1. What Happens If I Miss My Appointment at GEM Neurology?
GEM Neurology – No-Show & Cancellation Policy
At GEM Neurology, we aim to provide timely access to care for all patients. Missed appointments without notice prevent others from receiving needed care. Please read this policy carefully.
Cancellation Policy
We require at least 24 hours’ notice to cancel or reschedule an appointment.
You may cancel or reschedule by:
• Calling our office
• Sending a secure message through the patient portal
• Emailing us at info@gemneurology.com
• Messaging us through the online portal
Important: If you cancel, postpone, or reschedule your appointment, you will be placed on a waiting list that may be over 6 months long for new patients due to high demand.
For New Patients
GEM Neurology provides specialized neurological care and does not practice general neurology. Because our services are highly specialized, the waiting list is often several months to over a year. Every appointment slot is valuable—missed visits without notice delay care for other patients who urgently need evaluation and treatment.
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If you miss your first new patient appointment without giving proper notice, you will be required to pay a $75 rescheduling fee at the time the visit is rescheduled. This fee is not covered by insurance and must be paid out-of-pocket.
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If you miss a second new patient appointment, you will not be rescheduled at GEM Neurology.
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This policy will be clearly communicated to you at the time your first visit is scheduled (after your referral or evaluation request has been approved).
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Exceptions will only be made if you provide documentation of a legitimate emergency, such as:
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Emergency room or hospital discharge papers
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Accident or incident report
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Death in the family (obituary required)
For Established Patients
- If you miss 2 appointments within a 12-month period, you will:
– No longer be rescheduled for future visits, and
– Be dismissed from the clinic, with a 30-day grace period to find another neurologist.
- If you accumulate 3 no-shows total, regardless of timeframe, you will be permanently dismissed from GEM Neurology.
What Counts as a No-Show
Any appointment missed without 24 hours’ notice, unless due to a documented emergency.
Accepted Emergency Documentation
• Emergency room or hospital discharge papers
• Official accident or incident reports
• Documentation of a death in the family
• Physician’s note verifying a medical emergency
2. What Happens If I Am Late to My Appointment?
At GEM Neurology, we value every patient’s time and strive to maintain a smooth and efficient schedule.
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Established Patients: If you are 10 minutes or more late, your appointment may need to be rescheduled.
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New Patients: If you are 25 minutes or more late, your appointment may need to be rescheduled. Additional time is reserved for new patient visits to allow for a thorough evaluation.
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If you are late without a legitimate reason, it will be considered a no-show and subject to the same policy as above.
We understand that unavoidable delays can happen. If you know you will be late, please notify us as soon as possible by phone at 865-666-4411 or email at info@gemneurology.com. We will do our best to accommodate you, but rescheduling may be necessary depending on the day’s schedule.
Exceptions for Emergencies
If your late arrival is due to a legitimate emergency or unavoidable circumstances, please inform our office immediately. We review each situation individually to ensure fairness and flexibility.
3. How do I request medication refills?
For medication refills, please start by checking with your pharmacy. In most cases, our providers make sure you have enough refills to last until your next appointment, except for controlled substances, which require closer monitoring. If there are no refills remaining, your pharmacy can contact our clinic directly on your behalf.
For non-urgent refills, you may also use our
Patient Portal, available 24/7 for your convenience. If you prefer, calling our office is always an option for any questions or immediate concerns regarding your refill needs.
4. How do I request my medical records?
To request your medical records from GEM Neurology, you have several convenient options:
Tebra Patient Portal:
Patients can print their medical records directly from the
Tebra Patient Portal. Simply log in, go to the "Medical Records" section, and select the print option for easy access.
Release of Medical Records Form:
You can call our office to have a “Release of Medical Records” form mailed or faxed to you. Alternatively, you’re welcome to pick up and complete the form in person at our clinic.
Fees
Paper Copies: $0.05 per page (invoice will accompany the records; payment is accepted online or in person).
5. What is a Medical Emergency?
A medical emergency is a serious health condition that requires immediate attention to prevent serious harm or potential risk to life.
Here are examples of medical emergencies:
Severe Chest Pain
Especially if accompanied by shortness of breath, sweating, or nausea, as it may indicate a heart attack.
Difficulty Breathing
Includes severe asthma attacks, fluid in the lung, or allergic reactions.
Sudden Weakness or Numbness
Particularly on one side of the body, which may be a sign of a stroke.
Sudden Speech Disturbances
Difficulty speaking or understanding language may also indicate a stroke.
New, Severe sudden onset of Headache
A sudden, intense headache, especially if accompanied by vision changes, confusion, or nausea.
Falls with Head Trauma
Falls resulting in head injury with loss of consciousness, headache, or altered mental status.
Uncontrolled Bleeding
Bleeding that does not stop with pressure may need immediate care.
Loss of Consciousness (New Onset)
Any unexpected loss of consciousness should be treated as an emergency.
Acute or Sudden Altered Mental Status
Sudden confusion or disorientation may indicate a serious condition requiring urgent evaluation.
Seizure Emergencies:
• Impending Status Epilepticus: A seizure lasting more than 5 minutes.
• Multiple Seizures Without Full Recovery: Two or more seizures without regaining baseline awareness between episodes.
Severe Allergic Reactions
Signs include swelling of the face or throat, difficulty breathing, or rash (anaphylaxis).
Serious Injuries
Such as broken bones, deep wounds, or injuries to the head, neck, or spine.
If you or someone else experiences any of these symptoms, CALL 911 immediately or go to the nearest emergency room for medical care.
What are the Common Signs and Symptoms of an Acute Stroke?
6. How Do I Schedule an Appointment as a New Patient at GEM Neurology?
At GEM Neurology, a referral is required for all new patients, even if your insurance does not mandate one. This ensures we have the necessary information to determine if we are the right fit for your care. Self-pay patients do not require a referral.
Steps to Schedule an Appointment:
Obtain a Referral – Your referring physician’s office must complete and submit the referral form, which can be found in the upper right corner of our homepage (next to our office phone number).
Submit Required Documents – Along with the referral form, your provider must include:
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- A copy of your insurance card (unless self-pay).
- Face sheet from your medical records.
- Relevant imaging studies (e.g., MRI, CT, PET scans).
- Your most recent physician’s note.
- Prior neurologist’s notes, if applicable.
- Send Documents to GEM Neurology – Your provider’s office should fax these documents to 615-538-9421 or mail them to 155 Frank L Diggs Drive, Clinton, TN 37716.
- Dr. Zayas personally reviews all medical records before scheduling to ensure we can provide the best possible care.
Insurance & Payment Considerations
We strongly recommend contacting your insurance provider to verify your coverage before scheduling.
7. What is the cost for a new or established patient visit if I don’t have medical insurance (Self-pay)?
For self-pay patients at GEM Neurology, the out-of-pocket costs are:
New Patient Visit: $399 (CPT 99205)
Established Patient Visit: $199 (CPT 99215)
Payment is required in advance when scheduling, whether the visit is in-person or via teleneurology.
Additional Information:
Financial Policy Agreement: The Financial Policy for Self-Pay Patients must be signed online or received in the office before scheduling an appointment. Click here to sign the Financial Policy Agreement.
No Referral Needed: Self-pay patients do not require a referral.
Click here to see the Good Faith Estimate of Expected Charges - Self Pay Patients
8. What to Expect During My First Visit to GEM Neurology?
During your first visit to GEM Neurology, we aim to make your experience as comfortable and informative as possible. Here’s what you can expect:
Arrival: Please arrive at least 15 minutes before your scheduled appointment to allow time for check-in and any final paperwork.
Check-In: Our staff will confirm your personal and insurance information. If you’re a self-pay patient, we will verify payment details.
Initial Assessment: Your provider will review your medical history, discuss your current symptoms, and ask about previous treatments or medications to understand your health background fully.
Comprehensive Evaluation: A thorough neurological examination will be conducted, which may include tests of reflexes, coordination, balance, memory, and muscle strength.
Diagnosis and Discussion: Your provider will go over initial findings, potential diagnoses, and recommend any additional tests. Treatment options for symptom management will be discussed.
Treatment Planning: You and your provider will work together to create a personalized treatment plan, which may include medications, lifestyle recommendations, and follow-up scheduling.
Patient Portal Access: You’ll receive access to our Patient Portal for easy record review, appointment requests, and communication with our team.
Duration: The first appointment typically lasts around 1 hour.
If you have questions or need assistance before your visit, please contact us. We’re here to ensure you feel prepared for your care journey at GEM Neurology.
9. Do I need a referral to schedule an appointment at GEM Neurology?
YES. A referral is required to schedule an appointment at GEM Neurology unless self-paid.