The Nurse Practitioner
Fees and Insurance
Two types of allergy skin testing are
usually performed: scratch tests or multi-tests on the back, and intradermal tests on the arm. Infants and small children generally
receive only limited skin testing. Immune and allergy blood test are
more frequently necessary in our very young children. The number of
tests will vary based on the patient's need. Currently these three
testing procedures are the most accurate and reliable forms of
allergy testing. If other types of allergy tests are performed,
adequate explanation will be given at that time. Children are
special in our practice. They are not small adults and are
approached according to their appropriate developmental state. Their
fears and emotional needs are given the attention they deserve. If
your child is to be tested, we will be happy to demonstrate each
type of test on you, if so desired. The tests are read fifteen
minutes after application. Following the skin tests, a treatment
conference will be held. At this time, testing results and future
care will be thoroughly discussed.
If it is necessary for you or your
child to take allergy injections, the program will be outlined
thoroughly for you at the time of your consultation. Allergy
desensitization will benefit patients who are allergic to dust,
pollens and molds. Many patients find their medication needs
decrease by 90% after a year of full-strength injections. Your
vaccine will be available at any one of our offices or it may be
sent to another clinic for administration. After each injection, it
is necessary to remain in the office 30 minutes in order to have the
arm checked for possible immediate reactions. For children getting
injections, a parent or guardian must be present at the time of
service unless a minor accompanies the child. In this case, written
or telephone permission must be obtained prior to administration or
any allergy injection. Also, co-pays for each allergy injection are
due at the time of service. You should check your individual
insurance plan to determine if a co-pay is required to avoid
unexpected account balances.
Allergy injection hours at our offices are as
Regional Office/Highland Avenue
West/Cedar Bluff Office
Monday-Thursday 8:30am-11:30am | 1:00pm-4:45pm
Emory Road/Conner Pointe 1
Monday - Thursday 8:30am-11:30am | 1:00pm-5:15pm
Shot Office/Fountain City
Wednesday, Thursday & Friday 8:30am-11:45am | 1:30pm-4:45pm
Sevierville Office/Bradford Square
Tuesday & Thursday
8:30am-11:45am | 1:30pm-4:45pm
Tuesday & Thursday
9:00am-11:45am | 1:00pm-4:45pm
Monday, Wednesday & Friday
8:30am-11:30am | 1:00pm - 5:00pm
Note: The second Monday of each month is
designated for our monthly staff meeting. On these days, shot office
hours will begin at 9:00 am.
Most patients come to our practice by
referral from their pediatrician, family physician, or other
specialist. The purpose of this visit is to obtain a detailed
history, an adequate physical examination, and preliminary lab work
necessary to establish whether allergy therapy is indicated. Allergy
diagnostic tests, if indicated, will be performed at this time and
can usually be accomplished in one visit. X-rays and diagnostic
pulmonary function testing may also be necessary during the initial
Your initial visit will be comprehensive and may require up to
four hours. Due to the length of this visit, please make alternative
childcare arrangements for other children and/or siblings. At the
completion of your or your child's evaluation, a summary of our
findings and recommendations will be sent to your referring
physician. Problems of a general medical or general pediatric nature
should remain under the care of your primary care physician.
Accordingly, it is necessary for you to have a ediatrician or
general medical doctor, as we limit our practice to the diagnosis
and treatment of allergy, asthma, and immunology.
The Nurse Practitioner
Nurse Practitioners are nurses
with a Master's Degree or specialized training in a specialty area
of nursing practice. The role of the Nurse Practitioner (NP)
involves accessing, diagnosing, and applying treatment plans
developed for patients and their families.
In our practice, the specific role of the NP involves seeing
patients, ordering laboratory tests, and a major focus on educating
patients and parents. Our goal is to provide patients with as much
information and knowledge about their illness or problem as
possible. We think of parents as partners in their child's care, and
with this in mind, learning how to care for your child, and why we
operate a certain way, is as important to their success as any
medication we may prescribe.
While the Nurse Practitioner is not a substitute for your
doctor, the NP has specific knowledge and skills and is a very
important part of your health care team. Generally, the doctor and
the NP will try to alternate your regular check ups, and when you
have an appointment with an NP, the doctor is always available for
consultation. (In order to facilitate flexibility to meet your sick
needs, sick work-in visits are made with a NP). Written guidelines
for practice, which are closely followed, have been developed for
both the NP's and physicians.
Our Nurse Practitioners:
Megan Brumbelow, FNP
Kristine Meade, FNP
Amanda Guigou, FNP
An allergist is a specially
trained physician who has broad training in pediatrics or internal
medicine and thereafter received additional training in the
diagnosis and treatment of allergic diseases such as hay fever,
allergic rhinitis, asthma, hives, drug reactions and eczema. Dr. Don Ellenburg and Dr. Tim Frazier are board certified pediatricians as
well as board certified allergists.
Dr. Ellenburg received his medical degree at the
University of Tennessee Health Science Center. After completing
medical school, Dr. Ellenburg completed three years of general
pediatric training at the University of Louisville Children's
Hospital. Following his general pediatric training, Dr. Ellenburg
completed two additional years of allergy fellowship at the
University of Louisville. During his allergy fellowship, Dr.
Ellenburg was also broadly trained in pediatric chest disease. Dr.
Ellenburg founded the Cystic Fibrosis Clinic in East Tennessee and
acted as its Medical Director for 11 years. Dr. Ellenburg is also
associated with the American Lung Association of Tennessee. He
founded Camp Wezbegon, which helps aid in the transition of care
from parent to youngster. As the field of allergy and clinical
immunology is an ever-increasing broad span of information, Dr.
Ellenburg continues to update his knowledge with yearly professional
meetings as well as independent reading.
Dr. Frazier received his undergraduate degree at the
University of Tennessee, Knoxville in Agriculture and further
medical training at the University of Tennessee, Memphis in
Pharmacy. Dr. Frazier received his medical degree from East
Tennessee State University. Dr. Frazier's residency was completed at
the University of Louisville, Louisville, KY in both internal
medicine and pediatrics where he served as Chief Resident. Dr.
Frazier completed a two-year allergy and immunology fellowship at
the Medical College of Georgia in Augusta. Dr. Frazier continues to
update his knowledge with yearly professional meetings as well as
Our staff is
readily available should you need to contact us regarding any
matter. When calling our office, state the reason for your call to a
receptionist and they will then transfer you to the appropriate
staff member. If you have a health need, a nurse will take
your call, consult with a provider, if necessary, and then call you
back as soon as possible. This type of management for our telephone
messages will help us to serve you more efficiently.
Our offices are closed during the evenings and on
weekends, therefore no medical personnel will be available to help
you with routine and non-urgent health needs. For emergencies only,
however Dr. Ellenburg and Dr. Frazier are available after hours.
(See "Emergencies") All non-urgent calls will be deferred until the
next office day.
It is not our policy to
prescribe new medications over the telephone. Long-term, maintenance
medications may be handled over the telephone if you remain
under our care, but only during regular office hours.
When calling for refills, please have available the
name and strength of your prescriptions and your pharmacy's name and
phone number. In some instances, we request the pharmacist to call
our office for medication refills. Patients with a chronic disease
need good continuity of care; therefore, we can not authorize
refills to patients who have not had an office visit in more than
one year. A follow-up appointment must first be scheduled before any
prescriptions can be authorized.
In the event that you experience
a medical emergency due to your allergy or asthma condition or due
to treatment given in our office, please call us at (865) 525-2640.
During office hours, our staff will respond promptly, giving you
instructions as to what action to take.
After hours, our phone is automatically answered by our answering service, Tri-Star Communications. They have been given
instructions to relay your emergency call to us. We will then call
you back, assess your situation and give proper instructions. We
suggest that you not go to one of the hospital emergency rooms
without calling us first in order to minimize patient cost,
inconvenience and lost time. In order to maintain confidentiality,
after hour calls can only be returned by our provider while blocking
For your safety, no routine prescription refills
will be authorized or called in after hours.
Check-Ups- Routine checkup visits are
necessary within 3 to 6 months of each patient's visit. Those
check-up visits will function to help both you and us evaluate your
progress and make any changes necessary for your care. Please be
conscientious about your follow up visits.
For our patients with asthma, it is critical that
you are seen every three months after we establish an asthma action
plan. All patients who have lung symptoms will need serial pulmonary
Sick Visits- Occasionally, problems of an
allergic nature may arise between check-up appointments and demand
immediate attention. We are always available through our telephone
nurse to discuss and meet your allergic sick-call needs. Simply ask
to speak to a nurse to schedule a sick visit.
Cancellations- If it ever becomes necessary
to cancel an appointment, we would kindly ask you to notify us at
the earliest date so that we may offer that time to another patient.
We make a sincere attempt to adhere to appointments scheduled. At
times, emergencies arise which must take precedence and may cause
Allergy Skin Testing- Further allergy skin
testing is rarely needed, however when retesting is necessary, a
provider can only order it. Appointments for repeat allergy skin
testing can be made only after direct consultation with a provider.
Appointment Reminders- As an added value
service, we will remind you of your appointments by mail. You will
also receive a reminder call two or three days prior to your
scheduled visit. If we call and leave a message, please call our
office to confirm your appointment.
Note: For all patients under the age of 18, a
parent or legal guardian must accompany the child during their
appointment. We recommend that if the child is 18 or over and still
lives at home that the parent or legal guardian continue to
Fees and Insurance
It is our desire to
render high-quality allergy, asthma and immunology care for
reasonable and competitive fees. Our fees reflect the time and
specialized procedures that are necessary to optimally treat and
care for our patients.
We realize that successful treatment is dependent on
a clear, mutual understanding between patient and physician.
Similarly, the same level of understanding must exist between you
and Allergy & Asthma Affiliates concerning the payment of medical
care. It is our goal that you are aware of our financial policies,
as to minimize any confusion in the future. A summary of our
practice's financial policies are listed below:
1. The responsibility for payment of fees is the
direct obligation of the patient/parent unless superceded by
2. Please present your insurance card at each visit;
verifying your insurance coverage at each visit significantly
reduces billing errors. It is your responsibility to verify that
your insurance plan requires a referral for each visit or
pre-certification for certain office procedures.
co-pays and or deductibles are to be paid at the time of service.
This includes office visits and allergy injections, if applicable.
4. With the
initial evaluation of any new patient, we ask that 20% of the total
fee be paid at the time of service unless superceded by contract
office will file all claims with your insurance plan based on
information you provide.
6. After an
insurance payment has been received, you will be sent a statement
for the remaining balance of the account. However, the receipt of
insurance payment does not preclude your responsibility to make a
monthly payment on the unpaid portion of your bill. A minimum
payment of 10% of the unpaid monthly balance is required. Failure to
make this payment will cause the account to become delinquent.
allergy vaccine cannot be made for any account 60 days past due.
divorce situations, Allergy & Asthma Affiliates considers the
guardian/parent accompanying the child to be responsible for
payment. Credit can not be extended to parents not present.
notify our office of you have more than one insurance plan or if
your insurance policy changes. By doing this, you help us to prevent
insurance payment delays and to minimize the need for account
correspondence with you.