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When you come in for a visit, whether it’s for an acute need or a chronic condition please be aware that you are being scheduled for a certain amount of time. Unfortunately, time limits are necessary due to insurance reimbursement issues as well as the number of patients requesting appointments. When making an appointment be clear about your reason for the visit so we can schedule appropriately.
We try hard to stay on time so we can respect our patient’s time however; this gets difficult when a patient needs several issues addressed. So that we are able to serve you and others, please come to the visit prepared and focus on 1 or at the most 2 issues that need to be addressed. This allows the doctor to focus and provide you the best attention for those needs. Should you have more issues, please let the staff know so that they can make a follow up appointment for you. Thank you for understanding.
Welcome to our practice. We are happy to have you. We offer an online portal for you to provide us with your medical history. Call the office to register and provide us an email so we can send you an invitation to join. Or if you prefer, please come by the office to pick up a hard copy of new patient paperwork. We require all paperwork be done prior to your visit. This includes a medical records release so that we can get additional medical information about your past history. This will make the visit smooth and efficient.
We accept most commercial plans. Please check in with your insurance provider to see if we are in network. We can accept out of network plans, however you should be aware of what that means for your out of pocket costs.
We are a member of one HMO – Physicians Choice of Santa Maria (PCSM). We do not accept any other HMO plans at this time. All HMO patients require approved referrals from the HMO before they can see specialists or have tests completed. Those specialists must also be credentialed with PCSM.
It is your responsibility to understand your insurance benefits whether it is HMO, EPO, POS or a PPO. This includes your copays and deductibles and the services your insurance covers. We may recommend a service or provider that is not covered by your insurance. If there is any question, please call your insurance before you accept service. We can provide some direction; however, it is impossible for us to know coverage provided by your unique insurance plan.
We believe in a team approach to your healthcare. As long as we are going to the same destination and agree how to get there we can guide, but ultimately it is your journey.
Here’s a few of our guidelines to help you understand what you can expect:
Comments or concerns:
It’s bound to happen. There’s a slip up somewhere. We try our best but we aren't perfect. We work on numerous transactions with very unique people who have differing needs and ways of wanting to be communicated with. It’s a tough balance, but I think we do pretty well. However, if you do find yourself in that position give us a call so we can figure it out together. Typically, there is a simple answer and an easy fix.
Prescription Refills: Call your pharmacy and ask them to send us a refill request. Please allow at least 48 hours for refills. Medical Offices handle thousands of prescriptions every year with numerous pharmacies through a variety of mechanisms so plan ahead in case there is a hiccup. Also, make sure we are the prescriber on your medication bottle and it’s not prescribed by another specialist. This is a common mistake and it can be frustrating on both sides. Ideally, keep your prescriptions with the physician who prescribed it unless the doctor has agreed to take it over. If we have not filled that medication for you in the past or you haven’t listed that medication in your chart with documented medical reasons, then we require a visit to document the medical background for it.
Formulary Changes: Drug coverage can change a few times a year meaning your current medication may no longer be covered. This can be frustrating. First call your insurance to verify change. Higher deductibles may not be an indication of off formulary but instead deductibles, copays, coinsurance. Your insurance is the best place to get that information.
Any changes to medication requires either a visit to discuss alternatives with the doctor. Or our staff can research an alternative (overseen & signed off by the doctor) for a fee paid in advance.
Phone calls: We receive numerous phone calls every day. When our phone lines are occupied with other callers, you will be sent to a voice mail. We check that voice mail frequently throughout the day so please leave us a message and we’ll get back to you as soon as we can.
Unfortunately, the doctor is unable to take phone calls during the day. However, your message is noted in your chart and is routed to one of our staff for research. Please plan ahead and allow us plenty of time to respond.
Requests for Orders, Labs or other DME: Frequently insurance requires medical documentation with a face to face visit in order to make these requests and get them reimbursed. You may be asked to come in for a visit. This does not guarantee approval for the order, lab or equipment but is used as consideration for it. Criteria must be met and documented.
Follow up visits: If the doctor has not recommended a return visit while you are in the office, he may place a reminder in the system after he has documented your visit. This means our automated system will call you several weeks prior to that date to schedule that visit. You may elect not to follow up, it is a recommendation by the doctor and not a requirement. However, not doing so may impact your health negatively depending on your condition.
Family dynamics: Medical offices often get caught in the middle of challenging family dynamics including caregivers (who may not be related to the patient). Please keep in mind our focus is on medical issues. We understand social situation’s may impact a patient’s health therefore we highly recommend families seek out assistance from social service agencies or mental health groups. Referrals are not required. If you want a family member to take part in your health we require a consent form with the patient’s signature or a power of attorney document to be on file before we can release information.
Controlled substances: Addiction is a serious problem in our country. Addiction does not apply to any particular age, gender, socio-economic group or race, it is equal opportunity. We are very concerned about addiction and diversion. However, we understand patients can experience acute or chronic pain. It is our policy to not treat chronic pain except in the case of cancer patients. We may provide a referral to a pain management specialist for them to assess your chronic pain and recommend treatment. We track our patients on the CURES website and require our patients do random drug screening if requested.