Welcome Guide and Patient Agreement for The Foot and Ankle Joint
Introduction to The Foot and Ankle Joint
Welcome to The Foot and Ankle Joint, specializes in comprehensive podiatric services. Our unique house call model ensures personalized foot and ankle care delivered directly to your home. Each visit typically lasts between 30 to 60 minutes, fostering a deep and productive relationship essential for effective podiatric care.
Engagement and Care Protocols
Your active participation is crucial. This document outlines our practice operations and
your relationship with The Foot and Ankle Joint, ensuring clear mutual expectations.
Standard Visit Procedures
• Updated Information: It is crucial to keep your contact and insurance details current to ensure seamless provision of podiatric services.
• Financial Agreement: a credit card must be on file to facilitate seamless payment processing.
• Scheduled Visits: Our providers deliver regular podiatric care based on medical necessity. Visits are scheduled according to routes that effectively accommodate all patients within specific geographic areas.
• Appointment Confirmations: Appointments can be confirmed via text message or by calling the office directly. This ensures continuity of care; unconfirmed appointments are subject to a cancellation fee.
• Visit Windows: Appointments are set within a three-hour window, accommodating unforeseen delays.
Patient In-Home Engagement Policy
To ensure that each visit is productive and safe for both patients and providers, The Foot and Ankle Joint has established the following guidelines for in-home engagements:
• Timeliness and Preparedness: Patients should be ready and available at the scheduled time of the visit to avoid delays. This helps in maintaining the schedule and ensuring that all patients receive timely care.
• Proper Setup for Treatment: The patient must be positioned in the bed or in a working recliner during the visit to allow appropriate access to the feet and legs. This positioning is crucial for effective treatment and to facilitate the provider’s ability to perform necessary procedures.
• No Smoking Policy: Smoking is not permitted in the home during the provider’s visit. This policy ensures a safe and comfortable environment for the provider to administer care and supports the health considerations of all involved.
• Pet Control: All animals must be secured and kept away from the areas where healthcare services are being provided. This measure prevents interruptions and ensures the safety of both the provider and the patient.
• Medication List Accuracy: Patients are required to provide an accurate and updated list of all medications they are taking. This information is vital for the provider to deliver appropriate and safe care, considering potential interactions and side effects.
• Extension to Partners: These policies apply equally to all partners of The Foot and Ankle Joint who may visit the home to provide services. It is imperative that the same level of respect and compliance is afforded to each visiting team member.
By adhering to these guidelines, we can enhance the effectiveness of the care provided and ensure a safe, respectful, and professional environment for both our patients and our healthcare providers.
Financial Responsibilities and Policies
• Credit Card on File: A credit card is required upon registration. An initial $1.00 verification charge is applied and later credited back. This card is used for settling balances including copays, coinsurance, and fees for services not covered by insurance.
• Direct Billing: We directly bill your health insurance for covered services. Understanding your insurance benefits, including deductibles and copays, is crucial.
• Non-Covered Services: You are responsible for payments for services not covered by insurance, due at the time of service unless prior arrangements have been made.
• Account Balances: We will notify you before charging more than $200 for any balances due to non-payment of deductibles, copays, or non-covered services. Overpayments can be refunded or credited toward future services.
• Trip Fee: A $35 trip fee is charged per visit to cover travel expenses. This fee is waived for Medicaid patients, residents of assisted living facilities, and patients in skilled nursing facilities.
Cancellation Policy
The Foot and Ankle Joint values the time of both our patients and our providers. To ensure effective scheduling and resource utilization, we adhere to the following cancellation policy:
• Timely Cancellation: Cancellations must be made at least 48 hours prior to the scheduled visit. This allows us to reallocate our resources efficiently and accommodate other patients who may need urgent care.
• Late Cancellations and No-Shows: Any cancellations made less than 48 hours before a scheduled visit, or failure to be present at the time of a scheduled appointment, will incur a $75 cancellation fee. This fee compensates for the time set aside by our providers and the lost opportunity to serve other patients.
We understand that emergencies can occur that may prevent timely cancellations. We encourage our patients to contact us as soon as possible to discuss their situation so we can work together on a suitable solution.
HIPAA Privacy Practices
• Access to Records: You have the right to request both electronic and paper copies of your medical records, provided typically within 30 days with a possible nominal fee.
• Amendments to Records: If you believe your records are incorrect or incomplete, you may request an amendment. We reserve the right to deny the request but will provide a written explanation within 60 days.
• Confidential Communications: You may request communication through alternative means or locations. We accommodate reasonable requests when possible.
• Restrictions on Use: You may request restrictions on the use and disclosure of your protected health information. We will consider your request carefully, though we are not required to agree to all restrictions.
• Accounting of Disclosures: You have the right to an accounting of disclosures of your health information, excluding those related to treatment, payment, and health care operations, or where you authorized disclosure.
Your Rights and Choices
• Sharing Information: You can direct us to share information with those involved in your care or in emergency situations. You also have the right to limit information shared in a hospital directory or for fundraising.
• Advanced Directives: If you have provided an advanced directive, it will guide our actions in providing care according to your wishes.
Complaints and Grievances
If you believe your privacy rights have been violated, you may file a complaint with us or the Secretary of the U.S. Department of Health and Human Services. We assure you that filing a complaint will not affect the care provided to you.
Contact Information for Privacy Matters
• Office Contact: Contact our office directly for privacy-related issues or complaints.
Dismissal Policy
The Foot and Ankle Joint is committed to providing a safe and professional healthcare environment for both our patients and our providers. To maintain this environment, we may find it necessary to dismiss a patient from our practice under the following circumstances:
• Creating an Unsafe Environment: Any behavior that threatens the safety of our providers, including physical harm, verbal abuse, or other hostile actions.
• Non-Compliance/Non-Adherence: Engaging in non-compliant or non-adherent behaviors that compromise the effectiveness of the prescribed treatment plans and healthcare protocols.
• Failure of Payment: Not providing a valid credit card for billing purposes or failure to maintain an up-to-date credit card on file. Patients may contact our office to establish a payment plan if they are unable to make immediate payment.
• Lack of Active Medical Insurance: Failing to provide an active and valid medical insurance policy. It is essential for the continuation of care that all patients have some form of medical insurance or a reliable method of payment.
Patients subject to dismissal under these policies will be notified in writing and provided with a reasonable time frame to find alternative medical care. This policy is in place to ensure that all parties involved receive the respect and safety they deserve and to maintain the integrity and efficiency of our healthcare services.
Acknowledgment of Practice Policies
By signing this acknowledgment, I agree to abide by The Foot and Ankle Joint’s Practice Policies, including its Financial and Credit Card Policies. I understand that non-compliance with these policies may result in my dismissal from the practice in accordance with its Dismissal Policy. I have been provided with a copy of these policies.
Acknowledgment of Financial Responsibility
I agree to abide by The Foot and Ankle Joint’s Financial and Credit Card Policies and acknowledge that I am financially responsible for all covered and non-covered charges associated with my care. I understand that charges for medical and related professional services performed or supervised are my responsibility. Charges may differ from estimates, and I am responsible for amounts not covered by insurance. I agree that any overpayment may be applied to outstanding charges on any of my accounts with The Foot and Ankle Joint.
Authorization to Retain and Charge Credit Card on File
I agree to keep an active payment method on file and understand that The Foot and Ankle Joint will notify me before charging my card for amounts over $200. This includes copays, deductibles, and coinsurance, as well as fees for non-covered services.
Insurance Certification, Assignment, and Payment Request
I certify that the insurance information I provided is accurate. I request that payment of authorized benefits be made on my behalf directly to The Foot and Ankle Joint upon submission of a valid claim. I agree to personally pay for charges not covered by insurance.
Consent for Telephone, SMS, and Email Communications
I consent to The Foot and Ankle Joint and its agents contacting me via the provided contact channels for purposes including account servicing, medical updates, appointment reminders, and collection of amounts due. Contact methods may include live calls, emails, faxes, SMS, and automated voice messages.
Release of Liability for Personal Property
I release The Foot and Ankle Joint and its agents from any liability for damage, loss, or theft of my personal belongings while in my home. I understand that The Foot and Ankle Joint does not assume responsibility for these items.
Consent for Use and Release of Protected Health Information
I hereby grant The Foot and Ankle Joint the authority to access, retrieve, and disclose my medical information as required for my healthcare management. I confirm that I have received and comprehended The Foot and Ankle Joint’s Notice of Privacy Practices. My health records will be utilized for, but not limited to, the following purposes:
• Developing a detailed care plan tailored to my ongoing health needs.
• Enhancing the coordination and communication among the medical professionals involved in my treatment.
• Recording diagnostic and treatment information for billing purposes.
• Allowing third-party payers to confirm the services billed.
• Contributing to routine healthcare operations, such as evaluating service quality and assessing the proficiency of healthcare professionals.
Consent for the Use of Artificial Intelligence in Medical Documentation
I also consent to the use of artificial intelligence (AI) technologies by The Foot and Ankle Joint for the purpose of documenting medical records. I understand that AI will be employed to assist in the creation and management of medical documentation, ensuring accuracy and efficiency in recording clinical encounters and treatment plans. This technology may analyze my health data to enhance the quality of documentation and facilitate better health outcomes. I acknowledge that the use of AI in medical documentation adheres to all applicable privacy and health information laws, safeguarding the confidentiality and integrity of my personal health information.
Emergency and Urgent Care Policy
• Non-Provision of Urgent Care: The Foot and Ankle Joint does not provide urgent care services. If you require emergency medical services (EMS), please call 911 immediately or contact your primary care provider for further instructions.
Contact Information
• Phone: 404-912-5000
• Fax: (404) 912-5163
• Address: The Foot and Ankle Joint, 1201 West Peachtree St. NW, Suite 2625, Atlanta, Georgia, 30309
• Email: info@thefootandanklejoint.com
Hours of Operation
• Office Hours: Monday to Friday: 9:00 AM – 5:00 PM
- Office is closed for lunch from 12:00 PM-1:00 PM
• Closed: Weekends and Holidays
Complaints and Grievances
If you believe your privacy rights have been violated, you may file a complaint with us or the Secretary of the U.S. Department of Health and Human Services.
Conclusion
Thank you for choosing The Foot and Ankle Joint for your podiatric care needs. We are committed to providing you with high-quality podiatric care and maintaining the highest standards of medical practice. For additional questions or policy clarifications, please contact our office.