Patient Policies

 

WELCOME…

Welcome to Clear Creek Clinic, PA.  We appreciate the opportunity to act as your Primary Care Providers. We have been in practice for over 60 years serving the Community and look forward to serving you and your family.

 

YOUR MEDICAL CARE:

Our Providers and Staff strive to provide you with excellent medical care. Our objective, first and foremost, is to provide the highest standard of patient care. A good physician-patient relationship, based on good communication and understanding, helps make those standards possible.

 

The Clear Creek Clinic Family Physicians provide primary, continuing and comprehensive health care to our patients and their families regardless of age, sex, or presenting complaint. 

 

We practice the discipline of family medicine.  The training and experience we demand of our physicians qualify them to practice in several fields of medicine and surgery, with a special emphasis on the family unit.

 

The Family Physician team regularly evaluates and manages our patient’s total health care needs and when necessary; the patient can be referred to an appropriate specialist or consultant. 

 

You may request a specific physician when you visit the Clinic.  If that physician is not available, you will receive the same quality of medical care from any one of the other providers.  Be assured that in the event of an emergency, you will have access to a physician who has your medical record available.

 

OFFICE HOURS:

Monday - Friday  8:00 am to 5:00 pm  

Saturdays 8:00 am to 10:30 am (See After Hours)

We are closed in observance of major holidays.

 

OFFICE POLICIES:

As you are well aware, the business of providing insurance based healthcare is increasingly complex and challenging.  For our office to operate effectively and provide the best service to you and your family, we need your cooperation with the following policies.  Your clear understanding of these policies is very important.  Please let us know if you have any questions or concerns.

NEW PATIENTS AND OUTSIDE RECORDS:

First time patients are asked to arrive 15 minutes early to allow adequate time for completing the initial paperwork.  For purposes of maintaining continuity of care, we ask that you bring us the latest relevant records with the most recent test results and current medication list.  We do ask that you remain the sole custodian of your entire medical record from previous healthcare providers.  Should there be a need to further examine your previous records; our providers will have you bring your records back for additional review during subsequent office visits.

 

COURTESY:

We strive to provide the best medical care for our patients.  While we make every effort to provide prompt on time service; the healthcare needs of each individual do not necessarily lend themselves to an exact schedule.  Therefore, we appreciate your understanding and patience.  If you have any suggestions or complaints for our office please let us know.  Angry or foul language directed at our staff, regardless of the issues involved, will absolutely not be tolerated and will be grounds for immediate dismissal from our practice.

 

CHANGES IN PERSONAL INFORMATION:

Please notify our office of any changes in address, telephone, billing, or contact information.  It is imperative that we have the most current information on file.

 

NEW PATIENT APPOINTMENTS:

New patient appointments are scheduled with providers currently  accepting new patients.  New patient appointments are scheduled for 20 minutes to review medical history, review medications and address problem issues. Because Physical Exams require an additional 20 minutes to complete, NO PHYSICAL EXAMS will be scheduled with a new patient visit.  A new patient deposit of $25 is required for all new patients and will be credited to your account at the time of the first visit and applied to the patients copay or deductible, which ever applies.  Patients who NO SHOW for a new patient appointment; will be charged a $25 NO SHOW fee. (See our NO SHOW policy for details.)

 

APPOINTMENTS:

The Clinic is organized around an appointment system.  This enables us to work as efficiently as possible.  We will try to honor your appointment time as closely as possible.  Due to the nature of insurance based medical practice we ask that you limit your visit to 1 to 2 problems per visit.  Should you have more medical issues that need to be addressed, please inform our staff when calling for appointments and we will make every effort to provide you with an adequate amount of time.  Your physician may request that you schedule additional or follow up visits to address your additional medical concerns.

Multiple family member appointments must be scheduled in advance.  Family members, who are present at the time of another member’s appointment but are not scheduled; will be required to schedule an appointment at a later date.

In general, we do not recommend scheduling a PHYSICAL EXAM and a PROBLEM visit at the same time, since your insurance company may not pay for both.

NO SHOW POLICY:

*NEW POLICY* Effective April 1, 2015

We make every effort to provide prompt medical care to all of our patients.  If you are unable to keep a scheduled appointment, please let us know at least24 hours in advance.  A NO SHOW is when a patient fails to keep a scheduled appointment. The first NO SHOW will generate a letter to the patient reminding of our NO SHOW policy.  A second NO SHOW will result in a $25 fee.  This fee will be charged directly to the patient and must be paid on or before the next scheduled appointment.  A third NO SHOW may result in dismissal from the practice.  In the event that you may have a special circumstance regarding your missed appointment, please contact our office manager.  We understand that there may be issues out of your control and want to be understanding of special circumstances.

If you are delayed and cannot make an appointment on time, please call to advise us of your situation and provide an estimated time of arrival. Any delay beyond 20 minutes after your scheduled appointment time, may result in the visit being rescheduled, or you may be given the option to wait until the end of the schedule. 

 

INSURANCE POLICIES AND FORMS:

Our office will submit claims for insurance carriers with which we participate.  At Clear Creek Clinic, PA, we are dedicated to offer quality and often times beyond the standard medical care to our patients.  However, it is YOUR RESPONSIBILITY to know your particular insurance plan benefits.  Comprehensive physicals, immunizations, certain laboratory tests, procedures, and prescribed medications may not be covered.  Prior Authorizations may be completed at the discretion of our providers.  We therefore cannot guarantee that all services and therapies we provide or recommend are covered by your insurance.  We also cannot just change CODES in order to modify insurance coverage as it is illegal and fraudulent.  We strongly encourage you to contact your insurance carrier ahead of time and verify appropriate coverage.

We also require proof of current insurance at check-in for every visit.  It is essential that you provide all the necessary information about your insurance both primary and secondary.  Since changes in insurance coverage are frequent, it is our policy to obtain a copy of your card(s) for applicable insurance.  Please be prepared to present your card(s) at each visit.  In case of a new policy, a copy of the enrollment form specifying insurance company name and phone number, employer and his/her phone number, insured employee name, date of birth and social security number will be required.

 

FEES AND PAYMENTS:

Payment in full is due at the time services are rendered unless we are submitting charges to your insurance company. Copays and deductibles are due at the time of service or your appointment may be rescheduled. We accept VISA, MASTERCARD, AMERICAN EXPRESS, and DISCOVER cards. We also accept money orders, cashier checks and cash.  We accept personal checks with a copy of a current valid driver’s license.  Those patients without proof of insurance coverage may be required to pay in full or be asked to reschedule their appointments.  If we are not contracted with your particular insurance plan, you must pay in full at time of service.  You will be given a copy of your charge slip to submit to your insurance company for reimbursement purposes.

Even though we bill your insurance, WE ARE NOT responsible to negotiate a settlement for a disputed claim.  Billing your insurance does not necessarily ensure payment by the insurance company nor does it release the responsible party from its financial obligation to our office for any unpaid balance.  In case of an insurance partial payment, the balance is due by you and we will send you a billing statement.  Balances over 120 days due, may be sent to a collection agency unless other arrangements have been made with our billing department. Effective April 1, 2015, a $25 may be placed on accounts placed in collections.  A $30 service fee will be charged for returned checks due to insufficient funds. Unpaid bounced checks will be reported to the courts.  We may also elect to discharge you from our practice should you fail to comply with our policy.  Should you require a payment plan please contact our billing department to discuss your options.

Uninsured / Cash Pay Patients:  Payment is due in full at the time services are rendered.  It is our policy to ask uninsured/cash pay patients to leave their identification (Valid Driver’s License) at the front desk to be held as a reminder to stop and check out with our office staff.  All uninsured /cash pay patients will receive a 10% discount on all fees when paid in full at the time of service.

Lab / X-Ray / Diagnostic Services:  Patients may receive a separate bill if their medical care includes lab, x-ray, or other diagnostic services. The patient or responsible party must further understand that they are financially responsible for any co-pays, deductibles and co-insurance due for these services if they are not reimbursed by their insurance company.

 

PRESCRIPTION REFILLS:

Please request refills through your pharmacy.  Your pharmacy will contact us electronically if a new prescription is required.  In most cases even expired prescriptions can also be refilled in this manner, provided you are up to date on required exams and laboratory testing.  We do recommend routine follow-up visits at least every 6 MONTHS, depending on your medical needs.  Refills will therefore be provided in general for up to 6 MONTHS, exceptions may include oral contraceptives and other long term medications, which may be refilled for up to 1 year per the physicians discretion.  Refills of prescription medications that fall under the general category of CONTROLLED SUBSTANCES such as narcotics and certain mood altering agents may require monthlyor quarterly (every 3 months) visits to be determined by your physician.  A signed contract is required for all controlled medications.  Please be aware that refills may take up to 72 HOURS to process, so please plan accordingly.  Your refill request may be denied should you fail to comply with our policy.

 

TELEPHONE MESSAGES:

We will try our best to respond to your messages as soon as possible.  However, please be aware that a message may take 24-48 HOURS to process and for respond to be issued.  More often than not, if your question requires extensive attention, your provider may elect to have you make an appointment and come for further evaluation for quality assurance purposes.

 

REFERRALS:

We have a referral specialist committed to providing timely attention to your referral request.  Most referrals will be processed 48-72 hours after physician approval. However, some insurance companies and referral processes can take much longer to approve requests.  Please allow 10 days for referral requests to be processed and completed.

 

 FMLA, DISABILITY FORMS, MISCELLANIES FORMS AND LETTERS:

In general NEW FMLA forms and Short Term Disability Forms will require an appointment with your physician during regular office hours, at which time our providers may refer you to appropriate specialists for further evaluation and management.  Additional forms  are subject to a fee and you may be charged $15 per form.  Letters written by your physician at your request are subject to a fee and you may be charged $15 per letter.

MEDICAL RECORDS:

Medical records are property of Clear Creek Clinic, PA. and will be maintained in accordance to the guidelines set by the Texas Medical Board.  All requests for medical records must be made on a HIPAA approved form, which must be properly and completely filled out and signed by the patient or legal guardian.  Please allow 15 business days for processing.

Medical Records New provider, specialist or school: For continuity of care and as a courtesy to the patient, our office will forward what we call basic medical records at your request at no charge. Basic Medical Records include: Last 3 clinical notes, most recent test results, most recent laboratory tests and medication list.

 

Complete medical records, records released directly to patients, law firms and miscellaneous requests: Records are subject to a copying fee.

 

AFTER HOURS:

When an EMERGENCY arises, and you need to get in touch with our on-call physician, you may call our office at 281-332-6573.  You will be directed to our answering service, they will then take your information and forward it to the on-call physician.  As a reminder this is for emergencies only and all non-emergent calls are subject to an after-hours fee of $50.  As a general rule we do not call in antibiotics and/or medication refills after hours.

Saturday Clinic:  Saturday Clinic is open to current patients for on-call/urgent care issues only.

 

IN A LIFE THREATENING SITUATION, PLEASE CALL 911 IMMEDIATELY.

 

Our staff is committed to making your visit as pleasant as possible. Your comments or concerns are important to us.  We rely on them to continue to improve our quality medical care to you and your family. Please don’t hesitate to ask to speak with our Office Manager should the need arise. 

Address : 302 S. Highway 3, League City, TX 77573   Phone : (281) 332-6573   Fax : (281) 332-7409

© 2007 - 2012 Clear Creek Clinic PA