What to Know

How do I make my first appointment as a new patient with Bulger SWPain?

You or your doctor's office may fax your most recent medical records/imaging to 214.203.1261. You may also bring your records/imaging to our office. Once we receive your records/imaging, one of our providers will review your paperwork to determine if you're a good candidate for Bulger SWPain. Bulger SWPain does not guarantee that we will accept all new patients.

How do I schedule an appointment?
Call our office at 214.389.9130 or e-mail us here. We have two receptionists and two schedulers on staff, as well as a voicemail system. If you reach voicemail, please leave a detailed message with your name and phone number. You should receive a return call within one business day.

Do I need a referral from my doctor?

No. We see many patients who have sought us out via the web, or from recommendations of other patients, friends or family. You or your doctor's office may fax your most recent medical records/imaging to 214-203-1261. You may also bring your records/imaging to our office. Once we receive your records/imaging, one of our providers will review your paperwork to determine if you're a good candidate for Bulger SWPain. Bulger SWPain does not guarantee that we will accept all new patients.

How quickly can I been seen?
You will be scheduled at the earliest opening available for a new patient. New appointments typically are available within 7-14 days, with rare exceptions. Emergency cases are seen more rapidly.

What is required for my first office visit with Bulger SWPain?

A legal photo ID, your health insurance card(s), and any copay, co-insurance or deductible for which you would be responsible. In addition, bring all your medications in their original bottles.

Will I get to see a doctor at every visit?

Bulger SWPain uses a care team approach. You may be periodically seen by a Nurse Practitioner (NP) or a Physician Assistant (PA) who are highly skilled in the specialty of Pain Management and work on a daily basis with the physician staff. The team approach allows us to assess and assign the needs of the patient to the most appropriate staff member, and ensures that you are seen in a timely fashion. The physicians are always available if any urgent matter is noted during your visit.

What happens if I am late to an appointment?
Every patient is important to us, and we try to respect your needs and time. However it can be difficult to predict the time needed for a visit, because by its nature, Pain Management encompasses a broad area of diagnosis. We embrace the challenge of finding the right therapy for each patient. This takes time, and it is not uncommon for our schedule to NOT run according to plan. We appreciate your understanding if we are running late. If you are running late, please call our office. We will make every effort to see you when you arrive, however, you may be asked to wait and be worked into the existing schedule. If your provider is no longer at the location of your appointment, you may be asked to see another provider.

I have no insurance. Can I still be seen as a new patient at Bulger SWPain?
Yes. We will see patients who do not have insurance. However, you will be required to pay for your first evaluation at the time of service. Typically a new office consultation is in the $250-$350 range. This can be discounted if we document need, as is required by Texas Department of Insurance guidelines. After the initial visit, an appointment with our business office manager will be arranged to develop a plan to cover the cost.

Does Bulger SWPain take my insurance?

Bulger SWPain accepts most health plans. We will file your insurance, but you are responsible for your copay (if any) and of course, ultimately you are responsible for your medical care.

How much will my visit cost?
The cost of a visit is largely determined by insurance coverage. Typically our services are covered, in part, by the insurance carrier; however, the patient is also responsible for a portion of the expense. Your specific insurance guidelines will give you an idea of how much our services are covered in your particular plan. To that note, if you have specific questions regarding an estimate of services, you may contact our patient account department for more information. Keep in mind, she will only be able to give estimates, and the final cost may vary.

Will insurance cover my planned pain treatment?
Bulger SWPain is contracted with most insurance companies, and will cover most procedures we perform. However, each insurance plan can be different; therefore, Bulger SWPain will call to confirm approval from the carrier prior to your procedure. Note that even though a health plan may suggest that a planned procedure is a "covered service" that you are ultimately responsible for the cost of your health care.

What if insurance does not cover the treatment recommended to me?
If insurance doesn't cover a particular procedure, we ask that you accept financial responsibility for the portion that insurance doesn't pay. We will then work with you to ensure a payment plan that is affordable, while still resolving the balance in a timely fashion.

What should I expect on my first visit?
Upon arrival to our office you will be asked to complete a medical history questionnaire to help us understand your condition. We will confirm your current demographical and insurance information, and you will be asked to sign some release forms necessary for us to obtain additional records. (You may also obtain these online and may be completed prior to arrival). A medical assistant will start a computerized medical record, asking you about your pain, how it started, and assist with any questions about the paperwork. Shortly thereafter you will typically be seen by a Nurse Practitioner (NP) or Physician's Assistant (PA) who will begin in-depth data gathering and review of your history. During this time, medical records, imaging studies and all other reports will be reviewed. A complete history of all the medications past and present, which have ever been prescribed, will be carefully reviewed. Please bring all old and current medications in their original containers. A problem-based exam will be performed. Often, during this evaluation it may be apparent that more/additional records are needed. New, or additional tests or imaging studies may be necessary before your physician can formulate a plan of care for you. Frequently, medication changes and/or treatment recommendations will occur at your FIRST visit, but not always. If any additional tests, screens, scans or consultations are deemed necessary these will need to be obtained. This information is then reviewed by a physician and a preliminary treatment plan is formulated, and will be discussed with you at your first follow up visit. Pain blocks, if recommended, may require pre-certification from your health plan and can take up to 2 weeks to obtain, depending on the type of plan and treatment being suggested. As every situation is different, it may be necessary for you to be seen every 2-3 weeks to evaluate your response to therapy. Once stable improvement is achieved, patients are seen every 1-3 months, based on need.

Why am I required to take a urine drug test on my first visit and then randomly during my relationship with this practice?
The State of Texas has extremely stringent standards of care that physicians must follow, if they feel that certain potent pain relieving medications are indicated. That is why screening tests are so important. Urine drug testing (UDT) is a useful tool in pain management that provides valuable objective information to assist in diagnostic and therapeutic decision-making. Results of a UDT provide confirmation of the agreed-upon treatment plan, which can enhance the relationship between healthcare professionals and patients. What the physician is looking for in a UDT is the presence or the absence of prescribed medications as evidence of their use. Screening tests also help us determine if you’re on the right medication. We’re also using a new DNA cheek swab test that can reveal a conflict between your metabolism and your medication.

My Doctor referred me to your office. He/she won't refill my pain medication any more. Why?
Your physician may be uncomfortable with the amount or frequency of your pain medication use and would prefer that a pain specialist help you with this. This is a common reason for referral to our practice. The reasons for this may be varied, but one common reason is that the Texas Medical Board (TMB) requires a certain level of monitoring and encourages the use of pain specialists.

I am a new patient and almost out of medications. Will I get my prescriptions refilled at my first visit?

Not necessarily. The Texas Medical Board has specific guidelines about this, and it will be necessary to review all your records, verify imaging studies, pharmacy records and correlate your current exam with past exams and records. New or additional studies may be necessary and required by our doctors. If this cannot all be accomplished at your first visit, typically a small "bridge" prescription of pain medication is given until all your data is reviewed. Please note that these TMB guidelines are very specific and may require us to actually CONTACT your previous physicians, before we can establish medical necessity for refills. As this process can take weeks to accomplish, bringing ANY and ALL records, including names of all past physicians, pain treatments, surgeries, pharmacy names, etc. will help speed the process immeasurably.

I am too busy to come in. Can my medication be refilled over the phone?
Bulger SWPain does not refill any medications by phone. All medication changes require an office visit.

My regular doctor refills my other medications via fax from my pharmacy. Why don't you do this?
Bulger SWPain does not refill any medication by fax from your pharmacy. You are given enough medication to last to your next visit. Any need for an early refill suggests adjustments are needed, and due to the sensitive nature of the medications prescribed, requires an office evaluation.

My medications were lost/stolen/misplaced. Will I be able to refill them early?

No. Even if you have filed a police report on the theft, we have a strict policy of non-replacement for any lost, stolen, misplaced medications. Each situation will be treated on a case by case basis but, the Texas Medical Board (TMB) has made prevention of diversion a priority in Texas and we are dedicated to the process.

I am going on vacation and I will run out of medications while away. Can I get early refills?

No. Bulger SWPain has a strict policy on this. If you are out of town or on holiday, you will have to arrange for a relative or trusted individual to pick up your medications at the appropriate time and forward them to you by any method you choose.

A procedure has been ordered, but I don't understand what it is; how can I learn more about it?
Please see the "services" tab on the home page for animated/dialogued explanation of all procedures we perform.

What should I do to prepare for a pain management procedure?
Unless told otherwise, do NOT eat or drink anything for six hours prior to your arrival time. (You may take any prescribed medications with a small sip of water only). You must arrange a driver. It is not necessary for the driver to wait at the office, but must be contactable by phone to take you home. A driver is necessary because we use anesthesia and sedatives to make you comfortable during the procedure. Additionally, the use of anesthetic medication in your "pain block" can cause temporary numbness that might impair your ability to operate a vehicle. You should wear comfortable clothing and leave all valuables at home. While your transportation may hold onto personal belongings, there is no locked storage to maintain your belongings during your procedure. You should arrive at the time you are given. This time includes the necessary time to prepare you for your procedure. It is important to disclose all medications you take or medical history you have prior to scheduling your procedure. Please TELL US IF YOU ARE ON ANY BLOOD THINNER! Conditions that require you to take a blood thinner will change the date when we are able to schedule your appointment. It is required that we have clearance from your cardiologist to stop the blood thinner, as it poses a risk to the procedures we perform. If you are diabetic, we must also modify your scheduled time or medication/dietary schedule to maintain your blood sugar levels.

Can I choose NOT to be asleep or sedated for my pain treatment?

Many simple procedures (such as trigger point injections, hip bursae injections, etc.) can be performed under local anesthesia, however many advanced pain management procedures are uncomfortable without sedation/anesthesia and the ability to perform many of these procedures safely depends on a still and comfortable patient. In our experience, being asleep or sedated makes the process easier for both YOU and your doctor.

I have received a bill that I don't understand. Who do I contact?
Call the Bulger SWPain office at 214-389-9130 and ask for the Business Manager