Telephone Calls

We try to answer calls as soon as possible but in order to minimize interruptions during office visits we may not be able to return your call until the end of the clinic day.  If you have an emergency, defined as an injury or illness which may represent a danger to life or limb, please call 911 or go to the nearest Emergency Department.  You may also communicate with us by email but keep in mind this is not the most secure method, and that your emails may be read by other family members.  If you are at work, your emails may be read by your employer legally.  We also have the Patient Portal service where you can send notes or questions directly to your chart.  Your response will come by a secure website, and you will receive a notification only by your email when your Portal has been updated.  These too can take a day to return.  If you have an urgent medical need, it is still best to call early in the morning for an appointment the same day.  We do keep several slots open daily for urgent needs.

Medication/Prescription Refills

Initial prescriptions and medication refill requests are designed to be completed during your scheduled appointments.   We try to maintain refills enough to last until your follow up appointment is due.  When you are out of additional refills, that would be the ideal time to schedule your next appointment.  Some medications will have refills to last a year, but medications that require physical or laboratory monitoring may last only 3 to 6 months.  Other prescriptions require additional time and administrative work to fill, and these may require an office visit as well.  Some clinics are charging additional fees to complete refills that are not associated with an office visit and we are trying hard to avoid this.  Refill requests that are made outside of a regularly scheduled appointment may take up to 3 days to process, so please plan accordingly.

We do not refill prescriptions on nights or weekends as a general rule.  Also, Class II controlled prescriptions cannot be called in to pharmacies and must be seen in person to refill.  There are some new DEA rules that allow 3 months of prescriptions to be written at one office visit with post-dated refill dates.   If you are on medications for Attention Deficit Disorder please ask about this new policy at your next visit.

Please be sure if you leave a message for refills to include your name, date of birth, preferred pharmacy, name of the medication, dose and how often you take it to confirm the process.

Referral Requests and Pre-Authorization Forms

Many insurance companies have additional administrative processes that are required to see a specialist.  It is the responsibility of the patient to obtain a referral prior to appointments with a specialist.  These referral requests are to be completed during your scheduled appointments.   We are held responsible to send you to the proper specialist for your specific problem.  In appropriate cases we may be able to complete referral requests without an office visit.   Some clinics are charging $25 for this service because of the administrative costs involved.  We are trying hard to avoid this.  Our clinic appointments will take priority, so please be aware that it can take up to 3 days to process referral requests that are made without an office visit.

Laboratory Services

Laboratory services are available at the clinic for Urinalysis, Pregnancy, Strep, Influenza and Guaiac testing.  Other testing must be done at a certified laboratory.  We use PathGroup Labs for or laboratory of choice.  The laboratory phlebotomist will draw labs in the clinic for your convenience, prepare the specimens for testing, and they are picked up during the day by a distribution service representative.  The labs are actually run at Pathgroup Nashville.

Our only affiliation with PathGroup is that they provide an onsite phlebotomist, and provide electronic ordering and resulting of labs for our EMR system.

Our clinic does not bill for laboratory services other than those listed above, they will be billed separately from the clinic from PathGroup.  If you feel you have received a bill inappropriately from the lab, we are happy to assist in any way possible, but most questions about billing should be addressed at PathGroup billing at (615) 234-2542.  The most common issues pertain to Complete Physical Exams (CPE) billing.  Please be certain your insurance covers wellness or CPE visits before your appointment.  There is not much we can do about billing charges for non-covered visits.

If your insurance requires that your labs be performed at a specific lab other than PathGroup, such as Quest or Labcorp,  we will not be able to draw the blood at our clinic but we are happy to send an order to the Hospital lab which can draw and process this for you.

Laboratory results are reviewed as quickly as possible and either called to you or a letter will be sent if normal.  These are reported on a priority basis with the most urgent results called first.  Results are also available on our Patient Portal service.  If you find results online before you have been contacted please be patient as we process and attempt to contact you.  If you have not heard any results within a week, please call and let us know.

Payment of Fees

Payment of fees not covered by your insurance plan are due on the day of your scheduled appointment.  These fees include copayment, deductibles and outstanding balances.  You may pay by cash, check, money order, Visa or Master Card.  Any checks that are returned will be charged an additional $25 fee.

Insurance Benefits

We will file your insurance claim as a service to you.  In order to do this we ask that each patient or responsible family member complete an insurance form with the assignment of benefits assigned to us on the initial visit and annually thereafter or if your policy changes.   All of this paperwork is time consuming for both of us so please allow additional time to fill out before your first visit.  We will do all that we can to process insurance claims, but please remember that your coverage is a contract between you and your insurance company.  Any balance that your insurance company does not pay or is considered a non-covered service is due from you or your responsible party.

Many insurance companies require a deductible to be satisfied each year by the patient or responsible party before insurance benefits begin. If the deductible has not been satisfied or there is a question whether the service we provide is a covered service, it is the responsibility of the patient or responsible party to provide payment at the time of service.  We will verify insurance coverage before your visit.  During the verification process we may find that your deductible has not been met and will have to collect a reasonable amount before the office visit.  Please keep in mind that insurance coverage is a contract between you and your insurance company.  If a claim processed is a covered service the payment will be applied to any balance on the account and difference refunded or credited to the account as requested by the patient or responsible party.

Additional Services Not Covered by Insurance

The completion of forms (school physicals, administrative physicals) should be done at the time of your office visit.  These physicals may not be a covered service by your insurance company.  There may be an additional charge for complex forms (disability forms, handicap placards, FMLA) to be filled out at the time of an office visit.

Preventive Visits and Problem Related Visits

For years there has been confusion about Complete Physicals.  Coverage of Physicals varies widely from each insurance carrier.  Please check with your insurance company prior to scheduling a Yearly Complete Physical.  There are many different plans, and each plan may have different policies.  It is administratively impractical for us to verify this information correctly for you. 

Regardless, Complete Physicals are highly recommended.  This is our only chance to cover preventive issues that are not part of routine problem generated visits.  At your Physical we start with a review your medical history, family medical problems that place you at additional risks, social habits that may cause risk, and age associated risks.  Then a thorough physical examination is performed to catch any such problem at an early stage before it becomes a problem.  This is when you will have your breast exam, cervical exam and pap or for men a prostate exam, and screening for colon cancer, skin exam, etc.  EKG and laboratory tests are performed to monitor for additional risks that can effect your health.  Age or risk appropriate testing will be scheduled such as colonoscopy, mammogram, bone density or stress testing.  Immunization discussion, and preventive counseling such as diet and exercise are covered.

These visits are time consuming and are designed purely for preventive health issues, not problem focused.   Most insurance companies will not pay for Complete Physical Examinations and problem specific complaints on the same day.  It is a very frustrating part of dealing with insurance companies, and not necessarily our policy, but we have to abide by their rules.

Appointments

We try to adhere to our appointment schedule as best as we can.  Unfortunately, there are many times when this is impossible because people are very unpredictable as a rule.  If you have a very tight schedule, we recommend making the first appointment of the morning at 7:30 a.m. or immediately after lunch at 1:30 p.m.  All of the administrative tasks mentioned above are some of the reasons that we may run behind schedule and in fairness to all our patients we are instituting these policies. 

There may be times when you could be asked to reschedule an appointment to discuss specific problems, especially if brought up during a physical or if you bring a list of complaints  during a 15 minute appointment.  Some problems take much longer to resolve properly and it would be inappropriate to rush through any issues you have, and unfair to those that are scheduled after you.  It is never popular to ask someone to reschedule for additional complaints, but we are more interested in doing what is right for everyone.  Please let the scheduler know all your concerns when you make your appointment so that we can do our best to allow the appropriate time.

We do require 24 hours notice of cancellation for appointments.  We offer email reminders of scheduled appointments and calls to remind before upcoming appointments.  If cancellation is less than 24 hours and we are unable to fill your appointment time you will be billed $50.00.

Statements and Collection Process

We send out statement and bills of outstanding balances on a regular basis.  We are very careful to be sure we do not send out a bill if there is still an outstanding insurance collection issue.  If you feel you have received a bill in error please let us know so that we may correct the situation or explain it more effectively.  We all know this can be a confusing process.

Please do not ignore a bill, but we encourage you to be proactive with these.  If you receive a final bill with collections notice please call the clinic to make appropriate arrangements.  Only those overdue statements that are ignored or fail to make appropriate payments will be sent to collections.  Once an account is sent to collections, there is a 43% charge added to the balance to cover administrative expenses and the cost of collections itself.  Once in collections we will be unable to provide any more services to the patient on that account until the issues are resolved and full payment is collected.