Policy and Procedures
DATE: July 2011
Pediatric Pulmonary Associates soon will begin our eleventh year in
private practice. . Please read over the following procedures to help us
continue to grow.
Each year we will ask you to complete a new Patient Information Update
Form,
so that we can be sure we have gathered all of the correct information
about our patients.
Please come to your appointment 15 minutes before your scheduled
appointment time when you will see the doctor.
You will be reminded about your upcoming appointment by one of our
staff. We ask that you let us know at least 48-72 hours before the time
of the appointment.
if you cannot be present. We must allow adequate time to schedule
another patient on our waiting list. We expect that you will come to all
appointments or call to cancel, or we may not be able to reschedule
another slot for you and you may need to follow up with your Primary
Care Physician.
All co-payments and co-insurance payments are due at the time of check
in.
We accept cash, check and MasterCard and Visa. We are happy to bill your
primary insurance carrier, however, we do not bill secondary insurances.
All Managed Care Recipients are responsible for obtaining the
authorization for their appointment with the doctor as well as for
testing such as pulmonary function testing, or x-rays. We will help out
in any way we can.
If we do not have accurate insurance or do not have a valid
authorization within 48 hours of your visit, we will call and cancel
your appointment until we can obtain the valid authorization from your
primary care doctor.
These policies and procedures are for our patients who need to see our
pulmonary doctors. Please arrive to your appointments on time, and make
sure that we have the correct insurance information. Thank you so much
for being our patient.
Multiple Insurance/Co-pays: If you have two commercial insurance plans
you will be responsible for your co-pay from the primary insurance
company at the time of service. We will supply you with a billing for
your secondary insurance, however we will not be able to provide you
with a copy of your primary Explanation of Benefits.
No-show: Patients who do not show up for an appointment, and do not call
to cancel or reschedule have impacted other patient's ability to obtain
timely medical care. We require a 24-hour notice of cancellation for all
scheduled appointments, or you may be billed for that appointment.
Please help us serve you better by keeping your appointments. After
repeated No-Shows without proper notification you may be discharged from
the practice.
Our practice firmly believes that good physician/patient relationship is
based upon understanding and good communications. I have read,
understand, and agree to the above Financial Policy. I understand that
charges not covered by my insurance, as well as applicable co-payments
and deductibles, are my responsibility. I authorize my insurance
benefits to be paid directly to Pediatric Pulmonary Associates, and I
authorize them to release any pertinent medical information to
facilitate payment of a claim.
