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Services Offered

Outpatient PharmacyEast Tennessee Children’s Hospital Outpatient Pharmacy serves patients within the State of Tennessee who are taking specialty medications. Our team will work with you and your doctor to help you get the best results from your drug therapy. Our services include:

  • Coordination with your insurance company for medication coverage
  • Free medication delivery to your home
  • Medication refills
  • Side effect management
  • Financial assistance
  • 24/7 clinical support

Introduction to Services

Once we receive approval from your insurance provider to dispense your child’s medication, your child we be enrolled in our specialty pharmacy
service.

Patient Management Program

As a patient of our specialty pharmacy, we will keep watch over your medications and your overall progress through our patient management  program. This program will help you manage side effects, increase your ability to stay on your drug therapy and improve your overall health. A limitation of the program is that you must be willing to follow the treatment plan your care team created. On a regular basis, we will review:

  • Current medications you are on and if they are still right for you
  • Any side effects you are experiencing
  • Your response to therapy
  • Your ability to stay on therapy

This service is provided to your family at no additional cost and enrollment is optional. You may contact us at any time to be removed from this service.

How to Fill a New Prescription

We will work with your child’s prescriber when a new medication is needed. In many cases, your child’s prescriber will electronically send the prescription to the specialty pharmacy. However, you may also reach out to the Children’s Hospital Outpatient Pharmacy to obtain a new prescription directly from your child’s provider. 

Insurance

Children’s Hospital Outpatient Pharmacy Staff will work with your child’s physician and your insurance company to get your child’s specialty prescription covered. This process is called prior authorization. While prior authorization may often take a few business days to complete, our team will be sure to keep you and your child’s doctor informed of each step of the process. We will send insurance claims to your insurance on 
the date your prescription is filled. 

Appeals

If your insurance denies coverage for your child’s medication, you may have the right to file an appeal with your health plan. Our specialty pharmacy team has the knowledge and resources available to help you with the appeals process.

Medications not available at the outpatient pharmacy

If the Children’s Hospital Outpatient Pharmacy is unable to provide your child’s specialty medication, we will work with you and an appropriate  pharmacy to ensure you receive your child’s medicine. If you would like your child’s prescription transferred to another pharmacy, please contact  the pharmacy to transfer the prescription on your behalf.

Financial Assistance

Specialty drugs can be expensive, even after insurance pays most of the cost. If you cannot afford your copay, Children’s Hospital Outpatient Pharmacy staff will research available financial assistance programs to help reduce your out-of-pocket expense. The outpatient pharmacy works with a number of foundations and manufacturer programs that provide financial assistance for specialty medications.

Prescription Delivery

We will contact you to determine how you would like to receive your child’s specialty medication. We can coordinate free delivery to your home, your doctor’s office or an approved alternate location. You may also pick up your child’s prescription at our location inside Children’s Hospital.

If you choose to have your child’s medication delivered, the outpatient pharmacy will ship securely. If you cannot be there to accept the package, we can arrange for it to be left at your home or at another approved location. If you feel your child’s medication has not been maintained at the  manufacturer’s recommended temperature, please contact the Children’s Hospital Outpatient Pharmacy immediately. 

Order Status

Check the status of your order by calling and speaking to our staff.

Refill Reminders

You will receive a courtesy call from the Children’s Hospital Outpatient Pharmacy about a week before your child’s next refill is due. At this time, we will confirm that your child is still taking the medication, verify shipping address, and connect you with a clinical pharmacist if you have any questions or concerns about your child’s treatment. You may also order refills yourself by:

Drug Recalls

If your medication must be sent back for any reason, the Children’s Hospital Outpatient Pharmacy will contact you with instructions that have been given by the Food & Drug Administration (FDA) or drug manufacturer. 

Drug Changes

Sometimes generic drugs need to take the place of brand name drugs. This can happen if your insurance company wants you to use the generic drug or it may be done to lower your co-pay. If this change needs to be made, a member of our staff will contact you before shipping your medication.

Payment Policy

  • Copayments: You may have to pay part of your medication cost called a copayment. This must be paid at the time of pickup or shipment. We accept all major credit cards.
  • Financial Assistance: We will help enroll you in assistance programs to help with copayments and make sure there are no financial barriers to starting your medication. These programs include discount programs from drug manufacturers and assistance from various disease management  foundations.