We appreciate your selection of Duke Neurology of Raleigh for your neurological care. Our goal is to provide you with quality neurological care in a comfortable and patient-friendly atmosphere.

Duke Neurology of Raleigh is a comprehensive diagnostic clinic for neurological disorders. We are an independent center, which strives to maintain the highest standards of care. We are certified by the American Board of Psychiatry and Neurology. Our neurologists have sub- specialty interests and training in electroencephalography, electromyography, and Sleep Medicine.

We hope the following information will answer many of your questions. Please ask our patient service representatives, nurses, technologists, or physicians any additional questions you may have about your care. Our office is in compliance with the Health Insurance Portability and Accountability Act (HIPAA).

We at Duke Neurology of Raleigh are working to help you achieve and maintain optimal health. Your active involvement is important in your diagnostic and treatment program.

We strive to provide professional and courteous care at all times. The physicians and the entire staff are concerned about you and we are always receptive to any suggestions you may have for improving our practice.

Should you have any comments about any of the services provided to you, please let us know. Only in this way can we assure that high quality, prompt and courteous services are being provided to our patients.

Thank you for selecting our office for your neurological care. We appreciate this opportunity to serve you.

Philip A. Davenport, MD
Diplomate, American Board of Psychiatry and Neurology
Diplomate, American Board of Electrodiagnostic Medicine

Vinod M. Krishnan, MD
Diplomate, American Board of Psychiatry and Neurology

Paul C. Peterson, MD
Diplomate, American Board of Psychiatry and Neurology; with special qualifications in Vascular Neurology, Diplomate American Board of Emergency Medicine

Frequently Asked Questions

Telephone Case Management Services

Automated Phone Answering

Appointment Reminders

Appointments and Cancellations

Notification of Test Results

Frequently Asked Questions

What happens during the initial visit?

Prior to your initial visit, please prepare a chronological summary of your neurological history outlining your symptoms, when they began, how they have changed, when you developed new symptoms, tests you have had and the results of them, medications you have taken for this problem, and all medications you are currently taking for any reason, including the dose and how many times takes during a 24-hour period. It would be best to bring all medications and/or over counter and any herbal supplements that you take to your appointment.

You must bring a copy of the results of any testing you have had performed for your neurological problem. Please arrive 30 minutes early for your appointment to complete necessary paperwork if not received prior in the mail. If you have the paper work complete please arrive 15 minutes prior to your scheduled appointment time.

You will be asked to provide some patient demographic and insurance information and to complete a medical history form. Please bring your insurance cards to all office visits. This information will enable the doctor and staff to better serve you. Insurance co-pays, deductibles, or balances due are to be paid at time of appointment. If you are unable to pay you may be asked to reschedule. Please contact our office prior to appointment if you have any questions in regards to payment that is due.

Your first visit is devoted to a complete neurological history and a comprehensive neurological examination. This visit will take approximately 60 minutes. It is considerably longer than most follow-up visits.

What is a comprehensive neurological examination?

Because the nervous system is complex, the neurological history and examination will explore a wide variety of body functions. The neurological examination will include tests of speech and memory, vision, strength, reflexes, coordination, balance and sensation. The examination may indicate that further tests are required.

A plan for the diagnosis and/or treatment of your neurological problem will be formulated at your first visit. A schedule for testing and follow-up visits will be established. Educational materials and resources may be provided. A full report of your consultation will be sent to your referring physician. Please be sure to give us the name and address of your primary care physician.

What is a sleep study?

A sleep study, or polysomnogram, is a recording that contains several types of measurements used to identify different sleep stages and classify various sleep problems. This study will probably be a new experience and we urge you to learn more about it before you arrive at the sleep clinic.

Many parts of the brain control sleep and influence its different stages. These levels or stages of sleep include drowsiness, light sleep, deep sleep, and dream sleep. We can tell which stage of sleep a person is in by measuring different activities of the brain and body. These activities include brain waves, eye movements, muscle tone, heart rate, and respiration.

The above mentioned activities that occur during sleep are monitored by applying small metal discs called electrodes to the head and skin. These electrodes are attached with an adhesive hypoallergenic tape. Flexible elastic belts are placed around your chest and abdomen to measure your breathing. The level of oxygen in your blood and your heart rate are monitored by a clip that fits on your index finger. None of these devices hurt and all are designed to be as comfortable as possible.

The sleep study and its analysis and interpretation involve a complex process. Many hours of work are required by specially trained people, including sleep technologists who process or score large amount of data from the night.

The information is then interpreted by a sleep specialist with special knowledge of and training in sleep and its disorders. A typical sleep study involves many pages of different types of data (e.g., brain waves, muscle movements, eye movements). Due to this time-consuming and labor-intensive process, sleep studies are usually not evaluated immediately and it may take some time to receive the results of your study. Treatment recommendations will be made if evidence of a sleep disorder is found.

Note: There is a $150 cancellation fee for EMG/NCV studies not cancelled within 24 hours of the scheduled time. This will be the patient's responsibility as an out-of-pocket expense that insurance will not cover.

How do I contact the doctor when a problem arises?

In the event of a life-threatening emergency, dial 911 and proceed to the nearest hospital emergency room for immediate care. After office hours, for any urgent problem that cannot wait until the next business day, call Duke Neurology of Raleigh at 919-862-5620 and follow the instructions.

If you are seen in the office and need to contact your doctor between appointments, please call the Patient Care Line at 919-862-5620 between 8:30 a.m. and 4:30 p.m. weekdays and select option 3 then option 2.

Please provide our nursing triage representative with as much pertinent information as possible. Organize and write down your problems before calling so that you can describe your symptoms and ask your questions. This will help our staff and answering service understand your problems and correctly convey the information. If a phone call is an emergency, please make this clear.

Our office nursing triage representatives will communicate with your doctor or other nursing staff about your problem. Urgent calls will be returned as soon as possible. Other phone calls should be returned within two working days by our nursing triage representatives.

How do I obtain prescription refills?

All prescription refills should be obtained during your office visit by telling your doctor which medications you need. Please bring a list of all your medications, pill strength and dosage to each visit. This ensures that you receive the correct medication and dose and provides the best medical care. Should you require a prescription refill please contact your pharmacy and ask them to fax us a refill request? For an emergency prescription refill, please call your pharmacy and ask them to fax a refill request to 919-862-5611. All requests for refills require approval from your physician so please allow 24 hours. Prescriptions are not refilled on nights, or weekends.

What hospital does Duke Neurology of Raleigh use?

Our doctors have privileges at Duke Raleigh Hospital.

Telephone Case Management Services

Duke Neurology of Raleigh provides nurses for telephone case management services. These nurses consult with your neurologist to convey medical decisions to you. You may be charged for case management services provided by telephone, or you may be asked to make an appointment with your doctor to review your health problems.

Many patients call frequently with lengthy questions and medical assistance needs. Rather than increase fees to all patients to cover the costs of telephone services for only some patients, Duke Neurology of Raleigh may charge for telephone calls in accordance with the American Medical Association Current Procedural Guidelines for those services. Charges will be based on the length of the telephone calls and the nature of the medical services provided. Infrequent and brief calls may not be charged. If your health plan requires a referral, it is your responsibility to advise the staff that a referral for these telephone services is required.

Automated Phone Answering

To provide better service to you and to expedite telephone calls throughout Duke Neurology of Raleigh, we have installed an automated phone answering system.

When you dial our number, 919-862-5620, you will be greeted with a menu. Please make the appropriate selection.

• To schedule an appointment: Press 2
• For directions to the office: Press 4, then 3
• For doctor or nurse questions: Press 3, then 2
• For EMG Tech: Press 3, then 3
• For billing questions: Press 4, then 2
• For medical records requests: Press 4, then 1

If you are dialing from a rotary phone, please stay on the line and you will be connected to the appointment desk.

Appointment Reminders

We have implemented a computerized personal appointment reminder system called Smart Talk provides our patients with the courtesy of a reminder call for upcoming appointments. Our appointment reminder system is programmed to call you at home two days prior to your scheduled appointment to confirm the day, date and time of your next appointment. E-mail remainders may be sent as well if you have given us an e-mail address. The Smart Talk reminder and e-mail reminder will give you the exact time of your scheduled appointment but keep in mind that we ask that you arrive 30 minutes prior to complete the check in process. If you give the front desk your e-mail address you can receive notification of an up coming appointment. You may visit healthview.dukehealth.org to create an account.

Appointments and Cancellations

We know your time is valuable and we diligently try to stay on schedule. On some occasions, emergencies do occur and appointment schedules may be altered. We will inform you as soon as possible should this happen. Your understanding is greatly appreciated. If you are unable to keep your appointment, please give our office 24-hour notice, this would allow us to make your time available to others requesting to be seen that day.

Late Arrivals

Patients 15 or more minutes late are considered missed appointments. You will be given an opportunity to reschedule.

No-Show Policy

Duke Neurology of Raleigh has instituted a no-show policy. Giving our patients undivided attention to each and every patient is important to us, as we're sure it is to you. We block out the time for your visit accordingly. In fairness to all patients and as a courtesy to our staff, please call our office at your earliest convenience upon becoming aware of potential conflicts with your scheduled appointment time.

Note: please provide at least 24 hours notice of any cancellation or reschedule. The Duke Neurology of Raleigh clinic reserves the right to charge a $50 administrative fee for any non-emergency cancellation or no show.

Notification of Test Results

If you have been or will be scheduled for a test at a laboratory, hospital for a 2- hour EEG or at any imaging center (for EEG, BAEP, VEP, SEP), and this information is important to know.

On average it will take two to six days before we have the actual results of the tests, or the radiology films. It then will take your doctor one day to review the results. If at any time in that process a serious problem is discovered, you will be called directly by your doctor or his nurse as soon as we are aware of the problem. In such situations, we often hear within 48 hours from the testing centers. After three attempts to contact you by telephone, a certified letter will be mailed to notify you of any abnormal results.

Upon completion of all ordered tests, you will be notified of the results by telephone, notification by mail or at your next scheduled appointment. You may also be notified of normal test results via the Duke's HealthView patient Web site if you have an account. Please visit healthview.dukehealth.org to create an account.

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