PATIENT FINANCIAL POLICY
Before your appointments, please review your insurance information regarding its policies on, copayments, coinsurances and deductibles, which may be required. Office appointments are to be paid for at the time services are provided. This includes copayment, coinsurances and deductibles, and any outstanding balances. If our practice participates with your insurance plan, we will bill your insurance company for the services provided. Please bring your insurance card with you and present your card for verification at each appointment. Please note that any questions or complaints regarding your insurance coverage should be directed to your insurance company. If your insurance company happens to deny or does not respond to a claim that our practice has submitted for services to you, you may be liable for the expenses. If our practice does not participate with your insurance company or you do not have medical insurance, you will be required to pay the full cost of the office visit and any procedures or tests performed. All co-pays, past due amounts, and deductibles for office visits are due at the time of service. Payment for services can be made by cash, check, or credit/debit card. Patient or responsible party will be charged $25 for any returned check.
CANCELLATION POLICY
If you need to cancel or reschedule an appointment, please call 48 hours in advance. If you cancel or reschedule your visit without 48 hours advance notice, or do not show for your appointment, you may be charged $50. If you miss 2 consecutive appointments without contacting the office, you may be discharged from the practice. Please be on time for your appointment. If you are more than 15 minutes late, your appointment will be rescheduled.
CONTROLLED SUBSTANCES POLICY
Patients who take any controlled substances (i.e. opioid pain medications, benzodiazepines, etc) must be seen every month for refills (unless directed otherwise). Controlled substances with quantity over 30 pills per month may be referred to pain management/specialist.
PAPERWORK POLICY
Any paperwork that the physician agrees to fill out for you will take up to seven days to complete and return to you. The cost for each form is $25 and up depending on length of paperwork. The payment is due when paperwork is dropped off. Insurance does not cover this charge.
TEXT/EMAIL CONSENT
Primary method of communication with Rahma Health is through online portal or telephone. Email and standard SMS messaging may be used in certain situations. I hereby consent and to have my physician and other staff at Rahma Health communicate with me by email or standard SMS messaging regarding various aspects of my medical care, which may include, but shall not be limited to, test results, prescriptions, appointments, and billing. I understand that email and standard SMS messaging are not confidential methods of communication and may be insecure. I further understand that, because of this, there is a risk that email and standard SMS messaging regarding my medical care might be intercepted and read by a third party.
AI TRANSCRIPTION TECHNOLOGY
Rahma Health utilizes generative AI transcription technology to generate medical notes. Natural language processing allows the transcription software to analyze and dictate human conversations as they occur, similar to a physician's scribe. This technology can be used during or after the patient's visit when a doctor prepares after-visit summaries and updates a patient's chart. The attending physician will review the transcription for quality assurance purposes before the notes are added to the patient's medical chart. The transcription technology vendor is HIPAA-compliant. Patients can verbally opt-out during a visit if they choose. I agree to allow Rahma Health to use generative AI transcription technology.
I have read and understand the terms and conditions in the Office Policies and agree to abide by them.