Welcome to our practice!
It is an honor to care for you and your family. Please take a few minutes to read this document and sign. We are happy to answer any questions regarding our office policies.
Appointments
We strive to keep on schedule, and we do our best to notify our patients if there is a delay in the doctor’s schedule. We ask for your patience and understanding if there is an emergency that delays your appointment. If you are late for your appointment time, we reserve the right to reschedule your appointment.
Documentation
At the time you schedule your appointment, our office staff will review the documentation that you will need to bring with you (ex. Insurance card and personal identification, etc.). Please inform the receptionist of any changes to your address, phone number or other patient information. Not having the proper documentation may cause you to be financially responsible for your office visit.
Cancellations & charges for missed appointments
Cancellations for appointments/procedures require a minimum of 24 business hours advance notice for office hours. Procedures require a minimum of 48 hours advance notice. Failure to provide such advance notice to the office may result in a charge of $25 to your account for missed office visits and a charge of 10% of all procedural charges for missed procedures.
Follow-up
Please schedule your follow-up appointment before leaving the office, as this will enable us to better accommodate any special needs.
Pre-certification
If you require a referral from your insurance, it is your responsibility to obtain the referral prior to your visit from your primary physician. We will be happy to assist you in determining your insurance requirements. Prior to scheduling an appointment for an MRI or CT scan patients must contact our office with the date and location to begin the pre-certification process. Please be advised this process may take up to 5 business days based on your insurance.
Procedure Authorization
Many procedures require prior authorization. Our office will take care of this process for you, but please be advised that this process is labor intensive. Please be considerate of our office staff’s time in planning for your procedure.
Medication Authorization
Many medications also require prior authorization which is a long process. Please be understanding of the time needed to complete this request.
I acknowledge and agree to the terms and conditions of this document.