Please arrive on time to your scheduled appointment. We strongly recommend that patients arrive 25 minutes early to fill out any paperwork that may be required. Patients who arrive more than 30 minutes past their scheduled appointment may be asked to reschedule, and may be charged a late-cancellation fee.
If you plan to cancel, please notify us no less than 24 hours before your scheduled appointment. You may be charged a $25 late-cancellation fee for cancellation less than 24 hours in advance or missed appointments. Repeated failure to make scheduled appointments may result in release from the practice.
Minors must be accompanied by a parent/guardian.
Older minors may be seen upon completion of the preauthorization form. Please complete the form and fax it to our office, or send it with your teen to their appointment.
Unaccompanied minors without parental preauthorization will be rescheduled.
PRESCRIPTION REFILL POLICIES
We will only prescribe medications to current patients who have been seen within the past three months. If you require a long-term anti-inflammatory or other medication, we recommend that you contact your primary care physician.
We cannot call in narcotic pain medications. Refills of narcotic pain medications must be picked up at our office by you or a person appointed by you. No prescriptions will be dispensed without a photo ID.
No prescriptions will be dispensed:
- After 4:00 p.m. Monday-Thursday
- After 12:00 p.m. on Friday
- On weekends
Call our office for any refill requests. Please allow at least 48 hours for your prescription to be renewed.
We consider patients who do not have insurance to be “self-pay” patients. As such, you will be required to pay a $300 deposit at the time of your visit. Payment must be made in cash, by credit card, or money order. Future visits, surgery, and treatment will require further pre-payment. Until payment is made, you will not be seen.
DURABLE MEDICAL EQUIPMENT
Prior to receiving durable medical equipment, including, but not limited to, braces, splints, immobilizers, slings, and walking boots, patients must sign an “Advance Beneficiary Notice” (ABN). This ABN will clearly indicate the durable medical equipment that you may elect to receive, the reason that you are receiving the equipment, and the estimated cost of the equipment. By signing this form you consent to pay for the balance due on durable medical equipment dispensed should your insurance provider fail, in whole or in part, to cover the cost of the equipment. We will not offer refunds, nor will we accept returns or exchanges, for durable medical equipment once you have left our office. It is your responsibility to ensure the proper fit and function of any and all dispensed durable medical equipment prior to leaving our office.
DISABILITY, FMLA, AND CLAIM FORMS
The wait time for completion of forms is approximately 10 business days. There will be a $10 service fee charged for the completion of these forms.
Workers’ compensation appointments must be scheduled by your case manager or worker’s compensation adjuster. Our practice cannot make an initial appointment directly with a patient. Case managers must provide us with complete workers’ compensation information in writing prior to scheduling an appointment.
It is your responsibility to provide our office with complete insurance information, as well as contact information for your case manager. Our office will only submit open claims on your behalf, unless we are made aware in advance that the claim will be denied.
Should your workers’ compensation claim be denied, we will bill your primary insurance carrier for the full amount of your visit and treatment. Any balance not covered by the workers’ compensation claim and primary insurance carrier will be the responsibility of the patient.
MOTOR VEHICLE ACCIDENT (MVA) AND LITIGATION CASES
Our clinic does not recognize MVA and litigation cases. Unless you have active health insurance coverage and we receive a letter of subrogation from your insurance company, you will be classified as a self-pay patient.
Should your health insurance carrier determine that your claim should be refunded due to third-party liability, you will be responsible for handling the bill through a litigation attorney. For no reason should you delay payment due to ongoing litigation. Payment of the bill is the responsibility of the individual who has received the treatment, not the individual who is being sued.