APPOINTMENTS
Appointment times are accessible via the online booking feature only. Weekend and evening appointments are offered on a variable basis. Prior to your appointment being scheduled, all patient forms and consents will need to be completed.
EMERGENCIES: I have phone coverage for emergencies after hours and on weekends. Please use this for emergencies only. If there is an immediate life threatening emergency, please go to the nearest emergency department or dial 911. In the event of an emergency, you may call 317.572.5242.
CANCELLATIONS: Scheduled appointment times are reserved especially for you. If you cannot make it to your appointment, please let us know in advance so that we can schedule that time for someone else. You may cancel a scheduled appointment up to 2 business days prior to the scheduled appointment time, without penalty, by calling the 317-572-5242 directly and either leaving a detailed voicemail OR by speaking to a member of my administrative staff with no penalty or charge. Appointments cannot be cancelled via e-mail. Cancellations within less than a 2 business day time frame will incur a fee as outlined in the consent forms.
MISSED APPOINTMENTS / CANCELLATIONS / TARDINESS
It is very important to come to your appointment and be on time. I strive to keep the sessions as close to the appointment time as possible. If a patient is running late, they must contact the office staff as soon as possible to discuss if they will be able to be worked into the schedule that day, of if they will need to reschedule on a later date. A patient arriving late may be considered a "No Show" if late more than fifteen minutes on more than two occasions. If an appointment is missed or canceled with less than 2 business days prior notice, you may be billed a $100 No Show Fee.
PROVIDER CANCELLATIONS
Occasionally I may need to change my schedule, cancel, and reschedule appointments with you. You will be informed of this as far in advance as possible. In the event of illness, I may unfortunately be forced to give you little or no notice regarding the absence and the need to reschedule your appointment.
PAYMENTS AND BILLING
Payment is expected at the time of your appointment. My contracts and agreements with insurance companies and health plans require me to collect all co-payments and deductible amounts at the time of service. If you feel there are extenuating circumstances surrounding the missed or late canceled appointment you may contact my office. You will be required to put a form of payment on file. This will expedite the payment process and shorten the time you will need to spend on the phone. You can also make your payment through the Patient Portal. A receipt will be sent to you if requested.
PRESCRIPTIONS AND REFILLS
All Refills must be initiated by you via telephone, no other method is authorized. The pharmacy name, city/state, street name or address will be required. Please allow up to 5 business days for your request to be processed.
Practice Documents are required to be completed for any prescriptions or refills will be released.
Prescriptions are generally written in a quantity to last until the next scheduled appointment. Please fill your prescriptions promptly. If it becomes necessary for a refill to be called in due to you not keeping a scheduled appointment, a charge of $30.00 may be assessed. A charge of $30.00 will be applied to prescriptions and triplicate medications that are written between appointments. A $40.00 charge will be applied if a prescription must be rewritten due to the loss or expiration of that prescription.
Requests for prescription refills are to be called into my office from Monday through Wednesday for approval. A minimum of five working days is typically required for the prescription refill to be approved. Prescription refills cannot be ordered or approved after business hours because your chart may not be available.
Prior Authorizations may take up to seven days and a charge of $25.00 may be assessed for this service.
SPECIAL DOCUMENTATION AND LETTERS
In order to better serve you, FMLA paperwork must be filled out during a scheduled in person appointment. It is important that you be there for your input on some of the questions, and to be aware of the treatment plan and contents of this paperwork. If you need a letter for any other reason, I require a seven-day advance notice.
CLINIC TREATMENT PHILOSOPHY
Treatment goal or goals will be established after a thorough assessment. It is very important to be completely honest with the answers to the questions asked. You are asked to take an active role in setting and achieving your treatment goals. Your commitment to treatment and cooperation is necessary for you to experience a successful outcome. This may include proper use of prescribed medications. If you have any questions about the nature of your treatment or care, please do not hesitate to ask.
RIGHTS AND RESPONSIBILITY
1. You have the right to receive information about my services and qualifications, clinical guidelines, and patients' rights and responsibilities.
2. You have the right to be treated with respect and recognition of your dignity and need for privacy.
3. You have the right to participate fully in decision-making regarding your treatment planning.
4. You have the right to voice complaints or appeals about the care provided to you.
5. You have the responsibility to provide, to the extent possible, information that I need in order to care
for you. This includes all medication, alcohol and drug use.
6. You have the responsibility to follow the plans and instructions for care that you have agreed upon.
7. You have the responsibility to participate, to the degree possible, in understanding your behavioral health problem(s) and developing mutually agreed upon treatment goals.
8. Mutual respect is fundamental to treatment. Aggressive or threatening behavior either physical, written or verbal will not be tolerated and will be grounds for terminating your treatment at my clinic. If you feel mistreated by staff or myself, please let me or the office staff know so I can address your concerns.
MEDICAL RECORDS
If you would like another physician or other professional to obtain a copy of your record, a release of
information must be signed. The requesting party will be responsible for any fees. When applicable, the charge for records is $25.00 for the first 20 pages and .50 cents for each additional page after the first twenty. All fees must be paid in advance. It may take up to 15 business days to obtain a copy of your medical records once all fees are paid.