2. Your past medical records

3. A current list of medications and allergies.

Please keep in mind that while this office makes every effort to run on schedule, we sometimes run behind schedule due to emergencies and circumstances beyond our control. We ask your understanding in these situations, recognizing that we will extend emergency service to you should the need ever arise.

REFERRALS

It is the policy of this office that referrals will be done if you have been seen in this office at least once. We cannot do referrals if you have us listed as your primary care physician and do not become established with us. We cannot do post dated referrals. You must let us know, as soon as you have made an appointment with the specialist, so that we can make the referral in a timely manner.

TELEPHONE CALLS FOR NON-EMERGENCIES

Our office staff will take your calls and refer them to the proper person to be answered as soon as possible. Because of the volume of patients seen in this office, we will make every effort to make sure your question is handled on the date you initially called.

EMERGENCIES

We will try to accommodate seeing you in the office if you have a minor emergency. However, in case of any major emergency , please go directly to the emergency room. Please remember that if you go to the emergency room please let the office know if you need a referral for your insurance company.

PRESCRIPTIONS/MEDICATION REFILLS

Please remember to get new prescriptions from your doctor during an office visit. However, if you have a medication that needs refilled, please call the office with the name and dosage of the medication, the directions, and which pharmacy you would like us to call the prescription to. If the pharmacy is an out of town pharmacy, please make sure to have the phone number for us. We will try to have all medications phoned on the same day as they are requested.

CONFIDENTIALITY/MEDICAL RECORDS

Because we consider all aspects of your care to be strictly confidential, we will not release information to your insurance company, employer, or other interested parties, without your written permission. Should you wish to obtain a copy of your medical record, we will ask for written authorization.

TESTING

Our office performs a number of tests. These include: EKG, pulmonary function, bone density scans, echocardiograms, treadmill stress tests, and stress echocardiograms. Wood County Hospital has opened a lab draw station two doors down from the office for your convenience.

FINANCIAL POLICY

We recognize the need for you to understand our expectations regarding payment for medical services. The following financial policy should help answer those questions.

1. We will file all claims with your insurance company, however it is ultimately your responsibility to pay the remaining balance that is not covered by insurance. We participate in many insurance plans. You will be billed for the amount that is not covered. Also, if no payment has been received from the insurance company within 3 months, you will be responsible for payment to this office and for getting reimbursement from your insurance company.

2. All office co-payment amounts are to be paid at the time services are rendered. There will be a fee for non-payment of copay at the time of your visit. We request 24 hours notice for canceling appointments. We do, however, realize that emergencies happen and do request that you contact us as soon as possible to cancel in those instances. There will be a fee if you do not show for your appointment and don't call to cancel or reschedule.

3. If your insurance requires a referral to a specialist, you must let us know at least one week prior to your visit to the specialist. We are unable to do back dated referrals.

4. Our billing office will send claims to both primary and secondary insurances if they have a copy of all insurance cards. However, you are ultimately responsible for services rendered if your insurance companies do not cover the service or the office has not heard from the insurance companies in a timely manner.

5. If you have a change in your insurance, please let the office know. If this insurance change is older than 3 months, and your old insurance has been billed, and you did not advise us of the change, you will be responsible for payment and sending the claim to the insurance company.

6. We are "Participating Physicians" with Medicare, and therefore, accept assignment on all services covered by Medicare. This means that Medicare will send us a check for 80% of the allowed amount, minus your yearly $100.00 deductible. We will write off the difference that Medicare allows and we charge, but your are still responsible for the deductible and the 20% of the charge that Medicare does not pay.

7. If you have no insurance, we ask that you pay for services at the time the service is rendered. You may talk to our billing staff to set up payments, if needed. If you are a self pay patient, we offer a self pay discount of 25% if you pay at the time of service. If no payment or partial payment is made, the discount does not apply. If you are a new self pay patient and cannot pay in full at the time of your appointment, you will be expected to pay at least half of the charge. If you have insurance that does not cover office visits, you can qualify for the self pay discount, however the office will be unable to send the claim to your insurance.

8. This office accepts Visa, Mastercard, and Discover.

9. If your insurance requires you to list a primary care physician and we are not listed as that doctor, we have the right to cancel your appointment until the change has been made.

INSURANCES

Some of the insurances this office accepts:

Aetna	NPPN	CNA Health Partners	Tricare	Medical Mutual
Cigna	PHCS	Medicare	Beechstreet	Paramount
Medicaid	Anthem	Ohio Health Choice	Family Health Plan	WLEC

If you would like to know if we are on your insurance plan, please contact your insurance company.

All of our physicians have privileges at Wood County Hospital, Bowling Green OH.