Frequently Asked Questions (FAQ)

The Howell Allen Clinic accepts patients by physician referral only. If you are a patient and have questions about our referral or appointment process, please call our office at (615) 327-9543 between 8:30 a.m. and 4:30 p.m. Monday through Friday.

If you are a physician, you may refer a patient to the Howell Allen Clinic by calling (615) 327-9543 or (800) 668-9410. Same-day appointments can be requested.

Information about what to bring to your first appointment and what to expect can be found on our patients page.

The Howell Allen Clinic has nine locations to serve its patients. Locations and maps can be found on our locations page.

We are open from 8:30 a.m. and 4:30 p.m. Monday through Friday, except for holidays. We have an answering service available for emergent after-hours calls.

The Howell Allen Clinic is a provider for most insurance plans, including PPOs and some HMOs. We are also a participating provider for Medicare.

Our charges are determined by multiple factors including: complexity of the problem, review of symptoms, physical findings and radiological tests, and the type of treatment. You are advised to check with your carrier regarding benefits and authorization guidelines. Health insurance plans vary considerably in their benefit coverage. Failure to verify your carrier’s coverage may result in a reduced insurance payment and a higher cost to you. Please note that insurance contract networks change frequently. Our staff will assist you in obtaining this information if necessary.

Howell Allen Clinic will make every effort to obtain full payment from the insurance carrier on your behalf. If your insurance does not pay the entire fee, you are responsible for paying the balance in a timely manner. Patients are expected to pay their co-payment for office visits at the time of service. If payment presents a financial hardship, or if you have no insurance, please contact Patient Account Services at (615) 327-9543 or toll-free at (800) 668-9410 to establish a mutually agreed-upon payment plan.

We request payment at the time of your appointment for services that are not covered by your insurance. Your insurance company may also require you to pay a co-payment at the time of your appointment.

If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call our office at (615) 327-9543. Questions regarding your coverage and benefits should be directed to your employer or insurance company.

An Uninsured/Self-pay Discount (Financial Hardship) Program is available. This program provides a managed care-like discount to patients who qualify. For more information, call (615) 327-9543.

Most insurance plans require “pre-authorization”,”pre-certification”, or “second surgical opinions” before they will approve some tests, procedures, and hospitalizations. Please check your insurance card for that information or call your carrier for directions. It is your responsibility to notify our office whenever prior authorization or a second surgical opinion is required. If you receive an evaluation or treatment without pre-certification, your insurance may refuse to pay your bill. We will assist you in obtaining pre-certification for any test, therapy, or surgery. However, patients are ultimately responsible for contacting their insurance carriers to ensure that prior authorization has been received.

Howell Allen Clinic participates in most HMO, PPO, and POS programs. HMO and POS programs may require a referral from your primary care physician (PCP). Please obtain this referral form from your PCP and bring it with you to your appointment. The referral form may also be faxed to Howell Allen Clinic by your PCP. Howell Allen Clinic cannot treat patients without authorization from their primary care physician because we will be penalized by the HMO or POS.
Howell Allen Clinic accepts assignment on all Medicare patients. Please provide us with information regarding any supplemental insurance you have. We will submit the claim to Medicare for you. Once payment or denial has been received from Medicare, we will bill your supplemental insurance for the balance of the claim. After payment or denial has been received from your supplemental plan, we are required by law to bill you for any deductibles or co-insurance amount.
Yes, the Howell Allen Clinic does treat workers’ compensation patients.
Please provide us with the name of the workers’ compensation carrier, address, claim number, contact person and phone number at the time the appointment is scheduled. If your employer has not authorized your visit, you will be expected to pay for your visit at the time of service.
Disability, family medical leave, or loss-of-time claim forms will be completed by Howell Allen Clinic upon payment of a nominal charge. Please fill out your portion of the form and deliver or mail it to our office with a check or money order attached.
In most cases, the method of getting your test results will be determined when you undergo testing. If you have additional questions or are unsure how you will get your test results, call your physician’s office at (615) 327-9543.
Refill requests can be made by phone Monday through Friday during regular office hours. Please allow at least 24 hours for the request to be authorized by your physician and called in to the pharmacy. Refills cannot be made at night or on the weekends by the on-call physician or nurse, so be sure to call ahead of when you need your refill.
Call our office at (615) 327-9543 and our staff will assist you with the forms.
No, we do not. Pediatric neurosurgery is a separate sub-specialty.
HIPAA is the acronym for the Health Insurance Portability and Accountability Act of 1996. This federal statute was enacted by Congress to ensure and improve the continuity of health insurance coverage for U.S. workers changing jobs. It also mandates rules to maintain the privacy of protected health information, to establish security requirements to protect that information, and to develop standard identifiers.
Our physicians are affiliated with:

  • The Hospital for Spinal Surgery, Nashville, TN.
  • Baptist Hospital, Nashville, TN
  • Centennial Medical Center, Nashville, TN
  • Skyline Medical Center, Nashville, TN
  • St. Thomas Hospital, Nashville, TN
  • Williamson Medical Center, Franklin, TN
A neurosurgeon is a physician specially trained in the prevention, diagnosis, treatment and rehabilitation of disorders that affect the brain and spinal cord and all of the surrounding and supporting structures, including peripheral nerves and blood vessels going to and from the brain and spine. Although surgery is an important part of what neurosurgeons do, they are also experts in the diagnosis and nonsurgical treatment of these diseases.

After four years of medical school, neurosurgeons enter a training program consisting of a one-year internship in general surgery and then a residency program of five to seven years in neurosurgery to become eligible to take the final examination of the American Board of Neurological Surgery and become board-certified in neurosurgery. Some neurosurgeons also complete fellowships after their residencies.

Take this quick word association test. What do you think of when you hear “neurosurgeon”? You probably said to yourself “brain surgeon”. You’re half right. Actually, less than half right. Neurosurgeons do operate on the brain, and that is their public image. But neurosurgeons spend about 70 percent of their time treating spine problems.

Neurosurgeons are medical specialists who diagnose and treat the entire nervous system. That means they treat disorders of the brain, spinal cord and spinal column, plus the nerves that travel through all parts of the body such as the hands, legs, arms and face. They routinely see patients for low-back pain, carpal tunnel syndrome, epilepsy, stroke, Parkinson’s disease, sciatica, pinched nerves in the neck, sports injuries, chronic pain and a host of other ailments.

The American Association of Neurological Surgeons, a scientific and educational association for neurosurgeons, recently completed a statistical study that shows the range of neurosurgeons’ expertise. The number one surgical procedure performed by neurosurgeons was spine (includes back and neck disorders), followed by brain (includes aneurysms, tumors and head injuries), CSF shunting (for hydrocephalus), peripheral nerve (includes carpal tunnel), pain management (includes medication pumps and deep brain stimulation) and blood vessel abnormalities (includes strokes). That study focused on surgical procedures.

However, despite that study and notwithstanding what their name implies, neurosurgeons are not simply surgeons. That is another common misconception about neurosurgeons. Their role in treating disease is far more extensive than performing surgery. Neurosurgeons often provide or recommend nonsurgical care. They diagnose what is wrong and work with the patient to develop the optimal treatment plan, whether that includes surgery or not. For example, most cases of back pain are treated with anti-inflammatory medication, physical therapy and muscle relaxants. A common treatment a generation ago, surgery is now considered necessary for only a small percentage of back-pain patients.

Some of the specific disorders of the brain, spine and nerves commonly treated by neurosurgeons include:

  • Aneurysms – an abnormal increase in diameter (dilation) of a blood vessel.
  • Carotid artery disease – a disorder affecting one of the major blood vessels that carry blood to the head and neck.
  • Carpal tunnel syndrome – a painful condition that occurs when the ligaments in the wrist are inflamed after being aggravated by repetitive movements.
  • Cerebral palsy – a motor nerve disorder caused by a permanent brain defect or an injury at birth or soon after.
  • Cervical spine disorders – conditions that cause constant pain in the neck or shoulder, tingling or numbness in the arms or weakness when using arms or hands.
  • Chronic pain – pain that generally persists or recurs over a long period of time.
  • Craniosynostosis – a birth defect in which the bones of the skull close prematurely, limiting or distorting the skull’s growth.
  • Epilepsy – a disorder that causes abnormal electrical discharges in the brain.
  • Head injury – a major health problem commonly occurring in teens and young adults. The most common effects of a head injury are a hematoma (blood clot in the brain) or contusion (“bruised brain”).
  • Herniated disc – a break in the cartilage surrounding a disc in the spine, causing pressure on spinal nerves that produce pain down the legs.
  • Hydrocephalus – a disorder in which too much spinal fluid, usually under high pressure, accumulates in the cavities of the brain.
  • Low-back pain – the second most common chronic pain after headaches. Causes include disc herniation, spinal stenosis, tumors, infections and inflammatory diseases.
  • Lumbar spinal stenosis – a narrowing of the spinal canal that may result in nerve compression as well as pain that travels from the lumbar spine into the legs.
  • Parkinson’s disease – a slowly progressing disorder caused by damage to brain cells. Symptoms include tremor, or involuntary and rhythmic movements of the hands, arms, legs and jaw, stiffness of the limbs, loss of spontaneous movement and an unsteady walk.
  • Pituitary tumors – growths in the pituitary gland, which rests at the base of the brain.
  • Sciatica – inflammation of the sciatic nerve, usually accompanied by pain and soreness of the thigh and the leg.
  • Spina bifida – occurs during the third and fourth weeks of pregnancy, when a portion of the fetal spinal cord fails to close properly. As a result, the child is born with a part of the spinal nerve roots protruding from the back. With early treatment, the child can lead an active and productive life.
  • Spinal cord injuries – commonly referred to as a “broken” neck or back, spinal cord injuries can lead to paralysis and loss of motor function in the arms and legs.
  • Stroke – caused when normal blood supply to the brain is interrupted. This can happen by a blood clot (ischemic stroke) or bleeding in the brain (hemorrhagic stroke).
  • Trigeminal neuralgia – a disorder of the facial nerve, which may cause painful spasms.
  • Tumors of the brain and spinal cord – symptoms occur due to pressure on neural structures, with resultant irritation or destruction.

Neurosurgeons are well-prepared to deal with a variety of complex cases. They have one of the longest training periods of any medical specialty. They spend four years in an accredited medical school, complete an internship that may last a year and then complete five to seven years in a neurosurgical residency program. In addition, some neurosurgeons opt to complete an additional fellowship in a specialized area of study after their residency. The years of training are necessary because of the complexity of the nervous system. The advanced training also enables neurosurgeons to use some of the most sophisticated techniques in medicine. Few medical specialties come close to neurosurgery in terms of technological advances. Neurosurgeons use three-dimensional brain imaging, incision-free stereotactic neurosurgery, operating microscopes and other cutting-edge techniques to treat patients.

Acoustic tumors (neuromas) are typically slow-growing, benign (noncancerous) tumors that develop on a portion of the eighth cranial nerve that connects the inner ear to the brain. An acoustic neuroma is sometimes also called a vestibular schwannoma or neurolemmoma. See Howell Allen’s Specialties page.
Lumbar laminectomy is the removal of part of the bony canal around the nerve to relieve pressure. It can be preformed through an opening or using minimally invasive techniques. See Howell Allen’s Specialties page.
Patients with a herniated disc or stenosis, which is a narrowing of the spinal canal, are eligible for minimally invasive lumbar laminectomy/discectomy or “band-aid’ back surgery. It is an outpatient procedure, performed in approximately 45 minutes. “Band-aid” back surgery can be done for any part of the spine – cervical, thoracic or lumbar. See Howell Allen’s Specialties page.
Stereotactic radiosurgery is a highly precise form of radiation therapy used primarily to treat tumors and other abnormalities of the brain. See Howell Allen’s Specialties page.
Endovascular neurosurgery is the minimally invasive treatment of neurovascular diseases affecting the brain and spinal cord. See Howell Allen’s Specialties page.
The Howell Allen Clinic physicians are general neurosurgeons and have been practicing for a combined 231 years. Some of our doctors have specialized in particular areas of neurosurgery and have received additional training related to these specialties:

  • Acoustic Tumors
  • Brain Tumors
  • Complex Spine Surgery
  • Endovascular and Surgical Treatment of Aneurysms and Arteriovenous Malformations (AVMs)
  • Minimally Invasive Lumbar Laminectomy/Discectomy
  • Sports Concussion
  • Stereotactic Radiosurgery

See Howell Allen’s Specialties page.

An MRI (magnetic resonance imaging) is a diagnostic procedure that uses a combination of a large magnet, radio frequencies, and a computer to produce detailed images of organs and structures within the body. An MRI is often done to examine the brain or spinal cord.
EMG stands for electromyography, and this test is performed to measure the electrical activity of muscles. It is important in determining whether you are having a problem related to specific nerves, the brain, the spinal cord or a particular muscle.
EEG is the abbreviation for electroencephalogram. An EEG test is designed to record brain waves. Brain waves are the electrical activities and signals that the brain creates.
A CT scan is an X-ray technique that produces images of your internal organs that are more detailed than those produced by conventional X-ray exams.