Office and Financial Policies
Calling our office: Due to a high volume of calls, our doctors ask that you schedule an appointment to go over all labs, X-rays and other test results. Results will be shared over the phone only if the doctor needs to discuss something with you prior to an appointment.
Copayments: Your copayment is due at the time of service prior to seeing your doctor. If you are unable to pay at the time of your visit, please mail in your payment promptly to help us avoid added paperwork.
Preparing for your appointment: Please be ready to discuss your most pertinent issue first. Since appointments are based on a 15-minute time allowance, it becomes difficult to address multiple issues. We do our best to stay on schedule to minimize your wait time and that of other patients.
Your insurance card: We copy your insurance card at each visit to make sure we have the most recent information.
Payment policy: Recent changes in health insurance coverage have led to confusion for some patients. If you have questions or are experiencing circumstances that necessitate a payment plan, please contact our business office. Our payment policy is as follows:
- Our physicians based decisions on medical expertise, not on what your insurance covers. It is your responsibility to pay for services not covered by your insurance plan. Please check with your insurer to find out whether a particular service is covered. We ususally do not know what your insurance covers because there are so many different plans and providers
- You will receive a monthly statement. Payment is due within 30 days. All open accounts will be charged a $15 fee after the 30-day billing period.
- If you have not paid your bill within 61 days, or worked out a payment plan with the business office, payment by cash, check or credit card will be required for future office visits.
- Please ask for your refills at the time of your office visit to avoid additional charges. We now charge $25 for prescription refills over the phone, to cover the physician’s time in reviewing your charts and a nurse’s time to arrange the refill with you and your pharmacy.
- We suggest that you bring your insurance plan’s drug formulary to your doctor visits. This is the list of medications that your insurance covers. Referring to this list, the doctor may be able to find equivalent or generic medications that will cost you less.
We at Fairlawn Family Practice firmly believe that a good doctor/patient relationship is based on understanding and open communications. If you have any questions or concerns, or if you need assistance, please contact us immediately.
The staff at Fairlawn Family Practice
Patient signature _________________________________________ Date___________________________
I fully understand the office and financial policies as stated above.