How Our Office Works

Locations:
30 East 76th Street in Manhattan & 99 Maple Avenue in White Plains
Telephone: 212-794-3550 (appointments & general questions – ext. 0, prescriptions – ext. 1, Botox-related and billing – ext 2, prior authorizations and medical records – ext. 3)

First Visit:  Your first visit will consist of a thorough diagnostic interview and examination, and your initial diagnosis will be discussed at its conclusion. Together we will design an individualized treatment program for you, to include prevention of further attacks, and tools to manage an acute headache.  Please bring to your appointment your insurance card, physician referral forms (if required), any recent X-rays and appropriate records, and the completed New Patient Packet paperwork, which you can download below or can be faxed to you.
Download initial visitform

 (.pdf)
Download follow-up form (.pdf)
Download HIPPA_Authorization_for_Disclosure_of_Health_Information.pdf
Download Headache Diary

 (.pdf)

Children under 18 must be accompanied by an adult for initial as well as follow-up visits.

Please DO NOT wear cologne, perfume,  scented lotions, or deodorants to the office and do not eat in the waiting room. Odors are migraine triggers for many sufferers. We also ask you not to speak on your cell phone in the waiting room.

Insurance: The New York Headache Center providers (except for Dr. Mauskop) participate with the following insurance plans: Aetna, Aetna EPO, Aetna HMO – requires a referral with CPT codes, BCBS, Cigna, Emblem GHI/HIP (only Dr. Shkolnik), Horizon BCBS PPO, MVP PPO, Oxford Freedom, United, but not United’s NY Exchange plans. Any charges not covered by insurance will be your responsibility. We request payment at the time of your appointment for services not covered by insurance.  For your convenience we accept: your personal check, cash, MC, VISA, AMEX. Your insurance company may also require you to pay a co-payment at the time of your appointment.  Any pre-authorization required by your insurance company is your responsibility, but we will try to assist you.

If you require completion of any additional employment, insurance or legal forms you may be charged $25 to $250 per form.

Follow-up: Like other chronic conditions such as diabetes or arthritis, headaches require on-going re-evaluation and treatment modification.  Our goal is to help you gain control of your headaches and your life.  Frequent follow-up visits may be needed initially, but the frequency will decrease as headache treatment progresses.  As an exception, we allow follow-up consultations over the phone for people unable to come to the office because of distance or disability. These are almost never covered by insurance.

If you are suffering from a severe attack that requires an injectable non-narcotic medication (available in our office), nerve blocks, or another procedure, we will try to see you on the same day.  We make every effort to keep you out of the emergency room, where care is often delayed and suboptimal.

Emergencies/After-Hour Calls: During regular office hours (Monday through Friday, 9 to 5) call the office for an emergency headache issue.  For all headache emergencies outside of office hours, call your provider directly on his/her cell phone or go immediately to the nearest emergency room.  Please do not call providers’ cell phones and do not text for prescription refills and other routine matters.

Missed Appointments: We try to allow as much time as each patient needs to discuss current problems and therefore we do not overbook.  We typically have a waiting list for new patients.  Therefore, we ask you to confirm your appointment at least 24 hours in advance.  If an appointment is missed or not canceled 24 hours in advance your credit card will be charged $75 for a follow-up visit and $250 for initial.

Calling Your Provider: While we want you to feel free to call with problems or questions, we interrupt our time with other patients for emergencies only.  All calls will be returned as soon as possible; this usually will be towards the end of the day, but may roll over to the following day.  When you call, please leave a number where you can be reached both during the day and later in the evening.  E-mail is an alternative, but please keep e-mails brief and do not use them for urgent matters. We may charge a fee for high volume email exchanges.
 
Alexander Mauskop:  drmauskop@nyheadache.com
Lynda Krasenbaum: LJK@nyheadache.com
Lisa Yablon:  DrYablon@nyheadache.com
Sara Crystal: DrCrystal@nyheadache.com
Leonid Shkolnik:  DrShkolnik@nyheadache.com
Romee Patel: Romee@nyheadache.com
Olga Chrzastek:  Olga@nyheadache.com

Prescription Refills: Prescriptions written at the time of your office visit should cover you until your next appointment.  If you run out of medication please call the office prescription line for a pharmacy call-in.
Exceptions: 
1) If you are seriously overdue for an appointment your prescription may not be called in; as a general rule, you need to be seen at least every 6 months for regular prescriptions and every 3 months for controlled substances;
2) Routine prescriptions cannot be filled after hours or on an emergency basis;
3) Narcotics and sleeping medications cannot be called in and are written only at the time of an office visit, so please do not allow these prescriptions to run out without an office visit scheduled.
We need the following information to call in prescriptions:  
1) Medication name (if you do not use generics, please so state).
2) Dose in  milligrams.
3) The number of pills you take each day and in a month.
4) Pharmacy telephone number.

About reimbursement for Botox injections
Botox is the most effective and safe treatments for frequent migraine headaches. Since 2010, when Botox was approved by the FDA for the treatment of chronic migraines in adults, many insurance companies started to pay for it. However, getting the insurers to pay is not a simple process. Most of them require prior authorization, which our staff takes care of. However, you need to be aware of several prerequisites for getting this prior authorization approved.  First of all you have to have 15 or more days with headaches each month for the preceding 3 – 6 months. It doesn’t mean that you have to have 15 days with migraine – you can have 8 days with migraine and 7 days with a milder headache, although some insurers are less specific. Some may also require that the migraine headache, if left untreated, lasts at least 4 hours. We encounter many patients who will say that they have two migraines a week and do not mention the milder headaches, because unlike migraines, they usually are not disabling. It is a good idea to keep a diary (a paper one, which you can find on our website under the Initial Visit Forms or use an electronic Migralex Headache Relief Diary for iPhone) since it will provide documentation of the frequency, type of headaches you have and other information useful not only for the insurer but for your doctor too.

The second requirement is that you try and fail two or three (depending on the particular insurer) prophylactic migraine drugs, such as topiramate (Topamax), divalproex sodium (Depakote), gabapentin (Neurontin), propranolol (Inderal), amitriptyline (Elavil), etc. The drug is considered to have failed if it doesn’t help after the dose is escalated to the usual strength or if it causes unacceptable side effects, even at the smallest dose. Some insurance companies will request documentation from us or your previous doctors that you in fact tried those drugs.

Getting prior authorization does not guarantee that the insurer will pay for the Botox treatment and they clearly state that. After we perform the treatment and ask for payment they will often request doctor’s notes to verify that the treatment was appropriate and all the requirements were met. Even after the payment is issued, the insurer has the right to review charts and ask us for money back for up to six years after the service was provided, if they feel that the code used was wrong or some other requirement was not met. This is why you will have to sign a number of forms informing you about all these caveats.

It is also a good idea to check with your insurer yourself. All this information about Botox is usually posted on their website, but if not, call and write down the information along with the name of the person who gave it to you.

While most patients require Botox injections every 12 weeks, some need them more frequently – every 10 weeks and rarely, every 8 weeks. A few of the insurance companies allow injections every 10 weeks, but many pay for this treatment only every 12 weeks and some only every 3 months, to the day. Our staff can check about your plan’s policy.

Although Botox is not approved in children under 18, it is as effective in kids as in adults. Many insurers will pay for Botox in children if all of the above conditions are met. The youngest child with chronic migraines we’ve treated with Botox was 8.