Office Policies - WFCM2

MEDICARE:
What you do: Pay your Deductible ($203 for 2021), and
coinsurance (20% of the allowable).
If you request any services that Medicare
does not cover, you agree in writing to pay
our regular fee for those services.
What we do: We will file Medicare for you.

MEDICARE + SECONDARY INSURANCE:
What you do: No payment due at time of service.
What we do: We will file Medicare and your secondary
insurance for you.

COMMERCIAL INSURANCE:
What you do: Pay your deductible, coinsurance or co-pay
at time of service.
What we do: We will file your insurance for you.

INSURANCE WE ARE NOT CONTRACTED WITH:
What you do: Pay the visit in full at time of service.
What we do: We will provide a receipt for your services
for you to file with your insurance for
reimbursement.

HEALTH SAVINGS ACCOUNT (HSA):
What you do: Your HSA credit card may be used.
What we do: We will file your insurance and if the amount
due is not paid, you may use your HSA.

We are dedicated to helping our patients and appreciate those who value this dedication of time, energy and service. We received many calls from patients who wish to be seen on the same day. Our schedule is often full. Last minute cancellations and no-shows adversely affect other patients.

Therefore, effective Jan. 1, 2014:
-All no-show/missed appointments will result in a fee of $50.
-The same $50 fee will also apply to patients who do not give us at least a 24-hour cancellation notice.

Your understanding and cooperation is appreciated.

In general, we do not provide out of office refills. Patients will be scheduled for followup prior to running out of medications. If appointments are appropriately scheduled and kept, and pharmacy appropriately fills prescriptions with refills authorized, then a patient should never run out of medication.

Urgently needed medication refills should be called in to the office.

Any Rx refill messages received after 3pm may not be reviewed until the next working day.

Pain medications and controlled substances will only be refilled during an office visit.

An out of office visit refill fee may be assessed as follows:
$15 1-3 medications
$25 4+ medications