For Established Patients
If your child or teen is an "active" patient in our practice, this page is to help you manage situations that arise outside of scheduled appointments.
Emergencies:
In an emergency, proceed immediately to the nearest emergency room. Screening for psychiatric emergencies is handled by emergency room staff or by local crisis response in hospitals throughout our region. Dr. Grcevich has no ability to directly “admit” your child to any psychiatric facility or program. When you have arrived at the emergency room, feel free to share Dr. Grcevich’s cell number (440) 589-4350 with the emergency room staff.
If your child is becoming violent to the point that they are at risk of causing serious harm to themselves or another person, please call your local police department and then notify Dr. Grcevich. Dr. Grcevich responds to emergencies only for active patients. An “active patient” is defined as a person who has received services from the practice within the past six months.
Patients obtaining medical services from Dr. Grcevich will receive prescriptions sufficient to last until the next scheduled follow-up visit, unless specifically discussed in the follow-up plan for very stable, long-term patients. If you run out of medication, the usual reasons are that you missed an appointment, canceled an appointment or rescheduled for a later date. Exceptions may occur when Dr. Grcevich is initiating a new medication, adjusting the dose of medication, or discontinuing medication. If you cancel or reschedule an appointment and need a new prescription or refills prior to your next appointment, please e-mail Dr. Grcevich at least five working days in advance of your child's prescription running out. We don’t accept prescription requests from pharmacies by phone or fax.
There will be a minimum $50.00 charge for prescriptions provided outside of scheduled appointments unless a medication change is initiated by Dr. Grcevich. If more than one prescription is requested outside of a scheduled appointment, there will be a $10.00 charge for each additional prescription. The credit card you keep on file with us will be charged.
The recently enacted requirement by the Ohio State Pharmacy Board that all prescriptions for controlled substances (stimulant medications for ADHD, benzodiazepines used in rare instances for treatment of acute anxiety) has greatly added to the practice's administrative burden and significantly increased the length of initial evaluations and follow-up appointments. It also means that prescriptions need to be rewritten if families choose to use a different pharmacy between the time the original prescription was issued and the time they desire to have a prescription filled if their child's medication is considered a controlled substance. This sometimes happens even in situations when a family/patient desires to fill their prescription at a different location within the same pharmacy chain. Because of the time burden involved in responding to prescription requests, the $50 minimum charge will apply when Dr. Grcevich is asked to respond to these requests. The same charge applies when due to no fault of Dr. Grcevich, pharmacies insist upon prescriptions being reissued.
Phone Calls, E-mail and Texting:
Dr. Grcevich does not respond to phone calls or text messages during sessions. Most phone calls will be directed to voice mail. Calls will usually be returned during breaks in the schedule or at the end of the day. E-mail or text are preferred methods of communication. He usually responds to routine phone calls, e-mail or texts within two business days.
Dr. Grcevich’s cell phone number is (440) 589-4350. Please do not share this number with anyone except professionals involved with your child’s care so he might continue to prioritize patient concerns. This number may be shared with your child’s pediatrician or primary care physician, psychologists, counselors, or therapists involved in your child’s care or teachers/ administrators from your child’s school.
If your concern can’t be resolved with a brief phone call, e-mail or text exchange, Dr. Grcevich will likely request you schedule a formal appointment to address the concern, either via telemedicine or in-person.
Letters, Reports and Forms:
The production of letters and other forms of written communication can be extremely time-consuming for Dr. Grcevich. Time spent in response to requests will be billed on a pro-rated basis of Dr. Grcevich’s hourly rate with a minimum charge of $87.50 for any letters or reports requested of us by parents or school officials. Exceptions to the policy for which there is no charge include:
Forms for dispensing prescription at school
Brief letters including a diagnostic summary to support necessary accommodations at school
An evaluation summary to your child’s referring clinician and/or primary care physician upon
your signed, written request.
"Prior Authorization" Requests for Prescriptions from Pharmacy Benefit Managers, Insurers:
The vast majority of prescriptions Dr. Grcevich writes are for medications available in generic form for a modest cost. Effective December 1, 2022 Dr. Grcevich refuses to respond to prior authorization requests for prescribed medications available at reduced cost in a generic form. Insurance companies or pharmacy benefit managers (PBMs) often demand prior authorization for very inexpensive medications when arbitrary limits are exceeded on the number of pills in a prescription – more than one pill a day or 30 pills per month.
In situations when Dr. Grcevich prescribes medications unavailable in generic forms and prior authorization is required companies frequently demand highly detailed explanations of why previous medication trials failed and new documentation uploaded. These demands have become more detailed and complex as apps and software have been rolled out to simplify the process. To take advantage of the process, physicians need to use integrated electronic record systems that aren't used in our practice.
The same policy that applies to letters and reports will apply to prior authorization requests - time spent in response to requests will be billed on a pro-rated basis of Dr. Grcevich’s hourly rate with a minimum charge of $87.50. Prior to submitting such requests, Dr. Grcevich will attempt to notify parents if the cost of the medication does not justify the anticipated time required for the prior authorization process. In 2022, the average prior authorization request took more time to fulfill than was spent in the most common type of follow-up appointment.
It is your responsibility to pay for any medication prescribed to you or your child. If you are unable to do so, please contact Dr. Grcevich. He is happy to work with families to identify affordable treatment alternatives.
Dr. Grcevich encourages families to become knowledgeable about their prescription drug coverage and use tools such as GoodRx to comparison shop the cost of their child's prescriptions through the different pharmacy chains.
Release of information: Click here to download a release of information if you'd like records to be shared with other professionals involved in your child's care. Please initial (do not check) all lines on the release that pertain to your child and all lines on the bottom of the first page as "YES" since this information is contained in your progress notes. On the second page, please indicate "YES" to all categories that pertain to your child, sign and date.