For PatientsAbout Your VisitWe look forward to meeting you on your initial visit to our offices. It is the goal of our staff to provide you with the highest quality of service. In order to help us best take care of you, please bring the following to your first visit:
Patient Forms Please review, complete, and bring the following forms to your initial visit. By doing this, you will allow the doctor to spend more time with you to evaluate and discuss your condition. Please contact the office with any questions regarding these forms.
Please review our Privacy Statement form: Prior to being prescribed pain medications at our clinic, you will be required to review and sign the medication agreement below. Feel free to review the agreement prior to your first appointment. Please note, it is the discretion of the doctor if pain medications will be prescribed at any visit. Office PoliciesOur goal is to provide you with courteous and timely service. This requires all patients to make an effort to arrive on time and to let us know when appointments cannot be kept. Missed Appointment Policy: Please be aware that by scheduling an initial consultation with our physicians, you are agreeing to abide by the billing policies of our service. To better serve all our patients, we require 24 hour notification should you need to cancel or reschedule any appointment. Should you miss, or reschedule your appointment for a visit with less than 24 hour notice, you will be charged $35.00 for a clinic visit and $50.00 for a procedure visit. Payment will be required prior to your next appointment. Your insurance company will not cover fees for missed appointment. Late Arrival Policy: The appointment time you are given is when you are expected to be in the exam room or operating room. We require that new patients come in 30 minutes early, and established patients 15 minutes early to complete paperwork. Patients coming for a procedure must arrive 30 minutes early if they require sedation, and 15 minutes if they do not. It is the policy of Gateway Spine & Pain Physicians that Patients are to arrive on time. Patients who arrive late for visits or procedures cannot expect or demand to be seen. Other patients who arrive on time expect to be seen at their allotted appointment time. One late patient may make the schedule run late for the rest of the day. This is not considerate to other patients who arrive on time. There are many things that can occur to make a patient late; ie. Car trouble, traffic, parking, etc… We understand that this can happen, but need you to understand we cannot change the schedule for the rest of the day to accommodate any of these reasons. If you arrive late for any reason, please check in at the front desk. The staff will check the schedule for the rest of the day and if possible, offer you another available time the same day. If an appointment is not available that day, an appointment on a different day will be offered to you. Please remind the staff if your medication will run out prior to this new appointment date. There may be times when we run late. This is due to some unforeseen patient clinical need that we must accommodate. We respect our patient’s time and will do all that we can to be on schedule. Billing & InsuranceIt is our goal to make payment for our services a smooth process for everyone involved. With that in mind, please review our following policy: We cannot bill your insurance company unless you provide us with your correct, up to date insurance information and any special claim forms required by your insurance company. We accept assignment of insurance benefits. This means your insurance will pay us directly the amount due based upon your benefit coverage. As a patient at Gateway Spine & Pain Physicians, you authorize assignment of your benefits to our business. However, we do require, as your insurance benefits require, payment of co-pays, co-insurance, and deductibles at the time of service. Your insurance policy is a contract between you and your insurance company. Please know your benefits. Please be aware that only your insurance company can tell you if the services provided are covered under your benefit plan. While the filing of insurance claims is a courtesy that we extend to our patients, all charges are your responsibility from the date the services are rendered. In the event that your account is turned over to an outside collection agency, you will be responsible for an additional 30% of the balance owed and/or all the attorney fees and costs incurred to collect the unpaid debt. Those insurance plans in which we are a participating provider: All co-pays and deductibles are due at the time of treatment. Prior to seeking payment from you, we will work with these plans to obtain payment. Those insurance plans in which we are NOT a participating provider: If you insurance company has not paid your account in full within 45 days of the billed date, the balance is your responsibility. Your assistance in collection from your insurance company may be required. HMO Patients: You are responsible for notifying your primary care physician and bringing the authorization for your visit with you. Please present this documentation prior to being seen by our physicians. We may have to reschedule your visit if prior approval is not received For billing related questions, please call our billing department at 877-647-2570. |
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