POLICIES

 

IMPORTANT INFORMATION REGARDING RETURN PHONE CALLS

Please be aware that our office has one main phone line, and several other “private” lines. The main line is not always available when we are attempting to reach you for things such as return phone calls or appointment reminder calls. If your phone does not accept blocked calls and we are unable to reach you, we may not always have time to make repeated attempts. In these cases, we must put the responsibility in your hands to contact us.

In addition, if you place an after-hours emergency call to Sandy (Dr. Hoyte) through our answering service, it is your responsibility to ensure that she will be able to reach you from her personal private phone.

IMPORTANT INSURANCE INFORMATION

We will collect a co-pay from you at the time of your visit and file an insurance claim for you with your carrier. We will bill you for any balances that are subsequently assigned to you by your carrier, including any coinsurance, deductible, and denied charges. You are expected to pay your balance within 30 days of the billing date.

YOU ARE RESPONSIBLE FOR PROVIDING US WITH UP-TO-DATE INSURANCE POLICY INFORMATION. In the event that we must re-file a claim due to incorrect information, you will be charged a $25 re-filing fee.

You are also responsible for knowing what your policy covers. We have no way of knowing the rules of your insurance, so if there are any questions about what services are covered, please call your insurance carrier.

IMPORTANT DISTINCTIONS RELATING TO SCREENING AND WELL-CARE:

Many insurances are distinguishing at what level they cover “screening” or “well-care” (i.e. physicals with screening lab work; screening bone mineral densities). Some policies have an allowance for preventive care that will cover the services related to your annual physical, while other policies do not. Please make sure that you understand the limitations and/or exclusions that may exist under your policy. Let us know BEFORE YOUR PHYSICAL EXAM if there are specific limitations and/or exclusions in your coverage that pertain to SCREENING or WELL-CARE. While these types of visits are coded appropriately as SCREENING or WELL-CARE, if you do not have a preventive allowance in your policy, your insurance may not pay.

If you let us know prior to your exam that your policy contains limitations, we may be able to provide your insurance company with applicable NON-WELLNESS codes, or DIAGNOSTIC codes, for some of the lab work that is done as part of your annual physical. For example, if you have “high cholesterol” or “hypothyroidism” or “family history of heart disease”, we can provide appropriate codes other than general wellness codes that would allow consideration outside of the SCREENING or WELL-CARE arena. Obviously, we are not going to put ourselves at risk of fraudulent billing, however we can often justify testing that is normally done as part of your annual physical as diagnostic monitoring/testing.

WE CANNOT CHANGE THE CODES ONCE THE CLAIM IS SUBMITTED, so it is imperative that you provide us with the information prior to your visit.

PRESCRIPTION REFILL POLICY

Please allow 24-48 hours for refill requests to be processed.

Please plan ahead: routine prescriptions are not refilled after hours or on weekends.

If you have a managed care health plan, and the medicine you need is not on their formulary, you may need to obtain a Prior Authorization Request (PAR). This requires filling out paperwork and submitting it by fax. The insurance company may take up to 72 hours to respond to the PAR, so please take this into consideration as well.

If you have a "tiered" system of co-pays for medications, please be sure to ask the pharmacist what the medication actually costs. Occasionally, your co-pay will exceed the cost of your medication and the pharmacist may not have the opportunity to tell you up front.

APPOINTMENT CANCELLATION POLICY

Women’s Primary Care understands that, occasionally, you will be unable to attend your scheduled appointment. When this happens, we ask that you kindly notify our office as early as possible, so that we may open your appointment time to patients who may need more immediate care. We request that, when possible, you provide 24 hours notice. Please remember that given advance notice, someone else may benefit from your reserved time slot.

Unfortunately, we have frequently experienced patients missing their appointments without any advance notice. Such occurrences are detrimental to both our business and to our other patients waiting for an appointment.*

Ultimately, you are responsible for remembering your scheduled appointment time. We understand how busy and hectic personal schedules can get, and, time allowing, we try to help by placing courtesy reminder calls, especially for physicals and other appointment types that are booked in advance . . . . . However, unlike many other medical offices you may attend, we are a small practice and do not always have the luxury of extra time, so please be aware that reminder calls are not a service we provide.

The following fee schedule is in effect for appointments that are missed without advance notice:

Missed Appointment for a Scheduled Physical.............$75.00

Missed Appointment for a Scheduled Procedure........$50.00

Missed Appointment for Laboratory Visits...................$10.00

Help us maintain the standard of quality care that we strive to maintain.

Thanks for your support.

*Women’s Primary Care reserves the right to dismiss from the practice any patients who frequently miss scheduled appointments.