Lakeshore Family Practice Policies and Procedures 2017
Appointments
Appointments are required for all types of care administered at Lakeshore Family Practice. This allows us to manage our team and resources in a manner that gives each patient the time needed to care for their individual needs. Appointments can be made by telephone or by request on the patient portal. An important part of your care is maintaining an accurate medical record; for this reason, every visit will include an update of your current medications, any allergies, visits to any other health care provider or results from outside tests, and/or any changes in your medical status, history, or needs. New patients must see our Physician prior to making appointments with our Nurse Practitioner. Some appointments, such as those requiring Prior Authorizations, Wellness Exams, or special physicals such as FAA or DOT, may require more time than a standard visit, so be sure to communicate any of these needs to our office when scheduling your appointment. We understand that unforeseen events may cause you to miss an appointment. We ask that you call to reschedule your appointment in advance if you are unable to be on time, as this allows our team to ensure that they have enough time to address your needs during your office visit.
Sick Visits
We want to be there for our patients when they are ill. We understand that knowing you and your medical history makes us the first place to go when you are sick, and likely the best solution for your urgent needs. Our providers plan for same-day and next-day appointments in advance by keeping slots open in each day’s schedule. If your Primary Care Giver is out of the office, you may be scheduled with our other Provider to allow for more timely care. Our healthcare providers perform as a care team and collaborate daily to fully manage your needs. For same-day or next-day visits, we recommend you call in the morning to schedule either type of appointment.
Questions
As a Primary Care Provider, we understand that patients frequently have questions or concerns for which they would like to speak to a clinician. Depending on the type of question or concern, these questions may be handled over the phone, via the patient portal, or you may be asked to schedule an appointment to speak directly with one of our providers. Questions posted to our portal generally receive a response by the following business day. Calls placed after hours are routed to our answering service. For dangerous or life-threatening emergencies please call 9-1-1 or go immediately to an emergency care facility.
Medication Refills
Medication refills are typically handled during your regular office visits. If you require refills outside of an office visit, under most circumstances you may request a refill via the patient portal, by telephone, and pharmacies are able to contact us directly on your behalf. In some cases, patients who have not been evaluated in over 6 months may require an appointment for refills, keep this in mind if you have a chronic condition or disease that requires prescription medication. Due to State and Federal Laws and Regulations, we also have different procedures for controlled substances, which are listed below.
Controlled Substances
Lakeshore Family Practice takes the Alabama guidelines for controlled substances very seriously. As such, we are no longer taking new patients with a diagnosis of chronic pain requiring opioids, or new patients seeking anxiety or depression medication. Established patients requiring pain management may be asked to sign a pain agreement contract and/or be monitored. Patients who have signed pain agreements are generally required to have monthly visits. Refill requests made by patients for controlled substances after hours, during the weekend, or holiday period are generally not addressed until the following business day.
Referrals
As your primary care provider, part of our role is to provide referrals. Referrals typically require an office visit for the specific issue for which the referral is being requested. Insurance companies often require certain documentation before submitting a referral, this documentation will be taken care of during the visit. Referral requests are generally addressed by our office, or the office to which you have been referred to, within three business days.
After Hours Care
Patients can reach our office after hours by sending us messages within our patient portal, or by calling 256-582-2581 and leaving a message with our answering service. Messages posted to our portal generally receive a response by the following business day. Calls to our answering service will be forwarded to our on-call staff immediately under certain criteria. For urgent of life-threatening emergencies, call 9-1-1 or go directly to Marshall Medical Emergency Facilities.
Hospital Admissions
Dr. Henderson is on the medical staff at Marshall Medical Center North. We typically use these facilities to admit our patients when they need hospital care. We consider the specialists at Marshall Medical to be professionals with whom we have a good relationship and we are confident about the care they give our patients. We our able to view all recent medical records and test results from Marshall Medical Centers directly within our office. Older records may require a telephone request and are generally received within two business days. Hospitalization at facilities outside the Marshall Medical System will require a medical record release to be signed by the patient and submitted by our medical records clerk.
Physicals
We recommend patients have a physical annually, most insurance companies will also require them. Sometimes patients will require additional specific physicals; such as Sports, DOT, FAA, or Wellness exams. In the case that you are scheduling a specific physical exam, please let our Scheduling Staff know in advance, as these types of exams require more time to complete. We encourage all patients to obtain immunizations, screenings, and maintenance tests before these exams as it may be necessary for review during these visits.
Prior Authorizations
Most insurance companies now require Primary Care Providers to perform prior authorizations for specialty referrals, diagnostic imaging, and branded prescriptions. You may be required to have an appointment in order for us to obtain the information required to successfully complete these authorizations. As a general rule, we require an evaluation every six months for chronic medical conditions and more frequently for certain medical conditions.
Administrative Policies
We will ask you to verify and update your patient registration and demographic information annually. In addition, we will update your patient photo within our records, and your HIPAA privacy notice.
We are also happy to complete paperwork on your behalf, such as those for disability or FMLA. Assistance with certain forms may require a fee or an appointment, so be sure to mention these requests to our staff.
Insurance
We currently accept Aetna, Alabama Medicaid (accepted only WITH Medicare), Blue Cross Blue Shield of Alabama, Medicare, NAMCI, Railroad Healthcare, United Healthcare and Cigna HealthSpring (when accepted & assigned). Copays are collected at check-in during your visit, and you may also need to be prepared to pay your deductible. If you are not able to pay during the time of your appointment, we will happily reschedule you for another time. If you have any questions about your deductible, or any bill or statement you have received from our office, please call us and we will be happy to answer any of your questions. In addition, our team can refer to CHIPS, Medicaid, and Marshall Medical Foundation for patients who need financial support.
Appointments are required for all types of care administered at Lakeshore Family Practice. This allows us to manage our team and resources in a manner that gives each patient the time needed to care for their individual needs. Appointments can be made by telephone or by request on the patient portal. An important part of your care is maintaining an accurate medical record; for this reason, every visit will include an update of your current medications, any allergies, visits to any other health care provider or results from outside tests, and/or any changes in your medical status, history, or needs. New patients must see our Physician prior to making appointments with our Nurse Practitioner. Some appointments, such as those requiring Prior Authorizations, Wellness Exams, or special physicals such as FAA or DOT, may require more time than a standard visit, so be sure to communicate any of these needs to our office when scheduling your appointment. We understand that unforeseen events may cause you to miss an appointment. We ask that you call to reschedule your appointment in advance if you are unable to be on time, as this allows our team to ensure that they have enough time to address your needs during your office visit.
Sick Visits
We want to be there for our patients when they are ill. We understand that knowing you and your medical history makes us the first place to go when you are sick, and likely the best solution for your urgent needs. Our providers plan for same-day and next-day appointments in advance by keeping slots open in each day’s schedule. If your Primary Care Giver is out of the office, you may be scheduled with our other Provider to allow for more timely care. Our healthcare providers perform as a care team and collaborate daily to fully manage your needs. For same-day or next-day visits, we recommend you call in the morning to schedule either type of appointment.
Questions
As a Primary Care Provider, we understand that patients frequently have questions or concerns for which they would like to speak to a clinician. Depending on the type of question or concern, these questions may be handled over the phone, via the patient portal, or you may be asked to schedule an appointment to speak directly with one of our providers. Questions posted to our portal generally receive a response by the following business day. Calls placed after hours are routed to our answering service. For dangerous or life-threatening emergencies please call 9-1-1 or go immediately to an emergency care facility.
Medication Refills
Medication refills are typically handled during your regular office visits. If you require refills outside of an office visit, under most circumstances you may request a refill via the patient portal, by telephone, and pharmacies are able to contact us directly on your behalf. In some cases, patients who have not been evaluated in over 6 months may require an appointment for refills, keep this in mind if you have a chronic condition or disease that requires prescription medication. Due to State and Federal Laws and Regulations, we also have different procedures for controlled substances, which are listed below.
Controlled Substances
Lakeshore Family Practice takes the Alabama guidelines for controlled substances very seriously. As such, we are no longer taking new patients with a diagnosis of chronic pain requiring opioids, or new patients seeking anxiety or depression medication. Established patients requiring pain management may be asked to sign a pain agreement contract and/or be monitored. Patients who have signed pain agreements are generally required to have monthly visits. Refill requests made by patients for controlled substances after hours, during the weekend, or holiday period are generally not addressed until the following business day.
Referrals
As your primary care provider, part of our role is to provide referrals. Referrals typically require an office visit for the specific issue for which the referral is being requested. Insurance companies often require certain documentation before submitting a referral, this documentation will be taken care of during the visit. Referral requests are generally addressed by our office, or the office to which you have been referred to, within three business days.
After Hours Care
Patients can reach our office after hours by sending us messages within our patient portal, or by calling 256-582-2581 and leaving a message with our answering service. Messages posted to our portal generally receive a response by the following business day. Calls to our answering service will be forwarded to our on-call staff immediately under certain criteria. For urgent of life-threatening emergencies, call 9-1-1 or go directly to Marshall Medical Emergency Facilities.
Hospital Admissions
Dr. Henderson is on the medical staff at Marshall Medical Center North. We typically use these facilities to admit our patients when they need hospital care. We consider the specialists at Marshall Medical to be professionals with whom we have a good relationship and we are confident about the care they give our patients. We our able to view all recent medical records and test results from Marshall Medical Centers directly within our office. Older records may require a telephone request and are generally received within two business days. Hospitalization at facilities outside the Marshall Medical System will require a medical record release to be signed by the patient and submitted by our medical records clerk.
Physicals
We recommend patients have a physical annually, most insurance companies will also require them. Sometimes patients will require additional specific physicals; such as Sports, DOT, FAA, or Wellness exams. In the case that you are scheduling a specific physical exam, please let our Scheduling Staff know in advance, as these types of exams require more time to complete. We encourage all patients to obtain immunizations, screenings, and maintenance tests before these exams as it may be necessary for review during these visits.
Prior Authorizations
Most insurance companies now require Primary Care Providers to perform prior authorizations for specialty referrals, diagnostic imaging, and branded prescriptions. You may be required to have an appointment in order for us to obtain the information required to successfully complete these authorizations. As a general rule, we require an evaluation every six months for chronic medical conditions and more frequently for certain medical conditions.
Administrative Policies
We will ask you to verify and update your patient registration and demographic information annually. In addition, we will update your patient photo within our records, and your HIPAA privacy notice.
We are also happy to complete paperwork on your behalf, such as those for disability or FMLA. Assistance with certain forms may require a fee or an appointment, so be sure to mention these requests to our staff.
Insurance
We currently accept Aetna, Alabama Medicaid (accepted only WITH Medicare), Blue Cross Blue Shield of Alabama, Medicare, NAMCI, Railroad Healthcare, United Healthcare and Cigna HealthSpring (when accepted & assigned). Copays are collected at check-in during your visit, and you may also need to be prepared to pay your deductible. If you are not able to pay during the time of your appointment, we will happily reschedule you for another time. If you have any questions about your deductible, or any bill or statement you have received from our office, please call us and we will be happy to answer any of your questions. In addition, our team can refer to CHIPS, Medicaid, and Marshall Medical Foundation for patients who need financial support.