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For Changing Or Canceling Your Appointment
● If you “no-show” or cancel appointments without giving enough notice, YOU (not your insurance company) may be charged $25 prior to your getting a second appointment. This will be the standard and not the exception, but we will look at each individual case.
● To change MONDAY appointments, call by 10am on the previous FRIDAY. ● To change Tues-Fri appointments, call at least 24 hours in advance.
● Repeatedly failing to keep appointments may result in discharge from the practice.
It takes away times when others can be seen and it takes away revenue from the practice.
On Financial Responsibility
● YOU ARE RESPONSIBLE FOR PAYING YOUR BALANCE, EVEN IF ● Your insurance/guarantor denies payment, ● pays only partially, ● refuses to pay for any reason. ● This includes co-pays due at the time of service and co-insurance fees and costs applied to your deductible.
● If you are not familiar with these terms or if you do not understand your coverage plan, please consult with your insurance company immediately. As a courtesy, when time allows, we may try to verify your insurance coverage, but it does take time and ultimately, it is the patient’s responsibility to understand his or her plan, including eligibility to see us, co-pays, co-insurance, and deductibles. In the event that coverage fails, financial responsibility falls back on the patient. Patients should call the phone number on the back of their insurance card to verify benefits. Contracts sometimes change, so it is important that patients know what their insurance covers.
● Self pay charges are due at time of appointment.
● Currently, we are not in Network with several insurances including Blue Cross Blue Shield. These patients will need to pay the self pay charge amounts.
Wait time for Medication Refills:
● Please allow processing time of 24 hours after your in-office visit and 72 hours for refill requests through your pharmacy or Patient Portal.
● Calling us back early and/or calling repeatedly can substantially delay our ability to get that script to your pharmacy, as it ties us up on the phone and keeps us from doing the work necessary to process your request.
Medication Requests for in-office visits:
● Requests for medications should be requested at THE BEGINNING OF THE VISIT with the Medical Assistant (before the provider sees you)!!! Please do not wait until the end of your visit to request refills!
● Reminder: Failure to show up for appointments may result in a charge of $10 in order to get your refill. Non-Controlled Medication Refills ● When you need a refill for a medication that is not a controlled substance:
● Please, regularly keep track of the number of refills you have. You should be prompted at your visit to provide us with your preferred pharmacy as well as your preference for 30-, 60- or 90-day requests. ● Actively check and keep track of your current bottle to see if you have refills left at your pharmacy
● Contact Pharmacy first to request refills. Pharmacies will contact us if they have questions.
● If you know you are low on refills and do not have a scheduled appointment, please contact the office to make an appointment.
Controlled Medication Refills
● WE ASK THAT YOU REQUEST CONTROLLED MEDICATION REFILLS AT LEAST 5 DAYS BEFORE RUNNING OUT OF YOUR PRESCRIPTION. (THIS INCLUDES TESTOSTERONE) ● Understand, many of the prescriptions cannot be filled until around two to three days before you run out
● With Testosterone, please, indicate in the patient portal, when your last dose was taken or will be taken
AUTHORIZATIONS AND REFERRALS
● All referrals must be requested through your Primary Care Provider. We request that you have your PCP send us your records via fax at 844-518-2784
● If we are an out of network provider for your insurance, we CANNOT put in referrals or Prior Authorizations.
● FOR FAXED OR VERBAL REQUESTS INITIATED BETWEEN OFFICE VISITS: it may take up to 72 business hours for us to fulfill these requests. Again, calling multiple times could delay processing, so please be patient.
● FOR INQUIRIES ABOUT PRE-AUTHORIZATIONS FOR IMAGING STUDIES OR MEDICATION PRESCRIPTIONS, please allow 7- 10 work days to fulfill these requests. We cannot control how quickly insurance companies respond!
● Most paperwork, including prior authorizations, and referrals are done on Fridays. We will do our best to work on these requests as time allows and will take into consideration the time sensitivity of cases. ● Please, use your judgement in contacting our office before the time period mentioned. Patients should make first contact through the patient portal and then by phone.
ADDITIONAL SERVICES WHERE ALLOWABLE
We charge for additional services not reimbursed by your insurance. Because a substantial amount of time is required for clerical activities that are not reimbursed by insurance companies. We make every effort to keep your costs down.
● Requests for medical records from our office: Our office must receive a Release of Information Request from the provider needing the records. This should be faxed to us at 844-518-2784
● You may also pick up a physical copy of your medical records at the office.
● Requests for printed medical records are $.50 per page printed.
● You may be charged $10 for medication refill requests between scheduled and appropriate visits. Please, make every effort to keep your appointments.
● Form completions are a minimum of $10. We will try to keep the cost under $30, but understand that they are based on the amount of time needed for completion.
● Charges for Medical Letters begin at $30 per hour with a minimum of half an hour ($15).
● We will make every effort to keep patients informed as to any changes regarding these policies.