Terms & Conditions

Terms & Conditions

OFFICE POLICIES

Random Drug Screening: Please be advised that you may be asked or requested to be tested for random drug screen in office if indicated.

Why We Test: Many patients do not realize that the physician’s ability to prescribe medications can be limited or stopped entirely if patient misuse or divert their prescriptions. Our team wants to continue to serve you and want you to be safe. We make it a policy to test with or without your consent.

Appointment Cancellation: We understand that there are times when you must miss an appointment due to emergencies or obligations. If an appointment is not cancelled at least 24 hours in advance, you will be responsible for $25.00 fee that will not be covered by your insurance and it will be due at the time of service.

Please be advised that if you do not keep your appointment without any notice for 3 times during a calendar year, you may be discharged from the practice. If you need any assistance with rescheduling and cancelling your appointment, please call our office.

Medication Refills: Please allow 3-5 business days for prescription refills to be processed.  Controlled substance refills will not be processed on Fridays, please plan accordingly.  Please do not use our after-hours emergency answering service to request refills.

Emergency on-call after hours service:  A charge of $50.00 will be applied to patient accounts if after hour calls placed are non-emergent in nature.  Examples: Medication refills; appointment questions; any other questions that could have been addressed during scheduled appointment time.

FMLA / Short term disability:  You must be a well- established patient before we will consider filling out documentation or requests for FMLA or short-term disability.  This means you will need to develop a relationship with us including regularly attending your appointments, being compliant with all treatment, and be stable in treatment.  If these items are met there will be a charge to complete the necessary documentation.  You will be required to be in the office and submit payment before we can begin the documentation process.

Prior Authorization Policy:  At times, your insurance company may decline payment for a medication that may help you.  We can often work with your insurance company through a prior authorization procedure to get the medication covered.  If we need to undertake this process, there will be a charge for the service that is not covered by insurance and will be paid prior to starting the process.

NOTICE OF INFORMATION PRACTICES

  1. Instic Health may use and disclose protected health information for treatment, payment, and healthcare opera Example of these include, but are not limited to, requested preschool, life insurance or sports physicals, referral to nursing homes, foster care homes, home health agencies and / or referral to the other providers for treatment. Payment examples include, but are not limited to, insurance companies for claims including coordination of benefits with other insurers: and collection agencies. Healthcare operations includes, but is not limited to, internal quality control and assurance including auditing of records.
  2. Instic Health is permitted or required to use or disclose protected health information without the individual’s written consent or authorization in certain circumstances. Two examples of such are for public health requirements or court
  3. Instic Health will not make any other use or disclosure of a patient’s protected health information without the individual’s written authorization. Such authorization may be revoked at any Revocation must be written.
  4. Instic Health may at times contact the patient to provide appointment reminders or information regarding treatment alternatives or other health-related benefits and services that may be of interest to the individual patient.
  5. Instic Health will abide by the terms of this notice or the notice currently in effect at the time of the disclosure.
  6. Instic Health reserves the right to change the terms of its notice and to make new notice provisions effective for all protected health information of the Copies may also be obtained at any time at our offices.
  7. Instic Health will provide each patient with a copy of any revisions of its Notice of Information Practice at the time of their next visit, or at their last known address if there is a need to use or disclose any protected health information of the Copies may also be obtained at any time at our offices.
  8. Any person / patient may file a complaint to the Practice and to the Secretary of Health and Human Services if they believe their privacy rights have been To file a complaint with the practice, please contact our practice administrator.
  9. It is policy that no action will be made against any individual who submits or conveys a complaint of suspected or actual non-compliance of the privacy