Cancellation and No Show Policy:
As our goal is to meet the needs of our patients, we will make every effort to schedule your appointments as efficiently as possible. In return, it is your responsibility to make every effort to keep your scheduled appointments and to arrive at your specified time. We do realize that unanticipated event can occur and may prevent you from keeping your appointment. In fairness and consideration to other patients however, we request that you notify our office immediately when you realize you will not be able to keep your appointment. At least twenty-four (24) hours is required for cancellations to avoid a charge that is not covered by your medical insurance policy. A patient who does not show for an appointment and who does not give a twenty-four (24) hour notice will be charged a $40.00 cancellation fee. Any cancel fee may be required to be paid prior to any future appointments. Patients that fail to show on three occasions may be discharged from the practice for non-compliance, and a letter will be sent to your referring physician.
Late Appointments: Patients who arrive late for their scheduled appointment times will be worked into the schedule, will be seen at the end of the schedule, or may be rescheduled at the practice’s discretion.
Wait Times: This is a specialty office. We strive to keep to the scheduled appointment times. However, in this practice there are some circumstances beyond our control that can result in a longer wait time for everyone. We provide the necessary time and treatment for all of our patients and some may require more time than others for unforeseen reasons. For every appointment, patients should plan to be here for one to three hours, however, this time may vary.
Multiple Providers: We have multiple providers caring for our patients; therefore, some patients may be called before others who have been waiting longer because they are seeing a different provider. All patients will be seen in the order they have been scheduled. Patients who arrive before their scheduled appointment time will not be seen early unless there has been a cancellation or a no show.
Physician’s Assistant/Nurse Practitioner:
The Augusta Pain Center utilizes Physician Assistants and Nurse Practitioners licensed by the Georgia State Board of Medical Examiners who evaluate and treat patients according to the guidelines that have been set by this board. Under the Physician’s supervision, the PA or NP is directly involved in patient care and together they coordinate the best treatment plan for the patient’s needs.
Prescription Medication Policy:
Prescriptions will only be filled during regular business hours. Prescriptions will be faxed to your pharmacy whenever possible, otherwise they can be picked up at your regular appointment. All calls regarding refills received after 2:00 pm will be returned the following business day. Every effort will be made to return all other calls before the end of the day. NO prescriptions will be filled on Fridays. A medication for an accepted pain problem may be prescribed for you that may not have an indication by the FDA. This is common practice by physicians nationally that may be based on medical evidence when it is considered an appropriate treatment.
It is our desire that payment of your account is as easy and convenient for you as possible. We will assist you in any way we can to facilitate the settling of your account. In order for us to keep billing fees to a minimum, it is absolutely necessary for you to provide us with accurate and up-to-date insurance information at EACH visit. It is your responsibility to notify us of any changes in insurance so that claims can be filed correctly. Approval from your insurance company does not guarantee payment. The patient is ultimately responsible for payment of
You will receive a bill for the services provided for each of your visits. Please note that physician services are different from facility charges. The bill that you receive from Augusta Pain Center is for Physician services only. When you have a procedure, you will receive a separate bill from the facility. This is customary and is to cover the costs to the facility for supplies, equipment, medications, personnel, the procedure room, and observation following the procedure. As a courtesy to you, we will file the claims for physician’s services to your
In accordance with the agreement you have with your insurance company, any deductible or co-pay is required at the time services are rendered. Failure to keep your account current may prohibit future services until your account is current. Payments may be made by cash, check, debit card, money order, or accepted credit cards.
Authorization to Release Information:
Consent and authorization is hereby given to Augusta Pain Center, its associates and billing agents to release to any state agency, federal agency, insurance company or third party such information as may be necessary for processing claims (including copies of any medical records, including those that relate to history, treatment, diagnosis, prognosis, psychiatric care, drug and substance abuse, HIV/AIDS), or any confidential information that may be required for any health related utilization review or quality assurance activities.
Assignment of Insurance Benefits:
As a courtesy, this office makes significant efforts to verify insurance coverage and obtain authorization for the services rendered. However, verbal communication with the insurance company may not be accurate, nor will it guarantee payment for rendered services. By signing this document, you authorize and direct the following state agencies, federal agencies, insurance companies, and/or third party payers to pay direct to Augusta Pain Consultants, PC for physician services and you agree to be financially responsible for any service that is not covered by your insurance.
Health Information Privacy Act: (HIPPA)
According to the federal Health Information Privacy Act, effective April 2003, health professionals, using their judgment, may disclose to a family member, other relative, close friend and/or other person you identify, health information relevant to that person’s involvement in your care or payment related to your care. You will have the opportunity to list those persons that you wish to receive information related to your care, including billing and appointment information: