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Center for Adult and Family Medicine
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Center for Adult and Family Medicine
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Office Policies and Procedures
Your First VisitWe want to thank you for choosing the Center for Adult and Family Medicine for your health care needs. During your first visit, you will meet our staff, complete a few brief forms and, of course, meet your doctor. As your primary doctors, we will try to solve your current medical problem and detect or prevent other health problems. We hope to make the first visit not just an opportunity to deal with any medical concerns you have, but also a time to get acquainted with you.
The First Visit Paper Work Needed
When you come for your appointment, you will be asked to come 15 minutes earlier than your appointed time to fill out a personal and health questionnaire. When you complete the personal information sheet including all the insurance information, please give that to the receptionist along with your insurance cards. She will make a copy for our records and return them to you. We can mail these forms to you or you may pick them up ahead of time if you would like. Just let us know.
The First Examination
Your first examination can be one of either a: 1. Annual Preventive Physical Exam or Yearly Physical, is a well exam where we screen you for diseases, help prevent diseases and maintain health. In some cases your insurance will not pay for this service. You will need to call your insurance company and find out what they cover or don’t cover and bring us the information. Or, 2. A Problem Visit is a specific type of medical problem you are having and that problem will be addressed and treated.
The time allotted for a physical and a medical problem is different. Therefore, both things cannot be dealt with on the same visit. Separate appointments will need to be made.
Annual Preventive Physical Exam: Our MA/Nurse will call you to go back to the exam room; they will measure your height and weight and take your blood pressure and temperature. Your physician will review the health questionnaire with you. If you are here for a physical, you may be asked to undress and put on a gown in the privacy of the exam room. This enables the doctor to better evaluate your health. After the examination, your physician will suggest a treatment plan and future visits, if necessary.
A medical problem will still involve having your weight, blood pressure and temperature checked. The problem you are having will be addressed by our MA/Nurse and recorded into your chart. The Doctor will then see you and treat the problem. If need be they may have you come back. They will explain this to you.
As a commitment to your health, we recommend every patient have a yearly exam to allow us to evaluate your overall health. Any chronic illnesses will need to follow up every three months. This will involve a nurse visit or Dr. visit with your lab; and co-pay will apply only if you are required by your insurance company to pay co-pay. We want to monitor you closely to keep you healthy. For our established patients; we will make an appointment for your lab work and then your exam at least 2 days later so the lab results can be reviewed with you. On all normal lab results we will mail you a card letting you know they are normal. If lab is abnormal, they will not be discussed over the phone you will be called to come in and discuss the treatment plan with your Doctor.
We hope that after your visit you will feel confident that you’ve made a wise decision by choosing our practice. If you are not comfortable with one Doctors’ practice style, you may reschedule your next appointment with another Doctor in our practice.
Our Physicians
Dr. Sarmiento is Board Certified in Internal Medicine with special interests in Geriatrics and women problems and adolescents. She is the founder and senior Physician in the practice and she is”no nonsense,” straightforward individual who leads by example.
Dr. Aragon is Board Certified in Family Practice and also has special interests in the care of women and children including GYN care.
Appointments
We have open access to serve you when you are sick. You can be seen the same day by calling and having our Staff set up an appointment time for you during our normal business office hours. Please do not walk in and ask to be seen. Our schedule is structured and it is necessary to keep our office running on time for our patients. Therefore, it is essential for appointments to be made even for sick visits. If you are late for your appointment we will require you to reschedule for later that day if we have an opening or we may need to schedule for another day. If you arrive more that 10 minutes before your appointment time you will still need you to wait for your allotted appointment time. Please keep in mind that other patients do have appointments before yours. No Show Policy
We consider your time with the Doctor very important. We block time out on our appointment schedule just for you. If for some reason you are unable to keep your appointment, we require you to call in our office at least 5 hours before your appointment time. This will give us the opportunity to offer your slot on our schedule to someone else who needs to be seen. We will bill your account $25.00 if you do not call to cancel within the allotted time. If you miss three scheduled appointments this will be reason for discharging you from our practice. We thank you for your consideration.
Lab Services
It is the patients’ responsibility to inform the lab technician on your visit if your insurance requires your specimens to go to a certain lab location. At the present time we use Spectrum as our outside lab. If you do not inform us and your lab is sent to our lab instead of the one your insurance requires, it will be your responsibility to pay the charges that will be incurred. Our lab results will be available within 48 hours from the day you had your blood drawn. You may be asked to sign a ABN form if we believe that your insurance may not pay for the procedure.
Prescription Policy
Due to overwhelming phone calls for prescription refills, we have implemented a $10.00 charge on all prescriptions called in to the pharmacy. Please take note of the following;
1. If you have not been seen in the office within 3 months and need a prescription refill, you will have to make an appointment to have your prescription renewed. 2. Prescriptions called in to a pharmacy over the weekend that should have been taken care of during normal business hours will be charged the $10.00 fee. 3. Medical problems developed after hours that need prescriptions will not be charged a $10.00 fee. 4. For all prescriptions that have expired, will need to make an appointment to see the Doctor. 5. Prescriptions that are dropped off or called in ahead of time to our office will need to give the office staff the required 24 hours to be refilled.
For your convenience you may pick up the prescription at the front office if you have been seen within the last three months. However, we ask that you call our office ahead of time. We do require 24 hours for the prescriptions to be refilled so please allow yourself the time needed to have your prescriptions taken care of.
NURSE LINE For the convenience of our patients, we have a nurse phone line. The messages you leave on there are private. This nurse line is checked throughout the day and the messages are taken care of the same day. Messages may need to be sent to the Doctor and there will be a need to wait for the Doctor to respond to the message and prescribe the proper care for you. When Doctor determines what needs to be done, she will then send the message back to the MA/Nurse and they take care of it that day.
Insurance Filing and the LAW
Recent Federal laws addressing all insurance companies, require us to submit every claim accurately. Reporting the exact services performed and the exact reason for performing the services. We cannot adjust this information just so the insurance company can pay the claim. Our practice is committed to obeying these laws, and we will submit all claims to all insurance companies in this manner
We will file to all insurance companies, but we do not have a contract with all insurance companies. Therefore, we are not required to accept what the insurance companies decide to pay out of network. If we have a contract with your insurance company we are required to collect all co-pays and deductibles at the time of service. If you have not met your deductible, you are required to pay for this at the time of service. We do check to see if you are covered by insurance before your visits. We are also able to see what your co-pay and deductible is. If you are not covered we put your account to self-pay and expect payment in full at the time of your visit. We will give a 20% discount only if account is paid in full the same day of the visit.
Billing
It is necessary for this office to collect for fees due at the time of service. If we do have to send a statement to you, we will give you 25 days to send the payment in full. If payment is not received within that time frame and another statement is mailed out to you, a $2.00 fee will be added to your account. With each statement a $2.00 handling fee will be added until balance is paid in full. This went into effect January 1, 2004. We only hold our accounts in this office for 60 days. If the account is not paid in full within that time frame, your account will go to the CBA, Inc. collection agency. Your account will then be handled by them and will be reported to all credit bureaus. We do have financial plans available if it is needed. You will need to setup an appointment with the Billing Department or Management and agree to the terms of the plan. We do take Visa and MasterCard.
MEDICARE AND MEDICAID
We do accept both Medicare and Medicaid (Phytrust). We do not accept Medicaid (Phytrust) if it is the second insurance carrier. We only accept Medicaid (Phytrust) if it is the primary insurance. If you have both, we do not file for Medicaid (Phytrust), only the Medicare. The patient is responsible for the 20 % balance Medicare does not pay for.
If you have any questions about any of our Policies and Procedures, please do not hesitate to set up an appointment with Management to discuss them. We are here for you and want to make your experience a good one. Thank you.
Center For Adult and Family Medicine
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mpierg@drforlife.com with
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