NMUA - Office Policies

Office Policies

Referrals for our Care
We will evaluate any patient who wishes to be seen, including second or third opinions about surgical options. However, we strongly prefer referrals, even self-referrals, when a clear diagnosis of the clinical problem has already been accomplished. If we are not confident about a diagnosis, we may request additional medical consultation before making our final surgical recommendation. Finally, surgical care is expensive: we include a financial assessment as part of our pre-operative assessment. Although we rarely, if ever, refuse to perform surgery based solely on financial considerations, we wish to stress that the surgical aspects of care are only one component of managing the complex problems we typically see. We believe the financial impact of the surgical intervention with the cost of ongoing medical management is part of the informed consent process.

Office Hours and Appointments
We try to see each of our patients on an appointment basis, and so we request that you call in advance so that we can reserve a time for you. We have three offices and several satellite sites available for your convenience. Each office has a different daily schedule so we encourage you to call the office of your choice and make an appointment convenient for you. CLICK HERE for the listing of offices and phone numbers.

Urgent conditions and emergencies are given special consideration. If you must cancel or reschedule an appointment, please call us as soon as possible. We make every effort to be on time for our patients and ask that you extend the same courtesy to us. Should an emergency occur which would delay seeing you promptly, we will make every effort to notify you. We ask for your understanding in this matter.

Appointment Confirmation Calls
We will call the day ahead of your appointment to confirm the time and place. For new patients, we will pre-register you the day you call to make your appointment (to save time later). We will ask the usual questions regarding name, address, and phone numbers, and we will ask you for specific insurance information from your insurance card. We still need you to bring your card to your appointment as we need to make a copy for your chart.

Appointment Check-In
Please arrive at least 10 minutes before your scheduled appointment time for registration. You will need to bring your insurance card and driver's license in order for us to complete the registration process. Failure to do so may require us to reschedule your appointment. Please bring any medical records you may have, including films, and make sure you have a referral if your insurance plan requires one. Please call us with any questions or if you need to cancel or reschedule your appointment.

Appointment Cancellation / No Show Policy
If you cancel an appointment less than 24 hours in advance, or fail to show up for an appointment, you will be charged the full amount for the allotted time - unless we are able to fill your time slot with another patient. Our time is valuable too. (Note: Please be aware that charges for failed appointments are rarely, if ever, covered by insurance.)

Test Results
Results from procedures, x-rays, or tests your physician has ordered are generally returned to our offices within one week. While some results can be given to you by the nursing staff, our physicians generally prefer to discuss results with you personally. Therefore, when you wish to learn the outcome of your test, we request that you call the office and give both a day and evening phone number where you can be reached. Since our physicians spend daytime hours seeing patients in the office or performing surgery in the hospital, they return most calls in the evening, usually before 10:00 PM. For pediatric patients, some test results may require a return visit to the office.

Prescription Refills
We encourage you to call your pharmacy and have the pharmacist call us during normal business hours for prescription refills. Please call well before you are out of your medication so that we have time to properly process your request. If you have not seen your physician for some time, it may be necessary for you to come in for a visit before your physician can refill your prescription.

Medical Records
The information contained in your medical record is strictly confidential. We value the trust you place in us to keep this information confidential and will not release information without your signed permission. If you wish to have a copy of your medical records, please call the office to have a release form sent to you. When we receive this completed form in our office, we will release records to you at the address you have indicated. Please allow at least one week for this process. There is a $10.00 charge for copies of your Medical Records to cover our cost of preparing them.

Paying for Your Visit
We accept cash, checks, money orders, VISA, and Master Card. All forms of payment are accepted at check-out or enclosed with your statement. We send monthly statements to inform you of any balances due, and we also remind you of money due when you call to schedule an appointment (and when we call to confirm appointments). We expect that patient-due balances will be paid upon receipt of our statement, or at your next visit.

Self-pay patients: We expect payment at the time of treatment for patients who have no insurance coverage. We will do our best to give you an estimate of the charges the day ahead of your visit when we call to confirm your appointment. After the visit, we will expect payment of the actual charges by one of the methods listed above. If a surgical procedure is necessary, payment plans can be arranged with the billing department.

Insurance patients: As a courtesy to you, we will file a claim with your primary and secondary plans. When each has paid their portion of the charge, the remainder becomes your balance and is indicated on the statement you will receive from our office. While our billing professionals will do all they can to help you in communicating and negotiating with your insurance plan, we must remind you that you are responsible for all charges until they are fully paid. Should a surgical procedure be necessary, we will help you communicate with your plan to learn of their payment, and then arrange a payment plan for your portion of the charges.

Medicare patients: The majority of our patients are covered by Medicare and so we are very familiar with these requirements. As a courtesy to you, we submit claims electronically to Medicare on a regular basis and also submit to your Medigap (secondary) coverage. We request that you bring your Medicare and Medigap cards with you to each appointment.

Managed care plans: Plan requirements can vary significantly, but one major provision is that a referral is necessary to be seen in our office. Also, if your plan has a copay, it is due when you register for your visit. We do our best to keep abreast of the rules of each plan, but it is incumbent upon you as the patient to learn and follow the rules set forth in your specific plan. We encourage you to contact your employer, Medicare, or your plan directly for questions regarding deductibles, referrals, coverage, eligibility, and other concerns you may have. Should surgery be necessary, we will communicate with your primary physician for the necessary referral.

Telephone Calls
We try very hard to answer and return telephone calls as quickly as possible when you contact us. We do return calls in the order of perceived urgency - please be sure to communicate clearly to the receptionist or nurse taking your message how urgent you believe your call to be.
In life threatening situations, please dial 911 immediately before you attempt to communicate with our office.

eMail
Our policy on eMail communication is still evolving - this is still a new area for us and the confidentiality of communicating with patients in this medium will ultimately be tightly regulated by the federal government under the emerging rules of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Referral Forms, Managed Care Pre-authorizations, and Pre-certifications
You must give us all written referral forms and information BEFORE the visit begins in order for us to determine that all anticipated services will be covered. If you do NOT have this information BEFORE the visit, you may be responsible for some or all of the visit charges that insurance does not cover. We will inform you in advance when we have any reason to believe that scheduled services are not covered by your plan. In the circumstance that a non-covered service is recommended, we will ask you, in advance, to sign a form that states you will be responsible for the payment of any non-covered charges for the proposed procedure. Finally, your health plan makes all final determinations of coverage. Their coverage decisions are normally final; you will be financially responsible for any services we provide that are not covered by your health plan.

On Call Coverage
One of the physicians is always "On Call" for emergency care (24 hours/day, 365 days/year). Please do not call the On Call physician for routine questions, prescription refills, or problems that are more properly handled by your primary care physician.