FINANCIAL POLICIES & PATIENT PRIVACY

Financial Policies

1. Per your insurance plan, you are responsible for any and all co-payments, deductibles, and coinsurances. Copays are due at the time of your office visit.

2. Any and all charges not covered by your insurance company are your responsibility. If you are experiencing financial hardship, please inform us so we can make arrangements for you.

3. Patient balances are billed upon receipt of your insurance plan’s explanation of benefits., A payment plan may be arranged if you have a financial hardship.

4. If our office does not participate in your insurance plan or if you do not have insurance, payment in full is due at the time of your office visit.

5. Health insurance is a contract between you and your insurance company. It is your responsibility to be familiar with the specifics of your insurance policy, including, but not limited to vaccine and doctor visit coverage, referral/authorization requirements for specialty care, radiology, lab tests, and emergency and/or hospital care.

6. Not all services provided by our office are covered by every insurance plan. Medical care and treatment is dictated by medical necessity alone and may not be covered by your medical insurance. Any service not covered by your plan will be your responsibility. 

7. Filling out insurance claims is a courtesy that we extend to all of our patients.

Appointments

1. Please arrive on-time for your scheduled appointment. If you are late for an appointment, we will do our best to accommodate you. However, it may be necessary to reschedule your appointment to a later time or day depending on the severity of your illness or injury.

2. Missed and canceled appointments affect the operation of our practice and your fellow patients who could have been seen during the time set aside for your appointment.

3. Multiple missed appointments may result in dismissal from the practice. As a courtesy, we can text an appointment reminder to patients but ultimately, the responsibility to remember and be on time to an appointment is the patients.

4. We strive to minimize wait times but unexpected emergencies and prolonged visits are unavoidable. We appreciate your patience and understanding.

5. It is the patient’s responsibility, as the insured, to be familiar with the specifics of their insurance policy regarding Well Care Visits and Office Visits. 

6. A Well Care Visit, also known as a Routine Physical, is a Preventative Health Maintenance Visit. Insurance typically covers Well Care Visits and does not require a copay at the time of the visit. Please note, however, that if an additional diagnosis or chronic condition is discussed, an additional component will be added to the visit and may result in a copay or additional charge to, and from, your insurance.

7. An Office Visit is a non-routine visit for a specific health problem, question, or concern. This visit is problem-oriented and meant to address a specific health question. Your insurance may require us to either collect a copay at the time of the visit and/or apply charges for the visit to your deductible/co-insurance per insurance requirements.

8. Well Care Visits and Office Visits may be coded at the same appointment if both were done at the same appointment. (e.g. a patient was seen for a Well Care Visit but discussed hypertension as well.)

HIPAA

Important information regarding HIPAA (Health Insurance Portability and Accountability Act)

This notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law.  It also describes your rights to access and control your protected health information.  “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.

Uses and Disclosures of Protected Health Information

Your protected health information may be used and disclosed by your physician, our office staff, and others outside of our office involved in your care and treatment for the purpose of providing health care services to you, to support the operation of ourpractice including payment of your health care bills, and any other use required by law.

Treatment

Protected health information will only be disclosed to provide, coordinate, or manage your health care and related services. This includes the coordination or management of your health care with a third party. For example, your protected health information may be provided to a physician to whom you have been referred so that the physician has the necessary information to diagnose or treat you.

Payment

Your protected health information will be used, as needed, to obtain payment for your health care services. For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan so that hospital admission may be obtained.

Healthcare Operations: 

Your protected health information may be used or disclosed in order to support the business activities of your physician’s practice. These activities include, but are not limited to; quality assessment activities, employee review activities, training of medical students, licensing, and conducting or arranging for other business activities.  For example, we may disclose your protected health information to medical school students that see patients in our office. Additionally, we may use a sign-in .sheet at the registration desk where you will be asked to sign your name and indicate your physician. We may also call you by name in the waiting room when your physician is ready to see you

We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment. 

We may use or disclose your protected health information in the following situations without your authorization. These situations include: Public Health issues as required by law,

Public Health issues as required by law, Communicable Diseases:  Health Oversight:  Abuse or Neglect:  Food and Drug Administration requirements:  Legal Proceedings:  Law Enforcement: Coroners, Funeral Directors, and Organ Donation:  Research:  Criminal Activity:  Military Activity and National Security: Workers’ Compensation:  Inmates:  Required Uses and Disclosures:  Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500.