Office Policies

Thank you for choosing Rheumatology Center Of Houston for your rheumatology needs. The staff at Rheumatology Center Of Houston strives to exceed expectations in care and service in order to make your experience with us as comfortable and stress-free as possible.

In order to reduce confusion and misunderstanding between our patients and the office, we have adopted the following policies. If you have any questions about these policies, please discuss them with our office manager. We are dedicated to providing the best possible care and service to you and regard your complete understanding of your financial responsibilities as an essential element of your care and treatment.

Appointments

Rheumatology Center Of Houston is committed to providing quality care to our patients.  We strive to give all our patients the time that they require. For this reason, we kindly request your patience and understanding should a delay or rescheduling become necessary on your appointment date. To ensure quality care, Rheumatology Center Of Houston does not treat patients we have not seen (i.e., we will not call in prescriptions or offer medical advice for patients prior to their initial visit). Follow up may be required to be scheduled after testing has been completed, so that results may be reviewed together, so an effective and appropriate plan for your healthcare can be determined.  Patients are expected to bring in their medication bottles or a detailed list of medications to each office visit.  Patients are expected to take all medications as instructed and will not alter or change the dosage without consulting a medical provider. Patients are expected to keep all follow-up appointments as recommended so that medications and any relevant lab work can be monitored.

Missed or Cancelled Appointments/Late Arrivals

In order to be respectful of the medical needs of our patients please be courteous and call Rheumatology Center Of Houston promptly if you are unable to attend an appointment. Appointments are in high demand, and your early cancellation will give another person the ability to have access to timely medical care. This is how we can best serve the needs of our patients. As a courtesy, we attempt to contact every patient to remind them of their appointment.  However, it is the responsibility of the patient to arrive for their appointment on time.  Cancellations must be received 24 hours in advance.  We reserve the right to charge for missed, cancelled, or no-show appointments.  Please note that these fees are a patient responsibility and will not be billed to your insurance company.  Such fees are available for review with our practice manager.  If you arrive more than 15 minutes late, we reserve the right to ask you to reschedule.  If you are running late we recommend that you call our office to verify your appointment will be honored.

Prescription Refills

We request that you obtain refills during your office visit.  If there has been an over-sight, please have your pharmacy fax us a refill request.  Please plan ahead as refills may take up to 2 business days to authorize.  We will only authorize refills during office hours.  Medications will not be refilled if a patient continues to miss scheduled appointments or has not been evaluated by his/her physician in a timely manner. Female patients should notify the provider or nurse if there is any chance they may be pregnant.

Insurance

We participate in most insurance plans.  Please contact our office for an updated list. As a service to you, we will bill your insurance company for office visits and procedures and your insurance will pay your insurance benefits directly to Rheumatology Center Of Houston. We make every effort to include all necessary information and appropriate diagnosis codes when billing your insurance company. It is impossible for us to know everything that any given insurance policy does or does not include. If you have any questions regarding a bill or unpaid charges, please discuss them with our billing department. If you have questions about your plan’s benefit coverage, please contact the membership department of your plan. The terms of your insurance policy are between you and your insurance company. It is your responsibility to inform our office of any changes in insurance coverage. Failure to do so could cause delay or denial of insurance payment which then becomes your responsibility.

Outstanding Balance

If we have not received payment from your insurance company within 45 days of service, you will be sent a bill and be held responsible for payment within 30 days. It is our office policy that all past due accounts be sent three statements. If payment is not made on the account, a single phone call will be made to try to make payment arrangements. If no resolution can be made, the account will be sent to the collection agency, or attorney, and possible discharge from the practice. If an account goes to collection for processing, a collection fee (30% of the outstanding balance) will be assessed and all costs including attorney fees and court costs will be your responsibility. If the insurance company has requested information from you and you have not returned requested information, the insurance company will deny the claim and therefore hold you responsible for the balance in full. You are responsible for all your charges. If your coverage terminates after you have been seen, and it is retroactively canceled, you will be held the balance in full. If you have insurance coverage with a plan for which we do not have a prior agreement or your have a pre-existing clause on your policy, the charges for your care and treatment will be due at the time of service.

Co-payments, Deductibles, and Collections

Co-payments, co-insurances, and deductibles are due at the time of service.  If your medical plan determines a service is “not covered,” you will be responsible for the charge. Payment is due upon receipt of statement from the office or next office visit.  We accept cash, check, and credit/debit cards. Payments can also be made online from our website: www.rheumatologycenterfofhouston.com. Your insurance entity dictates your co-pay, deductible and coverage. In the event you are unable to pay your contracted obligations we will give you the opportunity to reschedule your appointment to a more convenient time.

Payment Plans

Patients with an outstanding balance of 30 days overdue must arrange for payment prior to scheduling appointments. We truly realize that people have financial difficulties. Payment plans must be set up by the patient and will automatically be deducted by credit/debit card on agreed date. If patient defaults in the agreed to payment arrangement, this will void the payment arrangement and the account will be placed on hold and sent to collection for processing.

Referrals

Some insurances will require a referral from your primary physician to see a specialist or to have certain procedures such as injections.  If this applies to you, please make sure your physician sends us a referral to avoid delays in you seeing the specialist.  If we do not have a referral for a procedure, you may be asked to return another day to have that procedure done after we obtain a proper referral.  If you have questions about your plan’s policy, please contact the membership department of your plan.

Forms/Copies of Records

Completion of any forms that require your provider’s input can be very time consuming for both you and your provider.  You may be asked to schedule an appointment with your provider to review the requested information.  We reserve the right to charge for copying of medical records or completion of forms.  All fees are available for review with our office manager.  Please allow 1 week for forms to be completed.

Disability Policy

Your health care staff cannot become involved in any disability-related activity, including such things as filling out forms for your employer or disability insurer, making a determination about your ability to do a job, communicating with an attorney, filling out any governmental form such as Family Medical Leave Act (FMLA), or parking handicap passes, etc, until you have seen your physician or physician assistant at least three times over at least 6 months.  This is to insure we have developed as accurate a diagnostic picture and treatment approach as possible.

Test Results

You will be contacted if diagnostic results require a change in therapy.  Normal or borderline results, or results that require detailed explanation, will be discussed at your next office visit.  If you cannot wait until your follow-up visit, please contact us to schedule a visit to come in and review.

General Questions or New Problems

A telephone call can never replace an office evaluation of a problem.  Brief questions to clarify confusion can be answered over the phone or through our patient portal.  In accordance with the American Medical Association CPT guidelines, we reserve the right to charge for telephone calls with our medical professionals that include evaluation and management of your medical condition. We will bill your insurance for such calls, but if it is not covered by your plan you may be responsible for the charges. New symptoms or complex questions will require a visit.

Insufficient Checks

If a check is presented on insufficient funds you will be responsible to redeem the check in our office on a cash basis for both the amount of tender and all fees assessed.  Our policy on such transaction is available for review with our office manager.

Feedback/Complaints

We welcome your feedback. If you feel that an area of our practice needs attention, please feel free to call, come in, or email us at [email protected] regarding your concern. You can voice your concerns with the practice manager. Please remember that any medical practice is dynamic, with ongoing change at all times. We constantly strive to meet your needs in a more efficient and effective manner. Please keep your comments constructive as we always welcome suggestions.

Patient Dismissal

We sincerely hope that we never have to part ways with a patient. However, extenuating circumstances may make this necessary. If this occurs, you will be notified by certified mail of this non-negotiable decision. You will have 30 days to find another doctor during which we will continue to offer urgent care services only.

Patient Privacy

The federal government requires us to share our Privacy Practices, which is made available at your initial visit to our practice and is available on our website.  Please review the Privacy Practices, which explains policy on sharing patient information for treatment and billing issues.

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