PATIENT GUIDE
>Confidentiality
>HIPAA Form
>Hours (Regular & After Office Hours)
>Insurances
>Insurances and Billing Related Questions
>Missed Appointments/Cancellations
>Patient Registration
>Patient Statements
>Payment Policies
>Prescription Refills
>Referrals and Pre-Certification
>Release of Medical Records
Welcome to PriMed
We are committed to providing you with the best possible care, and are pleased to discuss our professional fees with you at any time. Your clear understanding of our Financial Policy is important to our professional relationship.
Confidentiality. We understand that medical information about you is personal. We are committed to protecting your privacy. To comply with legal requirements, we create a record of care and services you receive. You will receive a copy of our Notice of Privacy Practice at your initial visit. This Notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. If you have any questions, ask to speak with the office manager.
HIPAA Form. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides federal protections with regard to the security and privacy of personal health data.
Hours (Regular Office Hours). Our offices are generally open Monday through Friday from 8:30 a.m. to 5:00 p.m. Schedules will vary by physician. Please contact your provider to find a convenient time. Physicians and staff recognize that your time is valuable. We make every effort to keep appointments according to schedule; however, on occasion waiting times may be unavoidable. Consequently, we will do our best to accommodate patients who arrive a few minutes late.
Hours (After Office Hours). For urgent medical concerns after hours, the answering service will alert the physician on call. For a “life-threatening” emergency, call 911 or go directly to the nearest hospital emergency room.
Insurances. PriMed accepts most major insurance plans. Insurance companies may deny payment or reduce payment depending on your coverage. You are responsible for payment of services not authorized by your insurance company. We employ a specialized team of billing staff who are knowledgeable in insurance requirements and work to ensure that your insurance company pays for the services you receive. Following receipt of payment or denial, you will be billed for all outstanding balances not covered under your policy. Please contact your insurance company if your claim was not paid appropriately.
Insurance and Billing Related Questions. Our billing staff members are available to assist you with questions related to your account. You can contact our Central Business Office by telephone at 944-1937 between the hours of 9:30 a.m. and 3:30 p.m. Monday through Friday, excluding holidays.
Missed Appointments/Late Cancellations. For the convenience of all of our patients and staff, we require 24 hours’ notice whenever you need to cancel an appointment. Getting cancellation information in advance allows us to serve other patients. We recognize that unforeseen circumstances can arise and appointments cannot always be cancelled in advance. We reserve the right to charge for patients who do not notify us in advance and will consider dismissing patients from our practice who miss multiple appointments or do not cancel with sufficient notice.
Patient Registration. Please bring your insurance card and plan to arrive 15 minutes prior to each visit so we can review registration information with you.
Patient Statements. Patient statements are mailed monthly. Please note that your statement may contain charges not covered by insurance, along with charges containing a balance due after insurance benefits have been paid. Charges pending with insurance companies do not appear on the patient statement; however, you may receive additional bills for these services in the future.
Payment Policies. Co-payments and payments for services not covered by your insurance are due at the time of service. Few plans do real time claims adjudication to enable us to find out before a patient leaves the office how much an insurer is paying for a procedure and how much money is left in a patient’s deductible and health savings account (HSA). With more health care costs paid directly by patients, we have had to adjust our business procedures. As a result, you may be asked to sign a pre-authorized healthcare form to establish automatic billing to a credit card for balances not covered by insurance.
If you do not have insurance, a pre-service deposit may be requested at the time of check-in. The front desk staff will not be able to quote exact prices until after your provider has examined you and determined the nature of your visit.
Payments can be made in any of our offices by cash, check, money order, and credit card (Visa or MasterCard). Balances remaining after insurance submission are due in full upon receipt of a patient statement. If payment in full is not possible, please contact our billing office to determine if you qualify for a monthly payment plan. Patients with outstanding balances must make payment arrangements prior to scheduling appointments. An ongoing unresolved balance may result in discharge from the practice and involvement of an outside collection agency. There will be a $20 service charge for returned checks.
Prescription Refills. Check your medication supply before each appointment to arrange for refills while at the office. If you run out of medication between visits, call your pharmacy. The pharmacy will then forward us a request. A provider will either refill the prescription or request that you schedule an appointment. No prescriptions will be refilled on Saturdays, Sundays or Holidays.
Referrals and Pre-Certification. If your insurance company requires a referral and/or prior authorization, contact your primary care physician prior to seeing a specialist. A referral may be required to see a specialist, while a prior authorization is usually required for ancillary testing or medical procedures. If your insurance company requires a referral and/or prior authorization and you do not have one, we may need to reschedule your appointment. We strongly suggest you contact your health insurance plan in advance of your appointment to discuss coverage and reimbursement. It is important for you to understand your insurance benefits as they relate to the services your physician may provide or prescribe.
Release of Medical Records. Advance notice is required to have your medical records copied and there may be charges associated with your request. Because your medical information is confidential, a signed authorization form must be completed prior to processing.
