North Hills Internal Medicine

Welcome to our practice. We are looking forward to assisting you with your healthcare at North Hills Internal Medicine. For those of you with Internet Access, you may find additional information and services at our website (www.northhillsim.com). To assist you, we have listed below NHIM’s policy or procedure in several key areas. We hope this will assist you when you need to reach us. Please feel free to forward your questions and suggestions, or ask us how we handle any situation that you have questions about.

TELEPHONE: When you call, please listen to the options until you find the one that most suits your needs. Most commonly used are: Appointments or to leave a message (Option 1), Referrals or Authorizations (Option 4), Billing (Option 5). You may reach one of the operators by pressing 1. Our receptionists are not advice nurses. A variety of medical office personnel answer the phones. Your doctor’s nurse serves to provide advice on medical care for you. When you call, leave a message with the receptionist, for your doctor or nurse to call back. Most calls should be returned that day.

APPOINTMENTS: Upon becoming our patient you are assigned a primary care doctor. When you request an appointment we first will check your personal physician’s schedule. If you have an “urgent” need, and want to be seen that day, you will be offered the next appointment with your doctor, if available that day, or if unavailable, with the physician assistant or another doctor. On each visit, always bring your current insurance card or cards. Please let us know if anything has changed, i.e.; employer, work number, address, home phone number, insurance, co-payment, etc.

PHYSICIAN ASSISTANTS: We have three physician assistants (PAs) who are often available to see patients the same day an appointment is requested. Physician assistants are licensed health care providers who work with the physicians to facilitate patient care. They can diagnose and treat a variety of illnesses, perform physical exams, order and interpret laboratory tests and perform a variety of procedures. You can schedule an appointment with a PA when your doctor is not available, or if you choose, you may see the PA exclusively.

NURSE PRACTITIONERS: We have one Family Nurse Practitioner (FNP). FNPs are advanced practice nurses who provide high-quality healthcare services similar to those of a doctor. From treating illnesses to advising patients on maintaining a healthy lifestyle, FNPs provide a full range of services. Among these services, FNPs order, perform and interpret diagnostic tests, diagnose and treat acute and chronic conditions, prescribe medications, and manage patients'' overall care. You can schedule an appointment with the FNP when your doctor is not available, or if you choose, you may see her exclusively.

LATE FOR YOUR APPOINTMENT? : Patients late for appointments will routinely be rescheduled to another time, so as not to interfere with patients arriving in a more timely manner.

*** APPOINTMENT CANCELLATIONS: We appreciate you promptly notifying us if you can not make your appointment, so that we can give that time to another patient. There may be a $25 charge for appointments not canceled prior to 24 hours of the appointment time or for a same day work-in appointment that is not kept. Also, we reserve the right to terminate our relationship as a result of repeated missed appointments. No Show or Cancellation Fees must be paid prior to, or on the day of, your next appointment. This $25 charge is not payable by your health plan.

*** PRESCRIPTION REFILLS: Ideally you should obtain any prescription refill you need from your doctor at a scheduled office visit. However, if you need a refill we prefer you to contact your Pharmacist and have them fax us your refill request. Refills will be called or faxed to your pharmacy within 24-48 hours unless there is a problem. PLEASE CHECK WITH YOUR PHARMACY FIRST BEFORE CALLING THE OFFICE BACK TO SEE IF IT HAS BEEN CALLED IN. Also, we are unable to call Pharmacy Benefit Managers, like Merck Medco or Advance PCS. But, we will provide you your appropriate prescription(s) so that you can forward these to your Pharmacy Benefit Manager. Please DO NOT wait until you have completely run out of medicine to request a refill.

Please note: there may be a $10 charge for phone or fax prescription refills. We encourage patients to get 6 to 12 month prescription refills for on-going prescriptions at the time of their office visit. Please discuss this with your doctor at each visit.

*** PRESCRIPITONS, AFTER HOURS: There will be a $25 charge for prescriptions that are called in after hours resulting from a phone consultation, and not part of an office visit or part of a continuing medical problem, for which we are treating. Your health plan does not cover this charge.

ATRIS: We have a system for lab results notification called ATRIS that allows patients to call in and hear a message recorded by their provider about lab results. In situations where more detailed information needs to be given, someone from the office will call you, or you will be sent the results through the mail.

LAB RESULTS AND OTHER TEST RESULTS: If your physician has given you an ATRIS card please call this number first. If you have not gotten results in 7-10 days, call the main number and leave a message with one of the receptionists answering the phone to request information about your test results. We suggest you hold onto this ATRIS Card for future test results. Your number will always remain the same.

REFERRALS/AUTHORIZATIONS: Please make an appointment with your provider if you need a referral. Based on your medical condition, your doctor will suggest an appropriate physician on your plan. The request will be forwarded to the referral coordinator who will contact your insurance company and then will fax the referral to the specialist office. You will NOT receive a phone call once the process is completed. We suggest you check with your specialist at least two days prior to your appointment to insure they have your authorization on hand.

ILLNESS AFTER HOURS: We always have a physician or physician assistant on call after hours if your medical problem absolutely cannot wait until office hours. Just call the main number and the answering service will take a message and page the doctor on call who will return the call. For an emergency, please call 911 first.

*** FORMS AND PHYSICAL EXAM DOCUMENTS: There are increasing numbers of forms and physical exam documents that are requested to be completed during the year for our patients. Various correspondences or documents that we take time to complete will incur fees between $10 to $25 depending on the time required to accomplish your request. Please allow 7 days to complete.

PHONE TRIAGE: We prefer to treat our patients in the office with direct histories and physical exams, but occasionally we will treat certain conditions over the phone. When we prescribe medicines over the phone for you, there will be a fee for this service. We will continue to refill your regular medications, which is best done during your health care visits to our office.

MANAGED CARE PLANS: Right now, we participate with the following insurance companies: Blue Cross Blue Shield, CIGNA, Health Care Savings, MedCost, State Health Plan, Primary Physician Care, First Health, and WellPath/Coventry. Please see the website and/or check with our office for an update on our participation in health plans.

When we “participate” with your insurance company your copay and/or your coinsurance payment is due at Time of Service.

When we do not participate with your insurance company we request that you pay In Full At The Time of Service. We will mail your insurance claim to your insurance.

When you have a secondary insurance company, with whom we participate, the patient needs to mail, fax, or bring us a copy of the Primary Insurance Company’s EOB (Explanation of Benefit). We will then file the claim to your secondary insurance company. We do not file to your secondary insurance company unless we have a contract with the carrier. Also, we follow the rules of your primary insurance company with regards to payment at the time of service; i.e., co-pay or payment in full.

When you have Medicare we ask you to Pay At The Time of Service. We do not participate with Medicare, and therefore, we do not accept assignment. We will file your claim to Medicare, and Medicare in turn reimburses the patient directly. If you have a secondary insurance company with whom we participate, then the same rule as above applies.