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Office Policies

Thank you for choosing Magnolia Primary Care LLC! To ensure you receive the best possible care, please review our office policies. Contact us with any questions.

 

Start the year with updated insurance information!

It's common for insurance plans to change at the beginning of the year. Please let us know if your plan or policy number has been updated. This ensures we can bill your insurance correctly and understand your coverage needs, so you receive the best possible care.

Arriving on Time for Appointments

Your appointment time is reserved just for you. To make the most of your visit and receive the best possible care, please arrive 10-15 minutes early. This allows time for check-in and completing any necessary paperwork.

If you arrive more than 10 minutes late, or if your paperwork isn't completed within 15 minutes of your appointment time, we will reschedule your visit and a $40 late arrival fee will apply. To ensure we can stay on schedule and provide each patient with the attention and care they deserve, we appreciate your understanding and cooperation in arriving on time.

Understanding Your Bill: How We Code Your Visits

We want to be transparent about how your visit is billed to your insurance. Here's a breakdown of the factors involved:

  • Type of visit: Are you here for a routine check-up, a sick visit, or a follow-up appointment? Each type of visit has a different billing code.

  • Time spent with the care team: This includes the time you spend with the physician, as well as any time spent with our nurses or medical assistants.

  • Documentation: Accurately documenting your visit takes time, and this is factored into the billing code.

  • Complexity of your visit: We consider the complexity of your health concerns, which may include reviewing your medical history, ordering and interpreting tests, and coordinating care with other providers.

It's important to understand that the complexity of your visit is a key factor in determining the billing code, even if it doesn't directly relate to the time spent during your appointment.

Because of these factors, your visit may be billed using more than one code to accurately reflect the services you received.

We are committed to providing you with the best possible care, and that includes clear and honest communication about billing. If you have any questions about how your visit is billed, please don't hesitate to ask.

Focusing on Your Wellness: Important Changes to Lab Orders

Starting February 1, 2025, we're making a change to how we handle lab orders for your annual wellness visits. Instead of mailing out lab orders in advance, we'll now discuss and order any necessary labs during your appointment.

In the past, we performed your wellness visit and discussed lab results together. However, to provide you with the most comprehensive and personalized care, we've found that it is necessary to provide separate dedicated time and appointment for the preventative/wellness visits and lab result discussion.

What's changing?

  • Lab Orders During Your Appointment: Instead of mailing out lab orders in advance, we'll now discuss and order any necessary labs during your wellness visit. This allows for a more focused conversation about your individual needs and any specific lab work you may want to consider.

  • Dedicated Results Review: To ensure we have enough time to review your results thoroughly, we'll schedule a separate follow-up appointment 4-5 weeks later. This dedicated time allows us to discuss your results in detail, answer your questions, and create a personalized plan for your continued well-being.

Cancellation, Missed appointment and Late for appointment 

Cancellation

Cancellations made less than 24 hours before scheduled appointment time will result in a cancellation fee of $40.00. We accommodate most other requests to reschedule and appreciate courtesy notice of at least 48 hours before the appointment.   

Because we reserve a specific time just for you, any cancellations and/or rescheduling your appointment can cause delay in getting timely appointment, as priority is given to urgent needs. Please be aware that the number of open appointments for non-urgent visits may be limited. Multiple cancellations (3 or more consecutive, or 5 or more per year) may make it difficult to ensure you receive the consistent care you need and could result in discharge from our practice.

No show

A “No Show” is when you do not show up to your appointment without prior cancellation. 

  • Each “no show” incident will be subject to an administrative fee of $40.00.

  • Two (2) “no-shows” within one (1) calendar year will result in temporary suspension of services, per our discretion. You will receive a letter indicating this suspension. In order to reinstate services, you must meet with your Primary Care Physician within 30 days of us sending out the service suspension letter to evaluate the circumstances. We will fill appropriate prescriptions for those 30 days. If you do not respond and/or schedule an appointment within the stated 30 days, we will consider your patient status with us terminated. 

Phone calls/correspondence policies

  • Please call us only on our 2 monitored lines 256-203-6676 & 256-203-3949.

  • For any phone call that is not answered, please leave a voice message. Only voice messages will receive a callback from us, not missed calls. 

  • Voice messages left during business hours regarding medical questions or scheduling will be prioritized and responded to as soon as possible before the end of the next business day. 

  • Voice messages regarding billing will be returned before the end of 3 business days

  • Please use the portal messaging for non-urgent needs. All portal messages will receive a reply as soon as possible within 24 hours, except for holidays and weekends

  • We charge for all asynchronous digital communication that requires physician time and involvement. Asynchronous digital communication includes but is not limited to: portal messages, non face to face digital evaluation services and telephone calls. This is excluding a "telehealth" which is billed differently. Asynchronous communication will be billed to your insurance if your insurance offers such coverage. Otherwise, you will be billed $15.00 per communication.

After hour/weekend services 

  • We offer after hours and weekend telehealth services for urgent concerns.

  • This visit will be billed to your insurance as a telehealth visit and coverage for this service will be based on your specific insurance coverage policy for telehealth services. 

  • If the concern can wait till the next business day, we request that you call us back when we reopen. 

  • If you suspect an emergency, please call 911 and/or head to the nearest ER.  

Payment and insurance Responsibilities

Insured patients 

  • Please update us on any insurance information changes immediately. If this is not done in a timely manner, you will be responsible to pay for the balance of a claim. 

  • Your insurance policy is a contract between you and your insurance company. It is your responsibility to know your benefits including insurance coverage, deductible, co-payments, etc. 

  • As a courtesy to you, we will submit claims to your primary, secondary and/or tertiary insurance plans on your behalf. Insurance coverage varies considerably from plan to plan and we rely on you to inform us of the appropriate filing order and any special rules your plan requires. 

  • If your insurance requires you to select a provider (For managed Care Plan, HMO), please call your insurance company before your visit and make this selection as we are not allowed to do this for you. If this is not done before your appointment, your insurance will not pay for the charges and you will be responsible to pay these in full.

  • You will need to pay your copay before the visit, at the time of check in.

  • We will remind you of any outstanding balance at the end of every month through letter/email. For patients with an outstanding balance over 120 days (that is despite 3 reminders), we will turn your bill over to a collection agency.

  • Please note that if we address chronic or acute medical conditions during your Preventative Care Visit (periodic physical examinations or annual wellness visits), we can send a separate claim for these problems with your insurance company. These additional concerns addressed may be subject to co-pays and deductibles, and this extra service may not be covered in full by your insurance. You may receive an additional charge for these services.

  • All non - insurance covered charges such as No-Show charges, form charges, asynchronous communication charges or medical records charges will be billed to you and not your insurance company. 

 

Uninsured patients 

Visit payment is due at the time of service after a visit at the time of check out and any missed add-on charges (injections, vaccinations, etc.) may be billed to you separately.

Controlled Substances

We do not regularly provide chronic pain management services with controlled substances or narcotics. Any chronic pain needs or other medical conditions requiring long-term controlled substances treatment will be referred to providers who can better manage your healthcare needs. 

Medications & Prescription Refills

  • All prescription refills require a 48 - 72 hour notice to our staff to process and this may be longer if your insurance company requires a Prior Authorization. Holidays and weekends may also delay these requests. 

  • If you call to request a refill but are overdue for a follow-up visit and/or blood work (necessary for monitoring the safety or effectiveness of a medication), the provider may agree to call in enough medication to the pharmacy to last until we are able to schedule an office visit. This is in your best interest and to ensure that you are responding adequately to a medication and to ensure adequate safety and side effect monitoring.

  • Patients are requested to bring all medication bottles currently being taken, including over the counter medication, with him/her to each visit.

  • We will not be able to call in new prescriptions without being seen in office.

  • If you need a change in existing prescription because you are having problems with side effects, or need a change in dosage, please schedule an appointment to discuss problems and explore alternative options

Referrals and Authorizations

  • Please allow 7-14 business days for referrals/prior authorizations to be approved. Most plans do not allow retro-referrals. Please ensure that your referral is active before seeing a specialist.

  • If your insurance plan requires renewal of referral each year, you are responsible for letting us know of this in advance and we will help you with this, but we cannot initiate or renew referrals until we get a request from you to do so. 

Test Results 

  • It may take up to 3-5 business days for your lab or imaging results to be available. Our staff will make every effort to notify you of these results as soon as they are processed and reviewed by the provider. Some labs (i.e. Lyme testing, stool samples, cultures) and imaging (MRI’s and CT Scans) may take much longer to process.

  • Any lab/imaging result will be published to the portal once we have made an attempt to discuss it with you over phone/ during a visit. You can avail these by logging into the portal.

  • Some results will require an appointment with your Provider to review and you may be asked to schedule a visit to discuss these with the provider.

  • We only contact patients with results for testing we have ordered. If your testing was ordered by another provider outside of Magnolia Primary Care LLC, please contact the ordering provider for results.

Patient Portal

We strongly urge our patients to register to the patient portal (no cost for this service) in congruence with the Terms and Conditions set forth in the patient portal agreement. Please note that you can avail your visit notes, instructions, lab/test results, send messages to the clinic staff and pay bills via the portal. We do charge for any asynchronous portal communication that requires physician time.

Forms

We understand that health forms are required by many schools, employers, and government agencies. Since this requires our time and effort, please note that we charge the following form fee each time we fill it. 

  • FMLA - $100

  • Any other forms - $20/page

Some forms may require an office visit with one of our providers for completion in which case you will be asked to come in for a visit. 

Medical Records

  • All of our medical records are in digital format.

  • Copies of your medical records will be available to you with a signed medical release request. We do not charge for provider - to - provider medical record fax transfers. It is also available for your personal access through the patient portal free of cost.

  • However, we do charge $0.50 per page for personal printed copies of medical records.

  • The law allows Medical Offices 30 days to complete requests for records. However, we will put forth every effort to respond to these requests in a timely manner.

Inclement Weather

In the case of extreme weather we must close the office so it does not compromise the safety of our staff & patients. In such instances, we utilize patient approved communication methods to send automated notifications by text/e-mail/portal messages/voice calls. We also strive to post statuses to our website and Facebook page. We encourage you to like and follow us for updates.

Patient Dismissal

We work hard to give you the best care possible. While we make every effort to work with you we reserve the right to dismiss any patient from our practice. In case of dismissal, you will be notified by certified mail of this non-negotiable decision. You will have 30 days to find another provider during which we will continue to offer urgent care services and refill appropriate medications. Common reasons for dismissal include: Failure to keep appointments; significant non-compliance with prescribed treatment plan; abusiveness to staff; failure to pay your bill etc. 

© 2024 by Magnolia Primary Care LLC.

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