OFFICE POLICIES
OFFICE HOURS: ALSA Medical Group's office is open Monday - Friday from 8:00am to 5:00pm. We are closed on all major holidays and from time to time during the lunch hour (12:00pm - 2:00pm) for office meetings and staff development. We answer the phone from 8:00am to Noon and 2:00pm to 5:00p on Monday's and Friday's and from 8:00am to 12:30pm and 2:00pm to 5:00pm on Tuesday's, Wednesday's and Thursday's. The phones will be answered by our exchange service at all other times.
RUNNING ON TIME: We know your schedule is busy and that your time is valuable. Please let US know if you have waited more than 15 minutes to be called up to the front desk to be checked in for your appointment. If someone who arrived after you is called before you, they might be seeing another provider, as we are running several different provider schedules every day.
NARCOTICS: We will not prescribe narcotics after hours or on the weekend, unless you are being discharged from the hospital.
PRESCRIPTION REFILLS: Please note the following regarding prescription refills:
- The best time to discuss a prescription refill is at your appointment
- If you need to call us for a refill, please don't wait until you have one pill left, or are completely out. Most refills require a physician approval. If your physician is out of the office, it is possible it will take 2-3 days for your prescription to be authorized
- Please do not go to the pharmacy to wait for your prescription to be called in. It is best to call them first to see ifit is ready.
- Some medications have to be monitored for effectiveness and side effects. We will require you to be seen in the office for these medications to be refilled. Please be sure to keep any follow up appointments.
- Some prescriptions cannot be called in and you will need to come to the office to pick up the prescription to be hand carried to your pharmacy.
- If you have a prescription for a chronic or long-standing condition, or a condition that ALSA is not treating, please contact the prescribing physician for any refill requests.
REFERRALS TO OTHER PROVIDERS OR FOR TESTING/PROCEDURES BY OUR OFFICE: When we refer you to another office or fora est/procedure, that referral is handled by our Referral Coordinators. Sometimes this can be completed the same day as your appointment and sometimes it can take up to 7 days, depending on your insurance and the urgency of the situation. We will notify you as soon as our office obtains the authorization for your referral. Please understand that it can sometimes take a few we eks, or longer, to get an appointment with a specialist. This is not something we have control over.
As a patient, it is your responsibility to ensure that any provider/facility we refer you to is on your insurance plan. It is also your responsibility to ensure we receive a copy of your test results. You should pick up a copy of your test results and bring with you to our office, in case we are unable to obtain it.
INSURANCE: It is the patient's responsibility to provide ALSA Medical Group with current insurance information. Your insurance policy is a contract between you and your insurance company. As a courtesy, we will file your insurance claim for you. However, we will not become involved in disputes between you and your insurance company. This includes, but is not limited to, deductible amounts, co-pay amounts, non-covered charges and "usual and customary" charges. We will supply any information that we have to help you resolve any dispute, but you are ultimately responsible for the payment of your account.
REFERRALS AND PRE-AUTHORIZATION FOR SERVICES PROVIDED BY ALSA MEDICAL GROUP: Your insurance plan may requirea referral from your primary care physician, or an authorization for services when you are seen by ALSA Medical Group. Under the terms of your coverage, it is your responsibility to obtain the appropriate referral prior to your office visit. If you do not have a valid referral and/or authorization on file at the time of your visit, we will have to reschedule your appointment. In compliance with our contracts with our participating insurance carriers, we CAN NOT obtain a referral after services have been provided (retroactively We also cannot contact your primary care physician's office to request a referral when you arrive at our office for your visit; this delays other patients who are waiting to be seen, and your PCP's office is not able to drop everything to respondto our request. Please contact your PCP well in advance of your visit if a referral is required.
NON-PAYMENT/DELIQUENT ACCOUNTS: If the self-pay balance on your account is over 60 days past due, and you have not contacted us regarding your balance or you do not make agreed-upon payments when we have approved a short term payment plan, your account balance is subject to placement for outside collection. If your account is placed for outside collections, the unpaid amount will be reported to credit bureaus by our contracted collection agency. In extreme circumstances, an unpaid balance may result in a patient's discharge from our care.
RETURN CHECKS: Returned checks will incur a $30.00 service charge by our office. You will be asked to bring cash, certified check or credit card to cover the amount of the check, plus the $30.00 fee prior to receiving further services from our office. Stop payments constitute a breach of payment and are subject to the $30.00 fee. Any checks that have not been cleared along with their $30.00 fee within 15 days of notification by the bank that the check was returned is subject to outside collections.
DISABILITY, INSURANCE FORMS, FMLA, ETC: There is a charge of $15.00 for completion of any disability form, FMLA form, individual work forms, etc. Payment is due prior to the form being completed by our office. Please allow 7-10 days for completion of any form. We will not complete any disability form prior to your surgery date.
PATIENT AND ALSA MEDICAL GROUP RESPONSIBILITIES (FOR BARIATRIC AND REVISION SURGERY PATIENTS)
ALSA Medical Group Responsibilities:
- We will refer you to the appropriate specialists/facilities for the completion of any required testing and/or procedures. If you have any HMO plan, we may have to refer you back to your primary care physician, however we will provide them with all the information that they need to schedule any test/procedure for you.
- We will review all tests and procedures to ensure that no additional testing is needed.
- We will compile all necessary tests and procedures for submission to your insurance company for prior authorization.
- We will timely log into your chart all received reports, however, we cannot be held responsible if a report/test result is not received from your provider/facility. Sometimes faxes are not received due to phone line issues, or mail gets misdelivered. To ensure receipt of any report/test result, you may hand carry them to our office.
Patient Responsibilities
- To keep all your appointments with our office and any specialists or procedures we have scheduled for you.
- To notify us if any of your tests/procedures have been cancelled or rescheduled
- To notify us of any insurance changes/updates
- To ensure that we have received a copy of all tests/procedures you have completed either prior to coming to our office or after. If you are having a problem obtaining a result, please let us know and we will work with you to obtain the report.
- To notify us when you have completed a block.
I have read and understand the practice's policies and - agree to its terms. Talso understand and agree that such terms may be amended by the practice from time to time.