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Jim Gagne MD: Patient & Practice Information

I'm a physician certified in internal medicine, pain medicine, and addiction medicine.

Who am I and what do I do?

I specialize in treating patients with chronic pain and addiction. I see patients privately 1-1/2 days a week in two locations: Glendale, just behind Glendale Adventist Medical Center, and in Pasadena on Lake Avenue. I'm also a physician consultant at two addiction treatment facilities: the Canyon in Malibu CA and Harmony Place in Woodland Hills

What sort of treatment do I provide?

I kid my patients that I have a "disease": I take too long and I'm too thorough! I take the time I think patients need to receive comprehensive care, typically 2-4 times longer than most other physicians spend in a visit. I believe passionately that an adequate visit is essential to arriving at the correct diagnosis and treatment, counseling, and in tailoring treatment to the unique needs of each individual. Many of my patients believe I'm the first physician who has truly listened to them.

For patients with problems with drugs or alcohol, I've been practicing addiction medicine since 1988 and believe this depth of experience provides a considerable head start in your recovery. I will provide a detailed assessment, perform outpatient detox, and refer you to any specialists or other treatments you may need. I prescribe Suboxone, Zubsolv, and other brands of buprenorphine and naloxone for many patients addicted to opiates. As an alternative, I also provide monthly Vivitrol (naltrexone) injections. Vivitrol is useful in opiate addiction and may also be helpful in alcoholism.

Patients with chronic pain require a highly detailed and specific approach to their care. I don't do injections or other procedures but instead try to understand all of the factors that contribute to causing and maintaining your pain. I'm an expert in medication management and helping people with medication use issues. Often the crucial question is why haven't you gotten better? Understanding how you are different from any other patient with chronic pain is critical. I believe I do especially well with patients no one else knows how to treat.

The only downside to spending the time patients need is that it costs more than rushing people out the door. That's why I'm "out of network" for medical insurance. I don't bill insurance directly but will assist you in obtaining the maximum possible reimbursement.

I've moved my office

Until 2014, I practiced internal medicine full time with the Verdugo Internal Medicine group. Frankly, it was too hard to make a living in primary care, and I was almost practicing for free. In 2/14 I closed my internal medicine practice and moved to Pasadena, sharing space with Dr. Hilary Fausett. In June 2015 she modified her practice and asked me to no longer use her office. I'm now spending all day Tuesdays in the office of Dr. Chris Charbonnet, a superb interventional pain management specialist. He's right behind Glendale Adventist Medical Center at 1530 E. Chevy Chase Drive, Suite 204, Glendale CA 91206. Validated parking is available in the building's lot.

On Fridays I'm at 424 N. Lake Avenue, Suite 102, sharing space with Dr. Michael's Wellness Center. I'm there for half a day from 11:00 AM to 3:00 PM. There's plenty of free parking. Here are directions and a map.

Contact Me

1530 E. Chevy Chase Drive, Suite 204
(Dr. Chris Charbonnet's office; click for a map)
Glendale CA 91206
(818) 790-4300 (voice)
(818) 790-4301 (fax)

To schedule an appointment

Please call weekdays from 9:00 AM to noon, 1:00 PM to 5:00 PM, to make an appointment: (818) 790-4300.

Change in Billing

While I was at Verdugo Internal Medicine, it was hard to earn enough revenue to cover my overhead and still have something left over at the end of the day. In a small, part-time practice there is no simple, affordable way to bill insurance directly, and many of you don't use insurance or have found it doesn't pay well anyway. So we do cash plus insurance: everyone pays at the time of service, and we'll provide you with a "superbill" to send to your insurance so you get the maximum insurance reimbursement. Credit cards will work fine.

Medicare patients: This will work the same way, with two exceptions. First, Medicare determines the fees you will pay, which are lower than my standard charges. Second, we will automatically send statements to Medicare about your encounter, so Medicare and your secondary insurance will reimburse you for most of the cost of the visit.

Workers compensation patients: For now we'll continue to bill workers compensation for your care, same as always. Frankly, it's always required frequent calls to the insurance company to get them to pay the fees they've agreed on, and that will be difficult to do with the new arrangement. We'll see how it goes.

The Prior Authorization Hassle

For many years insurance companies required prior authorization ("prior auth") for certain expensive, brand-name drugs, especially if a cheaper generic equivalent was available. This didn't come up too often and was usually quick and painless.

This has all changed since 2013, as drug companies relentlessly increase their prices. Most brand-name drugs now require prior authorization, even if there's no generic. Many generics need them too. Because it costs insurance companies money to do this, some companies have offloaded much of the time and expense to the prescriber and made it as difficult as possible to reach them. Here's how it works:

First, the pharmacist faxes me a note asking for prior auth, including the patient information, insurance 800 number, and the patient's special drug ID number. These numbers are different from the ones on your insurance card. If the information is incorrect, I have to call the pharmacist to get that updated. Without this information I can do nothing.

Next, I call the 800 number. About half the time the pharmacist has given me the wrong phone number, and I can't get through to anyone. I have to call the pharmacy to get the correct number. Or I call the insurance company, wait on hold, and am redirected to another number. Or it's after 2 PM and they're closed.

When I do get through, I wait up to an hour on hold. Occasionally they won't take my call at all and insist I fill out a form on a web page, which takes 20 minutes. (That way they don't have to pay a clerk to enter this information.)

If an insurance clerk will speak with me, we spend a few minutes going over the same information as before. Usually the clerk can authorize the medication, but occasionally it must be reviewed by a pharmacist. They'll fax me the determination in 1-2 days. The authorization is good for three months, six months, or a year.

The bottom line is that it often takes 20-40 minutes to get a prior auth for each patient, which is much worse than before. This is as much time as I spend on a patient visit. It was tolerable when I was doing one or two prior auths a week, but recently it's one or two a day. So now you'll be charged $42 for each prior auth unless I can get it done in a few minutes. (Unfortunately, insurance won't cover this charge.)

Biography and Practice Information
Health Information Articles and Handouts
Fifteen Minutes of Fame
Extraordinary Maturity
Spirituality in Medicine


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Last updated Fri, Jun 19, 2015

©2011, James Gagné, MD. All rights reserved. Except where otherwise indicated, Dr. Gagne is the sole author of all content.