BARNESVILLE URGENT CARE AND FAMILY PRACTICE

T. AARON BUICE, MD

522 Greenwood Street, Ste. A

Barnesville, Georgia 30204

HOURS OF OPERATION

Monday- 8:00am-5:00pm

Friday- 8:00am-5:00 pm

EXTENDED HOURS

Tuesday,Wednesday,Thursday

7:30am-6:00 pm

Saturday

9:00 am- 12:00 pm

770-872-3663

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PROVIDERS: Dr. Aaron Buice, Sean Parker, PA-C, Alice Turner NP

T.Aaron Buice, MD PC
522 Greenwood Street
Ste A
Barnesville, GA 30204
United States
ph: 770-872-3663
fax: 770-872-3665
taaronbuicemd@yahoo.com

We have found it helpful to give our patients the opportunity to review our office and financial polices before being seen for their appointment. If you have any questions, our staff will be glad to assist you.

OFFICE POLICY

Thank you for choosing our office for your medical care. We have written these policies to keep you informed of our current office policies. If you have any questions, our staff will be glad to assist you.

OFFICE POLICIES, EFFECTIVE JANUARY 2011-2014

Office Hours: Our office is open Monday 8:00 am –5:00 pm. Tuesday, Wednesday and Thursday from 7:30am- 6:00 pm Friday 8:00 am-5:00 pm. Saturday 9:00 am-12:00 pm

Appointments: We encourage all patients to call for an appointment. Same day and walk-in appointments are available for urgent or sudden illness. Please arrive at least 15 minutes prior to your scheduled appointment to allow us adequate time to properly check you in. If you have any changes to your demographic information (such as a change

of address or insurance), please make our office staff aware of the changes at check in

After-hours, Emergencies, and Holidays: If you have a life-threatening emergency, call 911 immediately. If you have an emergency (sudden illness or injury) and need to contact our Providers call 706-647-8111 and leave a message for the physician on call. All calls should be urgent care related. No calls should be made for prescription refills or appointments.

Cancellations/Rescheduling: Please call at least 24 hours prior to your scheduled appointment if you will not be able to keep your scheduled appointment. This allows us to provide that time slot to another patient. We attempt to confirm all appointments at least 2 business days prior to your appointment to allow you adequate time to reschedule or cancel. Failure to cancel or reschedule 24 hours in advance WILL result in a $25.00 charge to you for a missed appointment.

Running on Time: We know your schedule is busy and that your time is valuable. Our physician makes every effort to keep on schedule. If you have been waiting more than 20 minutes and have not been advised of a delay, please speak to the receptionist to ensure that you have been properly checked in. Patients are seen in schedule order,with few exceptions. Patients arriving more than 10 minutes after their scheduled appointment may be asked to reschedule.

Physical Exams: We believe that routine physical examinations (“preventative exams”) are important to the maintenance of good health. Your insurance policy may or may not cover preventative exams. Please review your benefits prior to your appointment so you will know what is covered by your insurance plan. All patients who request a physical exam will be required to complete an Advanced Beneficiary Notice. Please check in 15 minutes prior to your scheduled appointment to complete all necessary paperwork.

Test Results: A staff member will contact you if any action or follow up is required after we receive your results. Please allow 10 days before calling for your results. If the doctor needs to speak to you regarding your results, you will receive a phone call and be asked to schedule an appointment. A summary of your results will be mailed to you. If you wish to obtain a hard copy of your test results, please stop by our office and we will print them for you. Copies of test results will not be mailed unless you provide us with a self-addressed, stamped envelope.

Prescriptions and Refills: The best time to get a prescription refill is at your appointment. If you need a refill, and your current prescription bottle indicates that you have refills remaining, please contact your pharmacy. Most refills require the doctor’s approval. Please allow 2 business days for us to process your refill request. Please do not contact the on-call physician with a refill request, as they do not have access to your chart. Liability insurance requires that a physician have current detailed documentation on patients that are prescribed medications. If you have not seen the provider in a routine fashion, we will not be able refill medications.

Narcotics: We do not prescribe narcotics for long term chronic pain. Our Providers will refer you to a pain management specialist for most chronic pain issues requiring the use of narcotics. After-hours narcotics requests will be denied.

Mail order prescriptions: We will print your prescription to your mail-order pharmacy. If your insurance company requires an additional form to be submitted with your prescription, please tell the physician that you would like your prescription printed. If you would like our office to complete the form for you, there will be a $20 charge (please refer to the Financial Policies Section). If there is a problem with the fax to your prescription company, we print a copy of your Rx for you to correspond directly with your prescription company.

Samples: Drug samples are not stocked in our office. Short-term prescriptions will be written if you wish to try a new prescription for a short time period.

Patient Dismissal: While we make every effort to work with you, sometimes we feel it is best for all involved to dismiss you from our practice. If you are dismissed from the practice, you will be allowed 30 days for emergency treatment in our office. After that time, you will be required to seek the services of another physician in another office. Common reasons for dismissal include: failure to keep appointments, non-compliance, abusiveness to staff, failure to pay your bill.

Other Charges: The following request may incur additional fees:

*Prescription Refill Request: $15.00 (these request are for patients that have run out of their medications before making an appointment)

*Form Completion: $15.00 and up (disability, handicap, etc)

*Formulary Overrides and Prior Approvals: $15.00-$30.00 (these charges are for administrative time spent on the phone with insurance companies, pharmacies, and/or clinical to insurance company)

*Letters: $30.00 and up (life insurance, health insurance, etc)

*Prescription Changes: $10.00 (patient request change in medicine and changes due to cost/insurance requirements)

FINANCIAL POLICY

FINANCIAL POLICIES, EFFECTIVE SEPTEMBER 1, 2011

We accept cash, check, Visa, MasterCard, and Discover for your convenience.

Private Pay: If you do not have insurance, payment will be due at the time of service. We offer a discount to all patients who pay in full at the time of service.

Insurance: Although we are contracted with several insurance companies, it is your responsibility to make sure that our physician participates in your specific plan. If our providers are not participating with your plan, you may still select our office for your medical care; “out of network” benefits will apply. It is also your responsibility to know your insurance benefits. Our office will not advise you of your insurance benefits. Please contact your insurance company at the customer service phone number printed on your insurance card if you have questions pertaining to coverage.

As a courtesy to our patients, we will file insurance forms from our office. In order to do this, we require all information to be completed on the Patient Registration Form. We will request an update to your information annually. Please present your insurance card at each appointment. A photo ID is required at your first visit. We make every effort to verify insurance prior to your appointment. If our office is unable to verify your insurance eligibility, you will be required to pay for your visit at the time of your appointment. If you provide the correct insurance information to our office in a timely manner, we will file a claim on your behalf. We will refund to you any portion that is determined to not be your responsibility.

You are responsible for paying all co-pays at the time of service. Co-pays, co-insurance, deductibles and noncovered services cannot be waived by our office, as it is a requirement placed on you by your insurance carrier.

Billing: If you receive an invoice from our office for a balance due, it is because that is the balance your insurance policy requires that you pay. Please contact your insurance company first if you believe there is a problem. The balance on your invoice should be equal to the “Patient Responsibility” portion on your Explanation of Benefits that you received from your insurance company plus any “non-covered services” (less any copay that was collected at the time of service). If there is a discrepancy, please call the billing office immediately to advise us. You will continue to receive invoices and be subject to collections if you do not advise us of discrepancies. The billing office may be reached at 770-872-3663.

Collections: Invoices not paid within 90 days are subject to patient dismissal, submission to our collections agency and notification to your insurance plan.

Non-covered Services: The following services are considered “non-covered services” by most insurance companies. The fees listed below must be paid at the time of service.

 Returned Checks: If your check is returned to us for any reason, you will be charged $35

 Missed Appointments: If you fail to notify us at least 24 hours in advance that you will not be able to make your appointment, we may charge you $25.00.

 Forms Completion: Disability, insurance forms, travel forms, release from work, prior authorizations, and other forms are not required by all insurance plans or employers. If you require a physician or office staff member to complete these forms, there will be a $20 administrative charge in addition to your office visit charge.

 Paper Records: We will provide to you, upon written request, a paper copy of your medical record. We charge a base fee of $10 plus $0.25 per page.

 Phone Visits: If you request medical services via telephone instead of a visit to our office, the following fees apply. You must be an established patient to request this service. Phone visits are done only by prior physician approval and scheduling. If the phone visit results in an office visit within 24 hours, you will be refunded, per federal insurance guidelines.

o 5-10 minutes: $30

o 11-20 minutes: $45

o 21-30 minutes: $60

 Late Fees: Invoices not paid within 30 days will result in a $10 per month late fee. Invoices not paid within 90 days incur a 25% administrative fee for collections processing.

 Co-pay Collection Fee: If we must bill you for your copay, you may be required to pay a $20 Co-pay Collection fee.

 After-hours appointment fee: $25 in addition to the office visit charge.

Thank you for allowing us to provide you and your family the best medical care possible. If you have any suggestions that may assist us in providing better service, please let us know.

T. Aaron Buice, MD & Staff

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T.Aaron Buice, MD PC
522 Greenwood Street
Ste A
Barnesville, GA 30204
United States
ph: 770-872-3663
fax: 770-872-3665
taaronbuicemd@yahoo.com