***TexasMD Administrative/Courtesy Services $0 free e-mail responses from MD (when appropriate) $0 free refills from pharmacy fax (if you have been seen in the office in the past 6 months) $25 co-payment billing fee: if you do not have the required co-payment at the time of your visit $25 composing a letter or filling forms, each, up to 4 pages $25 each prescription prior authorization, good for 6 months $25 each specialist referral authorization, up to one year $25 each prescription call-in to pharmacy, or "mail-in" written outside of an appointment $50 Missed Appointment Fee (For no-shows, or rescheduling with less than one business day notice) $50 Drop-in fee (if you want to be seen in the office without an appointment) $50 Phone Visit with M.D. (scheduled phone consult, up to 15 min) ***Phone Visits "Phone Visits" are pre-scheduled, live telephone consultations with Dr. Peikari. These appointments last up to fifteen minutes and may be used in lieu of a traditional Office Visit in appropriate situations. Certain conditions, such as colds, bladder infections, back pain, and management of chronic diseases (e.g. hypertension, diabetes, cholesterol) can be safely and appropriately managed in this setting. Additionally, this is an option for discussing test results, medication changes, etc. This is an alternative to coming to the office to see Dr. Peikari, and saves you the time and cost associated with a traditional office visit. This is appropriate for patients that have previously been seen in the office by Dr. Peikari; only established patients may utilize this option. The charge for this service is $50 per use. At this time, 3rd party insurance payors and Medicare do not cover the cost of Phone Visits, and we will not bill it to them. Payment is due in advance, at time of request for the Phone Visit; a credit card is required. Please call the office to schedule these, and have a list of your symptoms, concerns and questions ready.