Gateway Family Medicine

Gateway Family Medicine

Billing - We gladly submit primary claims to your insurance, when you bring your insurance card to your appointment. As a courtesy, we will also submit any secondary insurance upon having a copy of the card. If you have a balance, our statements are sent monthly. Payment of professional fees (copay, deductibles, self pay) is due at the time of service. 

Refund Policy - If Gateway Family Medicine receives monies from a third party in compensation for office charges previously paid by the patient, a patient credit will be generated and added to the patient's account, to be applied to future office copays and deductibles.  A review of all patient credits is done once a year.  If a patient has an existing credit on their account for a period of two months or more and their family accounts are in good standing -- then a check, which refunds the credit on the patient's account, will be sent out to the financially responsible party we have on file.

Refills - Due to the many communication issues we’ve had with pharmacies, our office will no longer be accepting refill requests by fax, phone, or e-prescribe, as of May of 2011. If you are a patient and need to change or refill ANY medication, please schedule an appointment with one of our providers, and they will allow the appropriate amount of refills until you are due for your next appointment. 

Referrals

  • HMO Insurance - If you have an HMO plan, please schedule an appointment as insurances' require DX codes for referrals to specialists.   Our office will find a Specialist that is contracted with your insurance, complete a written referral, and send it to the specialist along with any required records (once authorized, if necessary).  Our office will call the patient with the Specialist's contact information once the records have been sent.  Then the patient can contact the Specialist's office to setup an appointment.

  • PPO Insurance - If you have a PPO plan, then the patient does NOT need a paper referral to see a specialist.  We will provide referral information to any patient that requests it so they can find a specialist and setup an appointment.  A patient can find their own specialist that's covered under their plan and setup an appointment.  If a patient would like our office to find them a specialist based off their insurance, it will fall in the que of other referral requests and be worked on based off the date the request was received.  Once we have found a specialist that is covered by your insurance, our office will send the required records to the specialist, and notify the patient of the speicalist's contact information and they can setup an appointment.

Radiology - If it is determined at the time of your appointment that you need to go get radiology done then depending on what needs to be done the following will happen.

  • X-ray - If after seeing one of our Doctors -- it is determined that you need an x-ray -- the patient will be given an order, along with the locations of different imaging facilities they can go to.  Radiology facilities perform x-rays on a walk-in basis.  Once our office gets the results from the imaging facility and they are reviewed by the Doctor then our office will call the patient with the results.

  • CT Scan/Ultra Sound - Some insurances require prior authorization before getting these done; if so then the Radiology Facility will obtain authorizaiton.  Once they get authorization from the insurance company, we'll fax the order over to an approved imaging location.  The Imaging Facility will call the patient to schedule an appointment.

  • MRI - These need authorization from insurances prior to the exam.  This may take a couple days for the insurance company to review, approve, and give us the approval.  Once we have authorization then our office will fax the order over to the patient's desired imaging location and they will call the patient to schedule a time.  Once our office has received the report from the imaging facility we'll call the patient to schedule an appointment.  All MRI's require an appointment to review results with the physician.

Paperwork - Any forms that need to be completed by the physician for such things as FMLA, Disability, or taking care of someone etc. will require an office visit, copay (if any) and a $50 paperwork fee. This will allow the physician to fill out the paperwork with you during the appointment making sure everything that  is required is accurately done.  If a patient needs a note for such things as school or work excuse, if you had been seen previously by the doctor for this illness, then we will write an excuse note for the date you were seen (allowing 24 hour turn around).  No extended or pre-dated excuse notes will be done unless appointment is scheduled, and per the provider’s discretion.

Missed Appointments - We realize that sometimes things happen and patients are not able to keep their schedule appointments; however, due to an increased number of missed appointments we are now charging a $35 fee for missed appointments, same-day cancellations, or rescheduling.  In order to avoid this fee, you must call and leave a voicemail BEFORE 8 am the morning of your appointment.

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