able to stop their injections after about 5 years but some require prolonged therapy.
As board-certified allergists, the physicians at the Bernstein Allergy Group are trained to safely utilize potent allergy extracts which are more complicated to use but which provide significantly greater benefit than the low-dose allergy extracts used by physicians not specifically trained in the subspecialty of Allergy/Immunology.
You should always consult with one of our Board Certified Allergists before beginning a program of allergy shots.
Q: Are Allergy Shots Expensive?
Studies have shown that allergy shots are a very cost-effective way to treat allergies. They have been shown to reduce medication requirements and improve the quality of life in those patients who take them. They are the only long-term way to bring symptoms under control in those patients who have significant allergic disease.
Q: I have heard of other types of allergy treatments different from allergy injections. Do you offer them?
Other treatment modalities, such as sublingual immunotherapy to grass and ragweed, have recently been approved by the FDA and are available at our practice.
Q: Can I be tested for food allergies?
Yes, food allergy testing is available. This is done by skin testing and/or blood tests. We may arrange for an oral challenge to be done in our office.
Q: I chronically get sinus infections. Is there any help?
Allergies and sinus issues often co-exist and managing the allergy component may in fact prove helpful in deceasing the frequency and severity of sinus infections.
Q: Why do I have a large bump on my arm where my allergy injection was given?
A large local reaction does not mean a patient is having a systemic reaction. It can be comforted with ice, ibuprofen, acetaminophen or Benadryl and should be reported to the injection clinic the next time you are in for an injection. It does not require further treatment and it is not necessary to call the on call Doctor after hours to be reported.
Q: Can I get tested for insect stings?
Yes, stinging venom insect testing is available and is warranted if the reaction to the sting was severe enough. Please call our office to discuss.
Asthma Questions
Q: Can asthma be controlled?
Yes, asthma is a very treatable disease. With appropriate treatment plans and consistent physician monitoring and evaluation, you can control your asthma and not have your asthma control you.
Q: What are the signs and symptoms that I may have asthma?
Coughing, wheezing, shortness of breath, tightness in chest, frequent or lingering bronchitis, exercise intolerance are just a few of the potential signs and symptoms that may indicate a reason to investigate a possible asthma problem.
Q: Can acid reflux make my asthma worse?
Yes, acid reflux can contribute to cough, SOB and tightness in chest.
Allergy Questions
Q: Why do I have bumps after skin testing when I didn’t have my reactions while in the office?
The delayed reaction is simply an irritation and can be comforted with ice and Benadryl. It does not change any diagnostic outcome of the skin testing.
Q: What is the youngest age of a patient seen by Bernstein Allergy Group?
We manage the care for patients ranging from small infants to elderly patients. Our practice works in conjunction with your pediatrician, family doctor, or internist to provide quality continuity of care.
Q: What can I expect during my skin test visit?
Allergen extract drops are placed on the skin (either on forearms or back) and lightly pricked to allow the antigen to enter the skin. After a 15 minute wait the testing is measured and read. If the results of prick testing warrant further investigation, additional antigen is placed just under the skin (similar to a TB test) followed by another 15 minute wait. Results are again measured and read at which time you will get a detailed description of the results by the doctor. The most difficult part for children is usually the need to lie still and the waiting time in between the testing steps. It is helpful to bring books, handheld games etc., to help with the waiting time.
Q: What is the difference between blood testing and skin testing for allergies?
Skin testing is a more sensitive, more specific, quicker and better standardized means of evaluating allergies. Your doctor will help determine when blood testing is needed for evaluation.
Q: What kind of testing can you do for allergies?
Many items can be tested for including foods, indoor and outdoor allergens, insect stings, and certain drugs like penicillin. Please call our office to discuss any particular questions you have regarding available testing options.
Insurance and Payment Questions
Q: Will my insurance pay for allergy testing and or allergy shots?
All plans have different benefits. Please check with your company for exact covered benefits.
Q: Do you charge an office visit every time we get an allergy shot?
No, shots are given by a nurse and the only time you are charged for an office visit is when you see a doctor.
Q: If I disagree with what my insurance has paid, will you call them for a better explanation?
No, if you disagree with the payment, you need to call the customer service department at the number on the back of your insurance card.
Q: Do you know if a co-pay applies to my allergy shots?
No, please check with your insurance provider.
Q: How do I know if my allergy shots are covered?
Our billing office is always willing to work with you and your insurance provider to determine what kind of costs you might be responsible for. We make sure you receive all details regarding costs before shots are started so that you can make an informed decision on whether they are right for you.
Q: What if I do not have my insurance information at my time of service?
You will be identified as a "self-pay" patient and will need to pay at your time of service.
Q: Do you participate with Medicaid?
No.
Q: My pharmacy/insurance told me I need a Prior Authorization. What is this?
Many insurance providers require a patient to have tried other less expensive medications in a certain drug class before they will consider paying for a particular drug. If this is the case, the process requires the doctor’s office to call the insurance and answer questions or complete paperwork regarding the patient’s medical and medication history. This process requires several days to accomplish. We will notify you and your pharmacy when we get a determination from the insurance.
Medical Records Questions
Q: How do I request my medical records?
Either call our office or send a message over the portal. We will need you to fill out and sign a medical records release form for us to send records to you or another practice. We can either fax, mail, or email you the release if you don’t want to come in and sign it.
Q: Do medical records cost to have them sent out?
If it is your first time asking for the medical records no, but if you are asking for them more than once then it will. Costs for records are: $2.98 per page for the first 10 pages, $0.62 per page for pages 11-50, and $0.26 per page for pages 51 and higher.
