Patient Information

Getting Ready for Your Visit

In order for us to provide the best care for you, it is very important that you bring the following items to your visit:

  • Photo ID
  • A list of your current medications
  • Any and all x-rays films
  • Insurance information and card
  • Information about what treatments and medications have been tried in the past
  • Medical records from prior visits that you think may be helpful
  • If you are a new patient to Crossville Medical Group, please arrive a few minutes before your scheduled appointment time to complete registration paperwork.


Q. How effective are pharmaceuticals at managing GERD?   Pharmaceuticals like PPIs and H2 blockers can be very effective at treating acidic symptoms of GERD for some patients.  However, medications are usually quite ineffective managing symptoms such as regurgitation of liquids or solid foods back into the esophagus. Thus, the risks of inury to the esophagus may not be controlled with medication alone.

Q. What medical diagnostic tests might be used to diagnose my GERD?  Any one or more of the following my be needed to diagnose and confirm GERD in certain patients.  Upper GI  Endoscopy (EGD), esophageal acid monitoring (pH monitoring), barium esophagram, esophageal Manometry, and various medical tests such as EKGs, blood work, and others to exclude other medical problems that could mimic GERD symptoms.

Q.  When should I consider surgical intervention? Ask your doctor whether surgical intervention,either laparoscopic or TIF (incisionless procedure), might be appropriate for you.  If your current GERD therapies are ineffective and you are concerned about the side effects and adverse long-term consequences of medication, talk to your doctor about a referral for discussion of other treatment options.

Q.  How many TIF procedures have been performed?  Over 14,000 TIF procedures have been performed.  At Tennessee Heartburn Clinic, we have performed more than any center in this part of the US.  The device used during the TIF procedure was FDA approved in 2007 and is indicated for the treatment of chronic GERD and to narrow the gastroesophageal junction and reduce hiatal hernias less than  or equal to 2 cm.

Q.  Is the TIF procedure covered by my health insurance? Third party payor coverage for TIF is increasing constantly. Many plans require you or your surgeon to submit paperwork for preauthorization since this is an elective procedure. Patients may be asked to pay a deposit prior to scheduling surgery which is refundable when their insurance covers and reimburses for the procedure.

Q.  Are there diet restrictions following the TIF?  Since TIF alters the lower esophagus and upper stomach, the healing that must take place needs a few weeks to finalize.  For the first 3 weeks, patients are on a soft diet and encouraged to eat slowly, chew their food very well and expect to eat multiple small meals daily rather than trying to eat larger meals three times daily. Most patients tolerate these suggestions very well and weight can be maintained.

Q.  What is Barretts esophagitis?  This is a condition that occurs from chronic reflux of stomach contents into the esophagus and damages the lining of the esophagus causing a change of the cell type lining the esophagus. Given time,this change can progress to a cancerous condition of the lower esophagus.  It cannot be predicted which patients will develope this progression. Therefore, frequent monitoring by endoscopy is merited.

Q.  Is TIF considered investigational?  Absolutely not.  Some insurance companies and third party payors are very slow to review the literature regarding and introduction of newer procedures and treatments.  When a procedure is introduced that they have not become familiar with, they often assign a designation of “investiagtional”  to the procedure so they can monitor its growth and utilization.  This often means patients must endure paperwork,  appeals, and delays on occasion when working with their insurance/payors. As is evidenced by various insurance companies and even some Medicare payors recognizing and paying for TIF, this procedure has long since not been investigational or experimental.

Q. Do I need a referral to see Dr. Fox at Tennessee Heartburn Clinic?  No referral is needed to make an appointment to see Dr. Fox unless your specific insurance company requires such. Please check your policy.