Common Questions 

and Answers

A. An allergist should be certified by the American Board of Allergy and Immunology which is the only allergy subspecialty board recognized by the American Board of Medical Specialties. This ensures that your physician has had at least 2-3 years of subspecialty fellowship training in an ACGME-accredited training program and has passed the board exam in Allergy and Immunology. Dr. Khalid is board certified by both the American Board of Allergy & Immunology and the American Board of Internal Medicine.

A. A complete evaluation includes a comprehensive allergy history, physical examination, and allergy skin test. Many new patients will have additional tests depending on the nature of their problem, such as breathing tests. You could expect to be in the office for approximately 2 to 3 hours. 

(To save time, please print and complete new patient packet and medical history forms under “Patient forms” tab prior to arrival) 

A. Skin testing is the primary way to identify your allergies; if possible, this will be done on the first visit. There are two types of tests which are performed:

Percutaneous (prick) tests – a skin prick through a drop of allergen on the patient’s skin, usually either the back or the forearm.

Intradermal test – an injection of a small amount of allergen into the skin on the arm.

The number of tests may vary depending on each patient’s history. The results of the tests are interpreted 15 minutes after they are applied. Please do not apply any moisturizers to your skin before testing.

Because certain medications block allergy skin tests, we advise patient to stop taking them prior to allergy testing if it is OK with the prescribing physician (Please refer to detailed information under “Patient forms” and “Allergy testing instructions” section). Do not stop any of your asthma medications. 

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A. Skin tests, in most situations, are preferable because the results are available immediately and they are more sensitive to allergies as compared to blood tests

A blood test is appropriate in certain situations, particularly when you (1) cannot stop antihistamine therapy or any other medications which can inhibit skin tests, (2) have widespread skin disease making skin testing difficult, (3) poor lung function or uncontrolled asthma or (4) cannot be skin tested for some other reason. 

A. Patch Tests for Chemicals, Orthopedic and Dental Materials: This type of allergy testing involves applying patches with test substances in small chambers or discs to a person’s back or upper arm. The patient will return to our office in 48 hours to have the patches removed and read and the final read will be performed at 96 hours

Chemical patch tests: are used to detect allergic contact dermatitis to something a person has contacted or exposed to

Orthopedic patch tests: are used for patients who have had a reaction to the metal or one of the components such as bone cement, adhesives, etc. used during joint replacements.

Dental patch tests: can be done for people who are having problems in their mouth or gums after having various dental procedures.

A. Allergies: Sinus pressure, nasal congestion and runny nose may occur during an allergy flare. The nasal discharge in allergies is usually clear and watery. The symptoms can be treated with an increase in allergy medications.

Colds: An upper respiratory infection, commonly known as a cold, usually last about 10-14 days, and is often accompanied by other symptoms of illness such as a sore throat, thick, colored nasal discharge, fever and muscle aches. Decongestant medications and sinus rinses are helpful in relieving symptoms of a cold or a sinus infection.

Sinus Infections: Sinus infections can cause a headache and pressure in the forehead or around and under the eyes. Nasal congestion and colored discharge is also a common symptom. A virus or bacteria can cause a sinus infection. Many sinus infections are over-treated and resolve in the same amount of time without an antibiotic. Viral infections do not respond to antibiotics. Decongestant medications and sinus washes are helpful in relieving symptoms of a cold or a sinus infection. 

A. Allergies and colds cause very similar symptoms. Colds are caused by a viral infection, and symptoms often last up to two weeks while your body’s immune system tries to defeat the virus. Sometimes, the nasal mucous color starts out clear, but then it often turns cloudy and/or discolored before it eventually goes away. Sometimes a virus is accompanied by a fever, headache and muscle aches. Allergies are genetic hypersensitivity that causes a reaction when a person is exposed to something. As a person breathes in the allergen, the immune system over-reacts and causes symptoms of itchy eyes, such as sneezing, congestion, or runny nose. Allergy symptoms can last for several weeks or months, and in some people can occur year-round. Typically, the nasal discharge is thin and watery and allergies do not cause fevers. Fortunately, allergies can be easily diagnosed with skin tests and can be treated with allergen avoidance and/or medications, including immunotherapy, a series of desensitization injections.

A. You should verify with your insurance carrier the specific benefits of your plan. If your insurance company requires a referral to pay for services, please contact your primary care physician to insure that the referral is sent to our office PRIOR to your appointment. Your healthcare insurance company mandates that we cannot see you without a written referral.

We wish to stress that the financial responsibility for payment rests entirely with the patient. Many patients have the mistaken belief that their insurance company is responsible to the doctor, and that it is the doctor’s obligation to be sure benefits are paid. This is not the case.

You will need to bring your insurance card and a picture ID to your visit. We will collect co-payments, deductibles and co-insurance at the time of your appointment.

A. What makes cluster immunotherapy different from conventional therapies is the frequency with which the shots are given - and how quickly a patient gets to what is known as their maintenance dose. The maintenance dose is the dose that proves most effective for treating the individual patient’s allergies. Because patients get to the maintenance dose faster with cluster immunotherapy, they also often feel better faster with this approach. During Cluster, the patient receives 2-3 injections every 30 minutes and by the end of the visit, most patients have completed a month’s worth of immunotherapy injections in a 2 hour visit. 

A. A biologic is a medication made from the cells of a living organism, such as bacteria or mice, that is then modified to target specific molecules in humans.

Recently, several new medications, known collectively as “biologics,” have been approved for the treatment of moderate-to-severe asthma, atopic dermatitis and nasal polyposis. Biologics are unique in that they target a specific antibody, molecule, or cell involved in asthma. Because of this, they are known as “precision” or “personalized” therapy.

A. Each time a patient misses an appointment without providing proper notice, another patient is prevented from receiving care. Therefore, we require 24 hour cancellation for all appointments both new and follow-up.  If you fail to cancel your appointment in this time frame, we will bill you $45 for established patient appointments and $88 for new patient appointments. 

A. For all life threatening emergencies please call 911 or proceed to the nearest Emergency Room. Otherwise, if consultation is needed with the allergy physician, dial 816-453-7771 for instructions on how to contact the physician on call.

A.  Routine prescriptions should be filled during regular office hours.  It is strongly recommended that all refills be requested during regular business hours, which allows time for appropriate patient care. Please call our office at 816-453-7771 or call your pharmacy. 

A. All insurance plans are different.  Please contact your insurance provider for your benefits.  Codes to check on are as follows:  Skin Testing 95004 and 95024. Allergy Injection: 95115 or 95117. Extract 95165. *For allergy injections:  there will not be a physician charge unless you are having a shot evaluation or have a reaction.

A. If you need a Prior Authorization, call our office at 816-453-7771.  Our office will call your insurance company and complete the paperwork.  We will notify you and/or your pharmacy when we get an answer from the insurance company.  This process can take several days. 

A.  If inclement weather occurs, please check our website and/or call our office at 816-453-7771

A. Please be aware that paperwork from your employer or insurance company does require a significant amount of office resources to ensure accuracy and completeness.  Our office charges within the guidelines imposed by the State of Missouri to complete these forms.  We process these requests quickly upon payment for their completion.