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It is important that you come prepared for each patient visit. INSURANCE INFORMATION • Contracted with most plans including all AHCCCS plans. Please call for details. • Bring your primary and secondary insurance card(s) to each visit. • We accept assignment of insurance at the time of service. We cannot bill your insurance company unless you bring all of your information with you to each visit. • It is your responsibility to know and understand your insurance coverage as it pertains to deductibles, co-pays, pre-existing condition limitations and if we are listed as medical providers on your plan. • Please be aware that some and perhaps all services provided may not be covered services under Medicare, Medicaid and other insurance plans. MINORS • The adult accompanying a minor will be responsible for payment in full. Minor patients not accompanied by their legal guardian will be denied services except in cases of an emergency nature unless the adult has a written note from the legal guardian stating the minor is under the adults care and can be seen by one of our providers. DEMOGRAPHIC INFORMATION • If you have moved, changed contact information or changed insurance let us know at the time of your visit so we can update your information PAYMENT • Bring your applicable co-pay/deductible/coinsurance payment. Payment for services is due at the time of your appointment. We accept cash, check, Visa and Master Card. • Remaining balances after your insurance plan(s) have paid may be your responsibility. Our billing department will bill you the appropriate amounts in accordance with the information received on the explanation of benefits. You will also receive a copy of this from your insurance plan(s). • Payment in full is due upon receipt of your billing statement. • If you have any questions during the billing process please feel free to call our billing department at (480) 289-3541. • It is in both parties interests to communicate about any billing issues and questions throughout the billing process and appropriate arrangements will be made based on the individual needs of each patient account. Should your account become delinquent you will be charged a collection fee. APPOINTMENTS • It is important that you show up 15 minutes before your scheduled appointment to complete all necessary paperwork. All new patients should show up 30 minutes prior to their appointment to complete all of the new patient information. • From time to time schedules can change and we understand. Please call our office 24 hours in advance to let us know if you need to cancel or reschedule your appointment or you may be charged for the visit. • We may also choose to discharge a patient for habitual late cancellations and or rescheduling. We want to serve all of our patients in a timely and efficient manner and effective communication is the best way to accomplish this. • If you show up late to your appointment, the appointment may be subject to cancellation. MEDICAL INFORMATION • Medical Records can be obtained by signing a release of records form at any of our locations. A fee of $40.00 will be charged to an outside agency other than a medical provider. • Medical providers requesting your health care information will be provided to free of charge. • If the patient is requesting a copy of their own records for personal use a fee of $10.00 for up to 20 pages will be due prior to obtaining the records. An additional fee of .25 per page will be due for pages beyond 20 pages not to exceed $40.00. • Form Fees such as FMLA, Life Insurance and other forms will be assessed a $20.00 per page fee prior to completing forms. • Letters from your provider on the Medical Practice letterhead will be made available at a cost of $100.00. AFTER-HOURS SERVICES • Our offices are open Monday through Friday from 8:00 AM – 5:00 PM and seasonally on Saturdays from 8:00 AM-12:00 PM. • We have a 24-hour, 7-day-per-week answering service. • Calls received before or after normally scheduled business hours will only be returned during after hours if it is of an emergent matter. • You will need to call during normal business hours for medication refills and other non-emergent calls. • All emergent calls received after hours will be responded to as appropriate to the individual need of the patient. • An after-hours fee may be charged to you for services rendered during non-business hours. |
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