Care Expectations & FAQ

We are committed to making your experience as comfortable and well-informed as possible. The information below outlines what you can expect from our team and what we ask of our patients to help us provide the best care.

Please take a moment to review these guidelines and frequently asked questions before your visit. We look forward to caring for you.

 

I believe my loved one has dementia. What can I do to help?

Start by speaking with their primary care provider (PCP). Even if the PCP does not have all the answers, they can point you in the right direction. If the PCP determines that a referral to TMDF is appropriate, ask them to fax us a completed referral form with all required documentation listed at TMDF.org.

Additional resources are available at alztennessee.org and alz.org.

My loved one has become unrecognizable. What treatment is available to restore them to who they were before?

Unfortunately, there is currently no cure that can reverse all effects of dementia. The earlier symptoms are detected and addressed, the better the potential care outcomes may be. Early action may provide more opportunities for meaningful, quality time with your loved one.

Many resources are available to support patients and caregivers at every stage of dementia. Start by speaking with your PCP and reviewing the resources available at alztennessee.org.

If I start a referral today, how long will it take to be seen in the office?

Once all required documents are received, referrals are typically reviewed within one week. During peak periods, the review process may take up to one month.

Once a referral is approved, new patients are scheduled for the first available appointment. Depending on provider availability and patient scheduling preferences, appointments may be six months or more from the approval date. For example, 8:30 a.m. Monday appointments may be available sooner than 1:00 p.m. Friday appointments.

I have all the records. Can I complete the referral for myself or a loved one?

All referrals must be completed by a primary care provider. In select cases, we may accept referrals from a neurologist.

Because TMDF is a consult-only practice, patients must maintain an ongoing relationship with their PCP and, when applicable, their neurologist or psychiatric provider. Patients must also follow up with their PCP after any major procedure or hospitalization before returning for a routine visit at TMDF.

We understand that circumstances change and may be flexible when rescheduling appointments.

An immediate family member is being seen at TMDF, and I have concerns about my own health. Can I be seen without a referral?

All patients must have a completed referral before they can be considered for care. You may call our office and provide the name of the family member currently being seen so that our providers can consider the family history when reviewing your referral.

Our team values its relationships with patients and their families. We also want to ensure that each person is seen by the healthcare professional or practice best equipped to assist them.

My PCP sent the referral. How do I schedule an appointment?

Once we receive all documents listed on our referral form, we will contact you directly to schedule an appointment. If we determine that another practice may be better suited to meet your needs, we will contact your PCP.

You are welcome to contact us to check the status of your referral. Your PCP may send any missing documents; however, TMDF does not request missing documentation or review incomplete referrals.

Why do I need an MRI and cognitive testing before I can be scheduled? Doesn’t TMDF perform these services?

Our referral requirements generally fall into two categories: patient screening and insurance requirements.

Insurance plans may require certain evaluations, such as laboratory testing, before we can provide specific services. Our screening requirements, including brain imaging and cognitive testing, also help reduce delays by ensuring that essential evaluations have been completed.

For example, memory loss may result from a serious condition outside our scope of care, such as a tumor or an undetected stroke. Completing these evaluations before scheduling helps direct patients to the appropriate provider as early as possible and avoids delays in their care and the care of others.

My first appointment has been scheduled. What should we expect, and when will we receive a diagnosis?

Initial appointments are the longest visits and are always conducted by a provider, typically one of our nurse practitioners. The first visit may include a physical examination, a review of family and medical history, comprehensive cognitive testing, and orders for any additional testing or imaging.

When a diagnosis can be made, it is typically discussed with Dr. Crane during the second visit. This allows the providers time to review all collected information and test results.

Routine follow-up visits generally include abbreviated cognitive testing to monitor changes from the patient’s baseline and are typically conducted by a nurse practitioner.

My family member was placed on the waiting or cancellation list. How many people are ahead of us, and how can we obtain an earlier appointment?

Patients are contacted on a first-come, first-served basis.

New patients awaiting their first visit may be moved higher on the list if we receive faxed documentation of a confirmed blood-based biomarker result. We generally accept p-tau217 testing, which may be ordered by a PCP through laboratories such as Quest Diagnostics, Labcorp, or C₂N Diagnostics/Precivity.

Current patients will not be offered an earlier appointment until we receive the results of any scans or tests previously ordered by our office.

I do not currently have memory concerns, but I have a strong family history. What should I do?

Discuss your concerns with your PCP. Depending on your medical history and circumstances, your PCP may discuss genetic testing, such as APOE testing. Adults over age 55 may also discuss whether p-tau217 testing is appropriate.

These tests may support a more informed discussion with your PCP and can be ordered without a referral to a specialist. Testing decisions and results should be reviewed with a qualified healthcare provider because they may have medical, psychological, and insurance implications.

TMDF is not in network with our current insurance plan. Can we be seen as cash-pay patients?

TMDF does not currently accept patients whose insurance plans are out of network, and we are unable to offer a cash-pay option.

Insurance changes involving current patients are handled on a case-by-case basis. Patients should carefully review how a change in insurance may affect coverage for their healthcare providers, services, and medications.

For questions about your specific coverage, contact your insurance company or healthcare provider’s office rather than relying solely on information from a salesperson or broker.

My loved one’s condition has progressed. Can TMDF help with legal or employment-related paperwork, such as FMLA forms, capacity letters, powers of attorney, diagnostic letters, or conservatorship documents?

TMDF can assist current patients with a limited range of documentation for a fee. In some cases, a PCP may provide or help coordinate these services at no additional cost.

Certain matters may require evaluation by a specialized professional. For example, conservatorship proceedings may require assistance from an elder-law attorney, while capacity determinations may require comprehensive neuropsychological testing.

Current patients may contact our office for more information about the documentation we can provide.

I live in Knoxville, but my loved one does not. Can I have them referred to TMDF?

In general, TMDF asks that its patients live within the region. We may consider patients who are willing and able to travel to Knoxville for follow-up appointments every four to six months and complete all required imaging.

Medicare coverage and regulatory requirements may limit the availability of telemedicine appointments. A practice located near the patient may be better able to monitor medications and respond to urgent situations.

TMDF patients who go extended periods without scheduling an appointment may be required to restart the referral process. Patients with excessive unexcused cancellations or missed appointments may not be rescheduled.

We were told that TMDF was in network, but we received high bills for an office visit or for services ordered by TMDF, such as an MRI or laboratory testing. How can we have these charges covered?

TMDF only sees patients with insurance plans with which we are credentialed. However, coverage, deductibles, coinsurance, copayments, prior-authorization requirements, and other patient costs are determined by each individual insurance plan.

If you believe a billing error has occurred, contact the billing department for the organization that provided the billed service.

For a bill from TMDF, contact our billing department at 877-501-1257. For imaging ordered by TMDF, contact the billing department of the facility where the scan was performed, such as Provision or Abercrombie.