THANK YOU for giving us the opportunity to serve you & your family in your healthcare needs.
INSURANCE FILING is done on your behalf as a service to you and requires the presentation of your current insurance card & drivers’ license at each visit. It is vital that you notify us ASAP of any changes (Insurance, job, address, phone, etc) or you may be required to pay in full and file your insurance yourself. Remember that it is your responsibility to provide us with your correct insurance information, correct address and correct phone contact information before your visit. If your account is turned over to collections, you will incur an additional $40 fee. We utilize Merchants & Professional Credit Bureau for collections.
After HOURS "On Call" For Urgent medical problems - Call our main line (512) 834-9999 and choose option 1. Please have your pharmacy number & your current medications & doses on hand. When you call after hours, we will respond promptly. If you do not receive a response within 15 minutes, please call back and verify your phone number. Make sure your phone line does not block caller ID restricted lines. The doctor will not be able to return your call. Please note you may be assessed a $20 fee for an after hours call.
REFILLS of regular medicines may take 48-72 hours to process. Do not wait until your prescription runs out! Contact your pharmacy to begin the refill process at least 2-3 days before running out of medication. Even if your prescription says 0 refills, your pharmacy will submit a refill request to Dominion. Please note that you must keep your follow up appointments or your meds will not be refilled.
REFERRALS are a labor-intensive process. Your cooperation is appreciated. You need to be seen by a Dominion physician to obtain a referral. Please notify the physician if you have a specific specialist you like. Once the physician orders the referral, our referral coordinator will contact your insurance carrier to obtain authorization. Response time from insurance plans varies and can be anywhere from 1-7 business days. Once we receive approval, the information will be entered into your chart, faxed to the specified specialist and we will contact you. Once you receive your referral, you may call and make an appointment with the approved specialist. Do NOT go to your appointment without an approval. You may be turned away or billed personally for services. HELPFUL HINTS for referrals: Not all insurance plans require a referral. Contact your insurance if you are unsure. Physical therapy and mammograms do not usually require a referral. Referrals are not always necessary for OB/GYN visits. Please call the office at least one week in advance for referral changes or extension requests.
PREVENTIVE CARE and IMMUNIZATIONS are vital to both young & old. Please provide us with a shot record and schedule appropriate exams. Preventative care is important - for men, women and children.
LABWORK and RESULTS When a physician orders lab work for you, if you come in and have it drawn within one week you will NOT be charged an additional co-pay. Once the blood is drawn, the specimen will be sent to the lab to be tested. Most results will be received back in our office within 3-7 days, depending on the type of test. Once received, a physician will review the results. If the results are out of the normal range or a meds change is needed, we will contact you. If they are normal, you can view the results on the secure website. Please note that HIV and STD results must be picked up in our office and will not be given out over the phone.
Bills from labs: You should first call the lab to make sure they have your correct insurance information and to find out why they are billing you. It may be that you are responsible for a deductible. Occasionally, a test may not be covered by your insurance and the lab will bill you.
We schedule appointments based on type and number of problems in an attempt to keep our schedule on time. When scheduling, you will be asked to list ALL the problems that you would like to have the doctor address. You will be asked to call us back should anything else come up so that we can adjust the appointment or reschedule if necessary. Please feel secure in providing the reason for your visit with our receptionists. They have been trained in HIPAA practices and will keep your information confidential.
Work-Ins: We discourage walk-in appointments, however our schedule may allow us to address one acute and urgent care problem. As a work-in, you will be worked into the first available provider’s schedule; therefore, your visit may be associated with a wait. Due to schedule constraints, we cannot guarantee which provider you will see. As a walk-in, the provider will address one acute issue. Issues such as routine care, refills or follow-ups will not be addressed on a walk-in basis. You will be asked to schedule a full appointment for these types of visits.
Please cancel: If a situation arises where you cannot make your appointment, please notify our office 24 hours before your appointment time or you may be charged a “no show” fee. If you arrive late to your appointment, please note that you may be asked to reschedule and assessed a “cancellation” fee of $35. Please note that these fees are not covered by insurance and will be the patient’s responsibility.
Worker's Comp: We will not be able to see you for Worker’s Comp Injuries. Please contact your employer for further instructions.
School/Camp/Athletic Physicals: Please bring your form, a pair of gym shorts and eyewear (if applicable) to your appointment.
Pre-Operative Exams: Please bring your surgeon’s information, any records pertaining to the surgery and the surgeon’s orders with you.
TB Tests: Once you receive a TB test, you will need to return to have the test read within 48-72 hours. TB Tests are not given on Thursdays.
FMLA forms: Bring your forms to our office at least one week in advance of the date that you need them back. Please remember to fill in your portion before turning them in to us. We will fill them out and then call you when they are ready to pick up. There is a $35 charge for filling out forms, payable at pick-up.
Your provider may charge a different amount each time you have an office visit. The amount depends on the level and type of service provided. How does your provider determine which level of service you received during your office visit?
New or Established Patient: If you have never been seen in our office before, or within the past three years, you are considered a new patient. Your provider will charge you more for a new patient visit because more time and work are involved in setting up a new patient’s records. If you have seen the provider or another provider in the same group within the last three years, you are an established patient. These office visit charges are lower than a new patient visit.
Levels of Service: The doctor looks at the following things to determine what level of service you received: Patient History, Coordination of Care, Examination, Nature of the Current Problem, Medical Decision Making, Time Spent, Counseling
Additional Time Spent: When you go to the doctor, many other people in the office also play a part in the process: the receptionist, medical assistants, lab and technicians, referral and billing clerks among others. The amount your doctor charges will include the work done by these employees. There may be time spent on your care by your provider or other staff members beyond the time spent with you in the office. Such time may be used to:
Review, interpret, and document all lab test results and communicate those results orally, electronically or in writing to you.
Review current x-ray or scan reports, compare them with reports of previous scans, and when the study is abnormal, consult with the radiologist.
Consult via phone about your case with referring or consulting physicians and other healthcare providers.
Prepare referrals to specialists if needed.
Prepare patient educational materials.
Conduct medical research relevant to your case.
Communicate with pharmacies about your prescriptions.
File insurance claim forms and follow up with insurance companies regarding processing and payment of claims.
Draft letters of medical necessity and/or obtain precertification to acquire medical services and prescriptions that you need.
The amount of effort and time the provider and staff put into your visit will determine what level of service we will bill you or your insurance plan.
I had labwork drawn in the office and the results came back abnormal. My provider is requesting that I come back in for additional labwork. Will I have to pay another copay? Yes, since new labwork has been ordered, which generates a separate visit to our office, you will be responsible for another copay.
All of these activities add to our cost of doing business. We strive to provide you the best possible care at a reasonable cost. We hope this explanation of our fees and charges has been helpful.
PATIENT RIGHTS & RESPONSIBILITIES:
Rights: *Help your physician make decisions about your healthcare. *Discuss with your physician your condition & all care alternatives, including potential risks & benefits. *Choose your doctors office. *Have all your medical records kept private. *Get up-to-date information about your physician & the hospitals they admit to. *Be referred to a specialist who is experienced in treating your illness. *Receive a prompt reply when you ask questions or request information. *Suggest changes in our policies or services. *Call “911” in a situation that is an emergency.
Responsibilities: *Help your physicians make decisions about your healthcare. *Tell your physician if you do not understand the treatment you receive & ask if you do not understand how to care for your illness. *Give correct & complete information to your physician & their staff. *Follow the directions & advice you & your physician agree upon. *Tell your physician immediately when you have unexpected problems or symptoms. *Consult with your physician for referrals to non-emergency specialist or hospital care. *See the specialists your physician refers you to. *Show your insurance card & Drivers License before seeing a physician. *Read & understand your insurance plan & benefits. *Pay all applicable co-pays, coinsurance and deductibles for which you are responsible.
Web Portal: In order for us to maintain confidentiality and ensure that only you have access to your sensitive health information, you must be a registered patient and present your photo ID in person at our office. When you come into our office, you can obtain a username and password for your personal health portfolio web site! Once you are logged in, you can:
View messages from Dominion
Send messages to Dominion
View lab results
View vital signs
View personal information
View insurance
View office visit
Request information
Change your password
