The Nuts & Bolts of Office Operations 

 

Appointments

 

We will make every effort to see acutely ill patients within 24 hours. If a call is received by noon, urgent appointments can usually be made the same day. 

For your visit, please remember to bring insurance card, driver’s license or picture identification, and payment for co-pay or deductible. If you have health insurance, we cannot see you without making a copy of your insurance card. Co-pay or deductible is collected at check-in.

Our schedule has been designed to minimize wait time; however, emergencies are given first priority. If your physician is treating an emergency patient, we will try to keep you informed of the wait time and give you the option of rescheduling your appointment for another day.

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Lab Work

 

As a courtesy to our patients, Quest Diagnostics has agreed to staff a phlebotomist in our office to draw blood for labs.  The phlebotomist is a Quest employee.  No appointment is needed for afternoon lab draws.  Morning lab draws do now require an appointmentand Dana's phone number will be provided with all lab orders.  You will need to bring your lab order, insurance card and photo ID. Unless you advise the phlebotomist otherwise, Quest will submit the lab-work claim to your insurance and bill you for any amount owed.  Please direct any billing questions to the phone number on the Quest invoice.

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No-Shows

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Unless cancelled at least 24 hours in advance, a fee of $45 may be charged for the first missed appointment, a $75 fee will be applied to any subsequent missed appointments, not cancelled in advance.  Click here to view our No Show policy.

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Prescriptions/Refills

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• Most refill requests should be directed through your pharmacy, and the pharmacy will send an electronic message to your physician, the exceptions could include refills for controlled substances, or medicines prescribed by a previous physician

• Please allow (2) two business days for refills to be processed

• Prescriptions last written over 1 year ago cannot be refilled without an appointment

• Prescriptions written by another doctor cannot be refilled without an appointment

• We may not write prescription for controlled substances (including narcotic pain medicines and stimulant ADD medicines).  Please see our Policy on Controlled Medications.

• If a pharmacy or insurance company requests that we change a prescription, we will not make any modifications without our patient’s understanding and permission

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After-Hours Care

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• Emergencies must be evaluated promptly in the nearest Emergency Department

• An on-call doctor is available by telephone for non-emergent issues.  Call the office's primary number, 928-1442, this will result in a direct call to our provider’s cell phone number.  Please, do not disturb our providers for non-emergent issues such as prescription requests or appointment related requests.

• Because we cannot examine a patient over the telephone, the doctor may be unable to diagnose or treat all symptoms by telephone

• Unfortunately, we cannot provide telephone advice to non-established patients, even if they are the spouse or child of an existing patient.  Patients must be established patients, who receive primary care services from Fairhope Family Medicine, to use the on-call service.

 

Billing Quirks as a result of our Complex Health Insurance System

 

• Additional Fees for Extended Hours Service

For appointments made outside of usual business hours, Fairhope Family Medicine uses Extended Hours Service specialty code while submitting insurance claims on your behalf for non-preventive care visits. The fee for this service code is up to $50. This fee is added to the baseline charges for your visit. Most insurance companies recognize this billable charge and will provide full or partial reimbursement. You may be responsible for only the allowable portion of this charge in the event that your insurance company assigns it to your deductible or coinsurance. If you have additional questions, please contact your insurance plan for specific details regarding this service.

• Billing Codes in addition to routine Office Visit Code

Insurance companies require physicians to very carefully document the events and information exchanged at an office visit. In addition the coding guidelines are precise and specific related to various services or issues discussed. There are certain services that have been given separate Billing Codes.  Fairhope Family Medicine strives to provide comprehensive care and meticulous documentation.  At times this results in use of Billing Codes in addition to the typical office visit Billing Code.  Some examples are Billing Codes for demonstration of how to use an inhaler, demonstration of stretching or strengthening exercises as it relates to a musculoskeletal injury or issue, discussions related to quitting smoking.  As with the Extended Hours Service Codes, you may be responsible for only the allowable portion of this charge in the event that your insurance company assigns it to your deductible or coinsurance. If you have additional questions, please contact your insurance plan for specific details regarding this service.

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What Is and Isn’t Considered During My Yearly Preventive Physical Exam?

 

This notice pertains to the components of a preventive physical examination (preventive services or wellness visit) that are normally covered by your medical health plan. Also, it includes what services are not normally covered by your medical health plan during a preventive physical examination.

 

Services NOT Normally Covered by Insurance Plans During a Preventive Physical Exam/Wellness Service:

 

• Evaluation and Management of specific acute problems or illness. (Examples would be discussion of a recent cough, sore throat, pain, injury, or refills or lab orders for chronic medical conditions, such as high blood pressure, diabetes or asthma.)

• Procedures other than a pap smear. (Examples would be mole removals, joint injections, and skin biopsies.)

 

Preventive Physical Examination Components Normally Covered by Insurance Plans Include:

 

• Screenings (evaluation to detect a disease that is present, but as yet unknown to the person and physician) for common or preventable diseases (Examples would be screenings for high blood pressure, obesity, high cholesterol, diabetes, and certain forms of cancer.)

• Complete physical examinations (Paps for women included)

• Review of immunization history and administration of any if necessary

• Counseling on healthy living choices, normal development and recommendations for proper diet and exercise

• Diagnostic testing, if appropriate. (Examples would be pap smear, fasting cholesterol and blood sugar tests, colonoscopy, bone density, and prostate blood test.)

 

Our providers will welcome discussing and/or providing any of the services that may not be covered by your medical health plan during your physical examination. However, please keep in mind that if your medical health care plan does not allow for, or applies a copay or deductible, to this additional non-wellness service on the day of your physical, then you will be responsible for any charges related to that additional service.  Also keep in mind that in our effort to provide efficient and timely care to patients, there may not be time at a Preventive Physical to address non-wellness issues.  We may require that an additional office visit be made to handle these issues.

 

Telephone Calls

 

Our staff is available to answer your questions and schedule appointments during regular office hours. If your concern is urgent, please inform the receptionist so that your call will be addressed immediately. If you have lengthy or complicated issues, we ask that you schedule an appointment with one of our providers for an evaluation/consultation.

 

We are pleased to offer alternate methods of communication  -  the Patient Portal allows for general questions, online Appointment Request, Refill Requests and you can review test results, statements, and much more.

 

Test Results (includes labs/blood work, xrays, imaging, pathology, radiology) 

 

In order to provide you the highest standard of care, if your test results are abnormal you will be contacted by our staff and you will be asked to make a follow up appointment with your doctor to discuss those results.  The method of communication may be a phone call, a post card indicating office visit is required, or may be an eMessage sent via the Patient Portal.  This follow up appointment will allow you time to ask your doctor questions about your test results and give your doctor an opportunity to discuss further testing and follow up that is needed. This follow up can be vital for your health and cannot adequately be done over the phone or by email so our doctors cannot discuss abnormal test results with you over the phone or by email.

 

If you need blood work in the future to monitor a chronic condition (i.e. high cholesterol, diabetes, high blood pressure, hypothyroidism, etc), you will be asked to have your blood work drawn at least 1 week PRIOR to this appointment. If lab work is required but is not done prior to a chronic condition follow up visit you may be asked to reschedule your visit.

 

Did you know you can view and print your lab results online? As part of our continuing efforts to provide innovative and convenient medical care we offer you the ability to view most of your lab results online. Please contact us to obtain a login for our patient portal to view your lab work.

 

• If your test result is normal, you will NOT receive a phone call from us.  Normal results will be published within 2 weeks to your patient portal account, or sent by post card via snail mail.  Please check your email for a notification if you are on the patient portal. 

• You WILL be contacted by post card via snail mail or eMessage on the Patient Portal for any non-urgent abnormal results that require a discussion with your provider, otherwise they will be published to your portal account.

• If the test results are abnormal and urgent or concerning, the lab or radiology department generally call the provider immediately and you will receive a phone call shortly after the provider finishes receiving that phone call.

• You will not be able to view your results until they are received and reviewed by your provider.

• If you have not been notified of results within 2 weeks, by either patient portal, snail mail or phone, please call our office so we may track the missing results.  

 

Fees & Payments

 

Full payment, by cash or credit card, including any co-payment or deductible that your insurance may require, is expected at the time of service. 

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Statements are only generated and sent if a patient balance is $15 or greater.  Any balances under $15 will be collected at your next visit.

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Insurance and Self-Pay

 

It is the policy of Fairhope Family Medicine to help keep your health care costs as low as possible. To do this, we need to keep our billing costs to a minimum. Please help us in the following ways:

 

• Always bring your current health insurance card to the office.

• Please notify us at time of check-in of any changes in insurance, address, telephone or family status.

• Please pay your co-pay or deductible balance and co-insurance amount at the time of service.

• You will be expected to pay in full (Self-Pay) if:

  • You do not have insurance

  • We do not participate with your health plan

  • You are unable to present a valid member identification card from your insurance carrier at your visit

  • We are unable to verify your insurance coverage.

 

Please take the time to review your insurance plan so that you understand your benefits. 

 

Returned Checks

 

There is a fee (currently $35.00) for any checks returned by the bank. This amount may change.