While you know it's you, the Health Insurance Portability and Accountability Act (HIPAA) made it illegal to share personal health information without confirmation of the recipient. Obviously, phone calls and email are not secure or verifiable.

If there is an important abnormality we will try to notify you by phone. However, we prefer you visit to discuss all your test results.  A face-to-face meeting gives us time to review all the information with you and answer your questions thoroughly.

As a contracted provider, I defer payment for my services until it is sent by your insurance carrier.  Even though we attempt to verify coverage, payment is not a guarantee, and there are  times I have not been paid.  This is a particular problem with vaccines.

Immunizations are expensive to purchase and keep in stock.  In some cases we are reimbursed less than what we have paid to purchase, so we actually lose money. 

Different insurance plans vary in what vaccinations they cover, and this is even more confusing soon after a new vaccination is released.  In such cases, the insurance plan may not initially cover it, but with more common use this may change. 

We can never know that insurance coverage is truly in affect.  Even though we call to verify, every plan will tell us that there is no real guarantee, as a lapse in payment may precede their awareness and decision to terminate coverage. 

As a result, it is no longer possible for us to risk losing what we paid to purchase the vaccine.  For these reasons, you may be asked to pay for the vaccination at the time of service.  If we receive payment from your insurance carrier, your payment will be returned to you.

Your co-payment is required as part of the contract we both have with your insurance carrier. You have an obligation to pay it and we have an obligation to collect it. If we don't, your carrier has the right to reduce the remainder of our payment by that amount.

It is also a courtesy due us for participating in your insurance plan. We defer payment for our services until we are paid weeks or months later by your insurance plan.  In the meantime, your co-payment is needed to help with our operating costs.

Without a visit we can't really know how you're doing.  If you're running out of medication, it's time to return to the office to update the status of your condition and treatment. 

We share your frustration.  When we prescribe medication, we use our best medical judgement regarding your problem and treatment options. However, insurance companies do not base their decision on effectiveness or appropriateness for your condition. It is cost and only cost. 

They often have sweetheart deals with pharmaceutical companies to cover a particular drug supplied to them at a discount, regardless of whether it is right for you. You may take a particular dose of a drug that has no equivalent.  And generic medication is available only when the brand name's patent expires, after 17 years! 

However, we will try to help in any way we can to get what you need.

Even if you have the same problem, if we didn't make the diagnosis and prescribe the medication, we cannot as a matter of faith renew the medication without confirming the problem and the appropriateness of the treatment.

You may have a different problem, it may be more severe than that medication may help, there may be something better, or any number of other reasons. In the end, it comes down to this: we can only accept responsibility for what we know and do ourselves, not on the basis of another doctor's opinion.

Referrals for medical services rendered outside our office are needed in two different situations: 1. authorization for payment for by your health insurance carrier; 2. need for specialized care outside the range of the services we provide. In both cases, the only way to determine what you require is to evaluate you in person.

If you make an incorrect guess about the nature of your problem and refer yourself on that basis, you may delay receiving the care you really need. Also, it is possibile that an unsuspected problem may be found during this visit.

Authorization for payment by your health insurance carrier may seem arbitrary and administrative, but the treatment you receive should still be appropriate for your problem. While it is true that a plan that does not require such a referral would not require a visit, we cannot absolve ourselves of the liability incurred when providing written authorization.

We care about your health.  If you need a referral, please make an appointment so we may help you.

We share your frustration.  However, the overhead generated by these services is not reimbursed directly by your insurance company, and must be covered some way.

If you have a health insurance plan that requires a referral or pre-authorization for services outside this office, we must hire staff to process this authorization and/or complete the required paperwork. We must purchase and maintain an electronic system that connects to your carrier to accomplish this. Alternatively, much time is spent on the telephone. These costs, shifted from the payer, are spent to administer and preserve your health care benefits.

We hope you understand, and will help us help you.

As much as we would like to get this done, it's a time-consuming task.  We can't "just write it out."  Most carriers require electronic submission so there is no longer any paper involved.  Also, until you have an appointment, we won't know exactly who you're going to see.  So we hope you'll understand that it's not always possible to leave the office with a referral in hand.  However, we will send it on before your appointment.

When a physician provides a consultation and orders tests, they are responsible for the outcome and the results. This includes interpretation, treatment, and instructions to you. 

We expect to receive a consultative note and will review their findings and recommendations.  However, we recommend that you complete the consultation by discussing those findings directly with that doctor.

We try to accomodate everyone who needs care through the week. 

I'm sure you understand that the doctor and his staff have families, interests, and obligations just like everyone else.

When the office is closed the doctor is available to give advice. If you don't have an emergency, please wait to call until after 9AM.

To render good care we want to do a proper evaluation, so we will gladly see you when the office is open.

As a general rule, you will prescribed the appropriate amount of medication at the time of an office visit. If refills are intended they will be anticipated then.  If you're running out of medication and don't have refills, it's time to return to the office. 

Unless we can check your condition and consult the record, we can't know how you're doing.  We don't want you to run out of medication and understand that situations occur.  At such times we may authorize a small amount until you can visit the office. 

The office staff is not available on weekends to process authorizations or referrals. These can only be done when the office is open.