Practice Policies
As you are well aware, the business of providing insurance-based healthcare is increasingly complex and challenging. For our office to operate effectively and provide the best service to you and your family, we need your cooperation with the following policies. Your clear understanding of these policies is very important. Please let us know if you have any questions or concerns.
Contents
- 0.1 Office Hours
- 0.2 New Patients
- 0.3 Courtesy
- 0.4 Supervision of Children & Minors Present Without Parents or Legal Guardian
- 0.5 Changes in Address, Billing, or Contact Information
- 0.6 Insurance Policies & Forms
- 0.7 Fees & Payments
- 0.8 Appointments & No Show Policy
- 0.9 Prescription Refills
- 0.10 Telephone Messages & Processing of Referrals
- 0.11 FMLA & Disabilities Forms
- 0.12 Medical Records & Forms
- 0.13 After Hours
- 1 IN A LIFE THREATENING SITUATION, PLEASE CALL 911 IMMEDIATELY.
Office Hours
Our office is open Monday – Thursday 8:00am – 5:00pm and Fridays to 4:00pm. Our phones are off from 12:00 pm to 1:00 pm for Lunch. However, our doors remain open for scheduled patients. We are closed in observance of major holidays.
New Patients
First time patients are asked to arrive EARLY to allow adequate time for completing the initial paperwork. For purposes of maintaining continuity of care, we ask that you bring us the latest relevant records with the most recent test results and current medications list. Please reference our New Patients Form for detail. We do ask that you remain the sole custodian of your entire medical records from your previous healthcare providers. Should there be a need to further examine your previous records, our providers will have you bring your records back for additional review during subsequent office visits.
Courtesy
We strive to provide the best medical care for our patients. While we make every effort to provide prompt on-time service, the healthcare needs of each individual do not necessarily lend themselves to an exact schedule. We therefore appreciate your understanding and patience. If you have any suggestion or complaint for our office, please let us know. Angry or foul language directed to our staff regardless of the issues involved will absolutely not be tolerated and will be grounds for immediate dismissal from our practice.
Supervision of Children & Minors Present Without Parents or Legal Guardian
For safety reasons, we depend on parents to properly supervise their child(ren) at all times. Our staff cannot watch your children. Under no circumstances should a child under the age of 10 be left unattended. We also require a consent form signed by a parent or legal guardian to legally provide medical care to minors 16 and 17 years of age when the parent or legal guardian cannot be present. Minors 15 years of age or younger must be accompanied by a parent or legal guardian.
Changes in Address, Billing, or Contact Information
Please notify our office in writing of any changes of address, telephone, billing or contact information. It is imperative that we have the most current information on file.
Insurance Policies & Forms
Our office will submit claims for insurance carriers with which we participate. At Pineapple Health, we are dedicated to offer QUALITY and often times beyond the standard medical care to our patients. To this end, it is YOUR RESPONSIBILITY to know your particular insurance plan benefits. Comprehensive physicals, immunizations, certain laboratory tests, procedures, and prescribed medications including nutrition and herbal supplements may not be covered. Prior Authorizations may be completed at the discretion of our providers. We therefore cannot guarantee that all services and therapies we provide or recommend are covered by your insurance. We also cannot just change CODES in order to modify insurance coverage as it is illegal and fraudulent. We strongly encourage you to contact your insurance carrier ahead of time and verify appropriate coverage.
We also require proof of current insurance at check-in for every visit. It is essential that you provide all the necessary information about your insurance, both primary and secondary. Since changes in insurance coverage are frequent, it is our policy to obtain a copy of your card(s) for applicable insurance. Please be prepared to present your card(s) at each visit. In case of a new policy, a copy of the enrollment form specifying insurance company name and phone number, employer and his/her phone number, insured employee name, date of birth and social security number will be required.
Fees & Payments
Payment in full is due at the time services are rendered unless we are submitting charges to your insurance company. Copays and deductibles are due at time of service or your appointment may be rescheduled. We accept VISA and MASTER cards. We also accept money orders, cashier checks & cash. We DO NOT accept personal checks. Those patients without proof of coverage may be required to pay in full or be asked to reschedule their appointments. If we are not contracted with your particular insurance plan, YOU must pay in full at time of service. A copy of your driver’s license will be taken. You will be given a copy of our charge slip to submit to your insurance company for reimbursement purposes.
Even though we will bill your insurance, WE ARE NOT responsible to negotiate a settlement for a disputed claim. Billing your insurance does not necessarily ensure payment by the insurance company nor does it release the responsible party from its financial obligation to our office for any unpaid balance. In case of an insurance partial payment, the balance is due by YOU and we will send you a billing statement. Balances over 120 DAYS due may be sent to a collection agency unless other arrangements have been made. A $50 fee may be assessed on accounts placed in collections. A $25 service fee will be charged for returned checks due to insufficient funds. We may also elect to discharge you from our practice should you fail to comply with our policy. Should you require a payment plan, our office manager will be glad to discuss your options with you.
For more information see our financial policies form.
Appointments & No Show Policy
We make every effort to provide prompt medical care to all of our patients. If you are unable to keep a scheduled appointment, please let us know in advance. A NO SHOW is when a patient fails to keep a scheduled appointment. A NO SHOW will generate a $25 fee and three no shows may require that you seek your medical care elsewhere. In the event that you have a special circumstance regarding your missed appointment, please contact our office manager. We understand that there may be issues beyond your control and want to be understanding of special circumstances.
If you are delayed and cannot make an appointment on time, please call to advise us of your situation and provide an estimated time of arrival. Any significant delay may require the visit to be rescheduled.
If you are a walk-in patient, please understand that there are patients who have scheduled appointments, and you will be seen at the next available time slot. We strongly encourage you to call the office for an appointment first.
In general, we do not recommend combining your PHYSICAL visits with PROBLEM visits at the same time since your insurance often may not pay for both.
Due to the current nature of insurance-based medical practices, we also ask that you limit your visit to 1 TO 2 PROBLEMS only. Should you have more medical issues that need to be addressed, please inform our staff when calling for appointments, and we will schedule more time for you accordingly. Your providers may also have you return for follow-up visits in order to address your additional medical concerns.
Multiple family member appointments must be scheduled in advance. Family members who are present at the time of another member’s appointment, but are not scheduled, will be required to schedule an appointment at a later time. Up to 2 members of the family may be scheduled at any one time.
Prescription Refills
Please have your pharmacy fax your refill request to (480) 961-2367. In most cases, expired prescriptions can also be refilled in this manner, provided you are up to date on required exams and laboratory testing. We do recommend routine follow-up visits at least every 6 MONTHS, depending on your medical needs. Refills will therefore be provided in general for up to 6 MONTHS, exception may include oral contraceptives and other long-term medications, which may be refilled for up to 1 year, at which time our providers may prefer to see you. Refills of prescription medications that fall under the general category of CONTROLLED SUBSTANCES such as narcotics and certain mood-altering agents will require MONTHLY visit. Please be aware that refills may take up to 72 HOURS to process, so please plan accordingly. Your refill request may be denied should you fail to comply with our policy.
Telephone Messages & Processing of Referrals
We will try our best to respond to your messages as soon as possible. However, please be aware that messages may take up to 24 HOURS to process and respond. More often than not, if your questions require extensive attention, your providers may elect to have you make an appointment and come for further evaluation for quality assurance purposes. Likewise, due to the nature of insurance-based healthcare, please also allow 48 to 72 HOURS to process your HMO specialist referrals.
FMLA & Disabilities Forms
In general, we do not complete or perform Long-Term DISABILITY Forms & Evaluations. We do require that FMLA Forms & Short-Term DISABILITY Forms be completed IN PERSON during our regular office hours, at which time our providers may refer you to appropriate specialists for further evaluation and management. Refer to our financial policies in regard to writing letters.
Medical Records & Forms
All requests for medical records must be on a HIPPA approved form, which must be properly and completely filled out and signed by the patient or legal guardian. Improperly filled out forms may delay your request. Please allow at least 5 BUSINESS DAYS for processing.
Medical records released to a new provider, specialist or school: For continuity of care and as a courtesy to the patient, our office will forward records requested at no charge. Medical records released to the patient, some insurance companies, law firm or miscellaneous requests: Records are subject to copying fees.
After Hours
When an EMERGENCY arises, and you need to get in touch with our on-call service, you may call our office at (480) 961-2366. You will be directed to our on-call service personnel, who will then provide you with appropriate instructions. As a reminder, this option should only be used for emergencies. Please be aware that as a general rule, we DO NOT call-in antibiotics and/or medication refills, and under NO CIRCUMSTANCES will narcotics be called to the pharmacy.
IN A LIFE THREATENING SITUATION, PLEASE CALL 911 IMMEDIATELY.
Our friendly staff is committed to making your visit as pleasant as possible. Your comments or concerns are important to us. We rely on them to continue to improve our quality medical care to you and your family.