Patient’s Agreement to Abide by Office Policies
In order to provide our patients with the best quality of care in the most timely manner, we have established these policies. We welcome your comments, positive and negative, and any suggestions. Our clinic office hours are 8:30 a.m. to 5:00 p.m. Monday through Thursday, and 8:30 a.m. until noon on Fridays. Doctors' schedules may vary from these hours. Physicians are on call 24 hours a day, seven days a week for emergencies.
Payment – Payment in cash, check, or credit card is expected at the time of service unless other arrangements are made in advance. We accept Visa and MasterCard.
Co-Payments – AII insurance and HMO co-payments are due at the time of the office visit prior to seeing the doctor. We are unable to bill for co-payments.
Insurance – We file any insurance with which we have a contract. Please check with us prior to seeing the doctor to make sure we accept your plan. Claims for any other insurance companies with which we are not contracted must be filed by you. After you pay us, we will provide you with the receipt you will need to send to your insurance company. In any case, you are reminded that, regardless of insurance coverage, you are responsible for paying the full balance due in a timely fashion.
Delinquent Accounts – If you fail to pay your bill or the bill of anyone for which you are also financially responsible (such as a child or spouse), the following charges also apply:
Office Visits – Office visits are made by appointment, only. We do not take walk-ins. The office is extremely busy and we try hard to accommodate everyone. Where possible, please call at least one to two weeks before you would like to see the doctor as we cannot guarantee same-day or next-day appointments. Please call and let us know if you will be unable to make your scheduled visit.
The nature of our practice is to give our patients the best possible care and service. Therefore, you may experience delays in being seen. Please be assured that you will be attended to as promptly as possible and be given the same careful attention as those who came before you.
Failure to Keep Appointments – After three times of failing to notify us that you will be unable to keep your appointment, you will be required to select a different clinic for your medical needs. There will be a charge for appointments broken with less than 24 hours notice.
Medical Students – From time to time, the doctor may have medical residents or students who are in training working with him or her. If you do not wish to have one of these students or residents see you, please let us know in advance.
Phone Calls – The doctor is quite busy during office hours, therefore he or she cannot be disturbed to answer or return phone calls unless it is an absolute emergency. If you need to speak to the doctor or the nurses, please leave your detailed message and phone number with the receptionist and someone will return your call by the end of the work day. If you need to speak to the doctor after hours for emergencies only, he or she will be paged and return your call. Patients who abuse this privilege will be asked to find medical services elsewhere.
Labs – If you have lab work done while at the office, we do not routinely call with normal lab results. We will call if any lab work is abnormal, if changes in prescriptions need to be made, or if the doctor wishes to discuss results with you. Normal lab results will be discussed at your next office visit. The lab companies bill independently from this office.
Prescriptions – If you need a refill, please allow 24 hours for your request to be completed. The doctors do not call in prescriptions after business hours or for health reasons, may not be able to renew your prescription until you have been seen. Let us know the name of the medication, the dosage (such as 250 mg tablets taken twice a day), and the name and phone number of your pharmacy. If you haven't seen the doctor recently, you may need to make an appointment to review your medical history and make any necessary changes before your prescription can be refilled. Some prescriptions require prior authorization from your insurance company and this may take up to a week, so please call well in advance of your needs.
Drug Abuse and Addiction – The doctor may refuse, except in an emergency, to issue a prescription if in his or her estimation, there is concern that a patient may be abusing or be addicted to that drug. In such a case, we will notify the patient to come in for an appointment to evaluate the situation. If we determine that treatment for addiction or abuse is necessary, we will assist the patient in making the appropriate arrangements. Patients are expected to fully cooperate with and complete any program approved by the doctor. Those who refuse to abide by this policy will be asked to find medical services elsewhere.
Referrals – We try to obtain referrals as soon as possible, however some may take up to five to ten working days. We will mail you the referral as soon as it is obtained. We appreciate your patience during this time.
If you are thinking about changing your insurance plan, please make sure the doctors you see (including the cardiologist, urologist, GYN, podiatrist or any other specialist you may be seeing) are on that new plan. We cannot get a referral for a doctor that is not included in your insurance.
Living Wills and Powers of Attorney – Please inform the receptionist if you have living wills or powers of attorney that pertain to your care. We will need copies and, in some instances, originals of these documents.
Medical Records – Your medical records may only be released after you have filled out and signed the appropriate forms. A copying charge of up to $1.00 per page may be billed to you.
Office Policies Form in PDF for printing