Policies

PAYMENTS & INSURANCE:

We bill participating insurance companies as a courtesy to you. YOU ARE EXPECTED TO PAY YOUR DEDUCTIBLES, COINSURANCES AND COPAYMENTS for participating insurance companies. There is a charge of $35 for returned checks. Patients with an outstanding balance 60 DAYS of more overdue must make arrangements for payment prior to scheduling appointments. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT OUR OFFICE HAS UP TO DATE ADDRESS AND INSURANCE INFORMATION.

PRIOR AUTHORIZATIONS, REFERRALS & ORDERS FOR TESTS::

Office visit is required for evaluation for NEW REFERRALS and orders for tests. For CONTINUING REFERRALS patients need to be seen in our office within 3 months. We will make referrals and orders for tests that are MEDICALLY NECESSARY. Once a referral is made, ORDERS OR PRIOR AUTHORIZATIONS FOR TESTS RECOMMENDED BY THE SPECIALIST NEEDS TO COME FROM THE SPECIALIST OFFICE. We work with specialists from Endeavor & Advocate Health Systems. We refer to in-network specialists and facilities only. We do not refer to out of network specialists and facilities. We will not change diagnosis codes to modify insurance coverage. Certain prior authorizations also require a recent office visit to assess continuing need.

APPOINTMENTS, PHONE CALLS & PRESCRIPTION REFILLS:

Routine phone calls, e-messages and prescription refill requests will be addressed within 24 HOURS. If you call with urgent symptoms or cannot be evaluated in our office immediately, we reserve the right to direct you the nearest emergency room or a walk-in clinic. For matter of sufficient complexity, or those requiring frequent or lengthy discussion, we require that you make an appointment for office visit. Prescriptions for controlled substances require office visits and cannot be e-prescribed or faxed. Office visit is required AT LEAST TWICE A YEAR for prescription refill for conditions such as hypertension, arthritis, diabetes, cholesterol, among others. WE DO NOT TREAT BASED ON TEXT, E-MESSAGE OR VOICEMAIL ALONE. IF YOU SEND US A TEXT, E-MESSAGE OR LEAVE A VOICEMAIL, YOU MUST BE AVAILABLE TO SPEAK ON THE PHONE IN CASE WE NEED A CLARIFICATION. If you cannot keep your appointment, we ask that you cancel within 24 hours. After two no-shows you can no longer be seen in our office. Please be advised that any phone calls requiring a medical consultation, clinical advice, or changes to your treatment plan will be billed to your insurance as a telemedicine visit. Standard co-pays, co-insurance, or deductibles according to your specific insurance plan may apply.

MEDICAL FORMS:

Certain forms (including FMLA, short-term disability, sick leave, return to work, school or work physicals) require an office visit. If you had recently been to the office, you may still be required to come in for a separate visit if the prior visit was not specifically for the medical issues on the form.