When do patients get discharged from practice?
Patients and their loved ones must immediately be recognized, welcomed, respected, seated, and given culturally competent appropriate excellent care based on their life experiences and not on opinions of providers and staff. Patients who have complaints against staff or other patients may submit verbal or written complaints to our patient advocate, a provider, or any staff and these complaints will immediately be investigated with no respect of persons.
Patients will be discharged for any of the following:
- Patients get discharged from Christian Global Medical Healthcare Incorporated for verbally or physically assaulting other patients and visitors inside and outside premises.
- For stealing clinic properties or from others on site.
- Patients also get discharged immediately for assaulting clinic volunteers, students, residents, externs, staff, providers and administrators in person or on the phone.
Professional fees and payment
Fees are based on the level of training, complexity of the problem, and time spent. They are within the range of fee guidelines and most insurance company allowances. Please feel free to discuss billing concerns and questions with the Office Manager. Professional fees for services rendered are due prior to leaving the office. You may pay by cash, money order, debit card, or credit card (American Express, Discover, MasterCard and Visa). In touch circumstances, payment arrangements may be considered after discussion with the Office Manager or Practice Administrator. Interest will accrue on past-due balances at the rate of 12 percent per annum. If your account is referred to a collection agency or to an attorney for non-payment, you agree to pay a pre-suit collection fee equal to 25% of the past-due amount plus our attorney’s fees and court costs if we have to file a lawsuit against you for nonpayment.
INSURANCE – We participate in state straight Medicaid , in almost all managed Medicaid plans, Medicare and manage Medicare plans, most managed care plans, Tricare plans, private and commercial plans, and we will bill your insurance plan as necessary. If we accept your insurance, you will be responsible for any co-payment and any unmet deductible on the day of service, and we will bill your insurance for the remainder. You are responsible for any service that is not covered by your insurance plan. If we do not participate with your managed care plan, the office will request payment in full at the time of service, unless other arrangements have been made with the Office Manager in advance. We may be able to bill your plan as a courtesy to you and credit your account if we receive any additional payment. If you are without health insurance and you will pay 50% of cost only if uninsured for any reasons. Knowing your insurance benefits and any restrictions or limitations (eligibility, covered benefits and medically necessary procedures) is your responsibility. Please contact the customer service department at your insurance company for questions regarding your coverage. You are responsible for any services not covered by your plan.
Proof of Insurance – All patients must complete and/or update his or her demographic and insurance information at each office visit, using a sign in sheet pad. You must furnish valid and up-to-date proof of insurance coverage. If you provide false or expired insurance information, you will be responsible for the balance of the claim. Please notify us of any changes in insurance coverage prior to your scheduled appointment. Insurance denials due to termination of coverage will be billed to you automatically.
Co-Payments, Co-Insurance and Deductibles – All co-payments must be paid before leaving the office. Deductibles and co-insurance will be billed to you after the insurance company has processed your claim. By contractural law, protection of your insurance benefits requires us to charge for, and you to pay for, all required co-payments, co-insurance, deductible and non-covered services.
Claim Submission – In most cases, we will submit your insurance claims and will assist you in any way reasonable to help get your claim paid. Your insurance company may need you to supply information directly to them. It is your responsibility to comply with their request in a timely manner. State insurance law requires your insurance to provide timely payment. Please be aware that the balance of your claim is your responsibility to pay, whether or not your insurance company has paid. We are not a party to your insurance contract.
Referrals – If your managed care plan requires approval or authorization for specialist evaluation, radiological imaging studies or care in another medical facility, it is your responsibility to inform the office of this requirement prior to referral. We require 48 hours notice to facilitate a referral request, and we cannot issue retroactive referrals.
SELF PAY PATIENTS – Christian Global Medical Healthcare recognizes that some of our patients may be without insurance coverage, or may choose to receive care even when we are not “Participating Providers” with their managed care plan (“Out-Of-Network”). We do not believe in, nor do we endorse charging a fee greater than the fees we have agreed to receive from most managed care networks. Therefore, we have been instrumental in creating a 50% discount off your cost for each visit with no questions asked about your income or investment. Please tell us if you have no health insurance so you benefit from this charity to gain early access to healthcare and prevent complications from delay down the road in your life.
OTHER SERVICES, CHARGES AND PATIENT RESPONSIBILITIES – Insurance policies generally do not include coverage for many administrative services, such as requests for medical records, prescription refills or after-hours medical consultation. The following services may be assigned an administrative services fee that will be billed directly to the patient. You are responsible for payment of these charges in full. Our practice is committed to providing the highest quality of service to our patients, while keeping our charges for administrative services at or below the usual and customary charges of other medical practices in the area. All such administrative fees must be paid prior to scheduling future appointments.
Payment Plans – In cases where a payment plan has been accepted and agreed upon by the office manager, a $5.00 monthly charge will be added to the balance due until the account is paid in full
Missed Appointments – Broken appointments represent not only a cost to us, but also reduce the available time we have to provide medical care to others who could have been seen in the time set aside for you. We require 24 hour notice of cancellation to avoid a cancellation fee of $10 for medication refill and $20.00 fee for missed adult physical exams and pap tests, initial visits, well child exams, and other physicals (depending on the type of appointment). While we strive to place a reminder call one or two business days before your appointment, it is your responsibility to remember your scheduled appointments. Repeated cancellation or no shows or coming late will place you on walk on in basis and if the providers have time to see that day, if not you will come back on walk in basis until space is found to get you seen.
Prescription Refills –
- Urine drug screens are done on all new patients and MAPS and pulled and review on every patients coming to clinic.
- Periodic drug screens can be requested by providers from patients on medications controlled by DEA.
- New prescriptions will not be issued without first seeing your providers. Prescriptions for chronic conditions are usually written with five refills to complete the course of treatment or to last until your next scheduled appointment. You must be seen if your refills are exhausted.
- Any patient not seen for over two weeks since last visit who wants medications written for conditions not examine in last visit must be seen and conditions evaluated before getting refills.
- We have allocated 30 minutes for medication refills to address all medications requested by patients given some have many medications.
- Requests for medication changes will not be handled over the phone – the patients must be seen by a provider. You must be seen if you have a drug reaction in our family practice or urgent care clinic. We will not address any issues on the phone.
Prescription Authorizations – We will honor prior authorization requests. However, the patient will be responsible for contacting the insurance company or pharmacy benefit manager to have a prior authorization form sent to our office, and for asking what “alternative medications” are covered by their plan. There will be a $15 fee for completion of a prior authorization form.
Form Completion – All forms requiring medical review and physician signature – including school, day care, and camp physicals, prior authorizations, Family Medical Leave Act (FMLA), disability or other paperwork – must be in a scheduled appointment in conjunction with the form completion request unless patients want to pay a flat rate $150.00 administrative fee for each form to be completed without being seen. In this case, do not blame provider for putting things on form you do not agree with.
Health Care Advice – With the advent of the internet and other sources of health information, we find that we are consulted for health care advice, oftentimes not related to the patient’s current medical care or needs. Providing such information may require considerable thought and/or investigation on our part to coordinate with the patient’s exact medical condition. Therefore, any such advice – when unrelated to the patient’s current medical condition – may be subject to an administrative fee of $75 per quarter hour of investigation and response.
After Hours Calls – We have urgent care by appointment every day Sunday to Saturday and 8AM -8PM Tuesdays and Thursdays to solve your problems daily and to prevent emergency room visits. If you wait until clinic hours to call for medical advice, you will pay a $25 fee. This fee will be billed directly to you, and it is your responsibility to remit payment in a timely manner.
Requests for Medical Records – In accordance with state law and federal laws, Christian Global Medical Healthcare Incorporated, requires a written and signed request for the release of medical records. The clerical fee of $25.00 charged for all records processed and a variable administrative set fees have been developed for records to individuals, attorneys, auto and life insurances. Records to other medical providers will be free up to two hundred pages and after that a set fee is charged per page. Both federal and state laws grants the office up to certain business days to process requests for records – Please take this into consideration when requesting copies of your records. Requests for expedited copies will be subject to an additional $25-100 fee, depending on the complexity of the records request. Research fees of $75 per quarter hour may be charged for complex record and/or billing requests. All payments for medical record copying, release and transfer services should be made to Christian Global Medical Healthcare Incorporated.
No Cell Phone Use: No body is allowed to talk on his/her cell phone in the waiting area or in the exam rooms. You must step outside to talk. You can text or bruise websites the Internet but no talking.
Patient Rights and Responsibilities: At CGMH, we value and love patients like family and have written patient bill of rights and responsibilities given each patient at the initial visit and signature obtained as proof of service along with HIPAA privacy policy in a take home folder. All parents are expected to keep their children under control in waiting areas and in exam rooms for the smooth flow of clinic.
