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MEDICINE REFILLS
For a quicker response to pharmacy refills, please have your pharmacy fax
us a request for your medication to 919-859-5834. Faxed requests are
usually handled the same business day. Phoned in requests are usually processed within 24 hours. Processing times may vary dependent on the availability of your doctor, who must review each request prior to completion. |
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OUR FINANCIAL POLICY
Thank you for choosing us as your health care provider.
We are committed to making health care less stressful and
more effective by clarifying financial responsibilities
in advance. The following is a statement of our Financial
Policy which we require that you read, agree to and sign
prior to any treatment. |
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All patients must complete our PATIENT INFORMATION FORM before seeing the
doctor. You may do this online by clicking on the blue link in this paragraph, or you may fill it out at the time of your appointment. If you have time, we prefer that you fill this form out at home, as you will have the time and resources to fill it out more accurately. In addition, you will save time at your appointment. |
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IF YOU ARE A NEW PATIENT, FULL PAYMENT IS DUE AT TIME OF SERVICE. All co-pays will be
honored if we participate with your insurance carrier after the initial visit. If you have
a question about your insurance carrier, please ask. |
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All subsequent visits require the co-payment at
the time of service.
We accept cash, checks and Visa/MasterCard.
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INSURANCE
Insurance companies with whom we currently participate include Blue Cross/Blue Shield, United Health Care, First Health, Aetna, Beechstreet, Great West/One Health Plan, Healthcare Savings, Mamsi, Medcost, and beginning July 15, 2005, Cigna.
As a courtesy to our patients, we file all insurance
claims electronically for you. If you do not wish for us
to do so, please pay for your visit in full at check out
and we will gladly furnish you with a completed HCFA form
for you to submit to your insurance company. The balance
is your responsibility whether your insurance company pays
or not. We cannot bill your insurance unless you bring in
all insurance information. We cannot submit insurance
without a copy of your card.
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Your insurance policy is a contract between you and
your insurance company. If we do not have a contract with
your insurance company and they have not paid the claim
in 60 days, the balance of your account will be automatically
billed and we will assist you in refiling your insurance.
After 120 days, if payment in full or a payment agreement
has not been negotiated, your account will be considered
due in full and placed for collection. |
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PLEASE BE AWARE THAT SOME AND PERHAPS ALL OF THE
SERVICES PROVIDED MAY BE "NON-COVERED" SERVICES
AND NOT CONSIDERED REASONABLE AND NECESSARY UNDER THE MEDICARE
PROGRAM AND/OR OTHER MEDICAL INSURANCE. |
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Regardless of the insurance company's determination
of usual and customary rates or amount of assignment, you
are required to pay the full amount charged unless we are
contracted with your insurance company to accept assignment.
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MINORS
The parent or guardian accompanying a minor
is responsible for payment. Minors must be accompanied
by a parent or legal guardian to be treated. |
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Thank you for understanding our financial policy! Please let us know
if you have questions or concerns. |
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