1050 E. Hwy 114, Ste 100 817/329-8364 Welcome to …

1 1050 E. Hwy 114, Ste 100 Southlake, TX 76092 817/329-8364 Welcome to your medical home 10/22/14 A medical home is a team approach to providing total health care. your medical home will include your health care provider, others who support you, and most importantly, you. You are the most important person on the health care team. Patient-centered is a way of saying that you are the focus of our health care. your medical home can: Help you manage your health care by using evidence based care and self-management support Help answer your health questions Listen to your concerns Work with other medical experts if necessary Coordinate your care through additional services Encourage you to play an active part in your own health care What can YOU do to help? 1. Be an active team player Talk with your team about your health questions Share your past health care successes and challenges Tell your team about other health care professionals who care for you Tell your team how you feel about the care you are getting from them 2.

2 Take care of your health Follow the health care plan you and your team have talked about. Make sure you understand how to follow the plan. Set goals you can reach. Once you begin to see results, you and your team can discuss adding new goals. 3. Talk openly with your team Tell your team if you are having trouble sticking with your care plan Speak up if your care plan is not working. Tell your team what is not working so together you can make changes if needed. What can YOU expect? In a medical home , you and your team will work together. As an active member of the team, you will have a chance to explain the things that are really important to you o your team can answer questions and help you better understand your health care needs o If you need to get help from other doctors, your team can support you every step of the way. o When you have concerns about your health, your medical home team will work with you to determine the best way to deal with them.

3 Together, you and your team can work on a plan that: o Is personalized or created just for you o Is coordinated with other health care providers o Connects you with your health care team Working with your team may improve the quality of your health care and shorten the time it takes to get that care. During your appointment, use this handy checklist Write down the names or your team members Use a list of questions you ve written down. Ask you most important question first. Even if you cannot get all of your answers on the first visit, having a list will help you keep track of the answers Talk with your team about what health issue to work on first. Use your own words to repeat back the things you ve discussed with your team. This way, both you and your team will know the information is clear. Before you leave the office, be sure you know the things you need to work on before your next appointment.

4 We have outlined a few of our office policies that help us serve you better. For more information please visit us at Clinic Hours We are open Monday through Friday 8:00am - 12:00pm and 1:30pm - 5:00pm Appointments Appointments can be made during regular business hours. If you are unable to keep your appointment, we ask that you be considerate of other patients who may need to be seen by canceling as soon as possible. We may bill you a cancellation fee for a missed appointment without proper notification. If you arrive late for your appointment, we will make every attempt to see you; however your appointment may have to be rescheduled. Telephone Calls/Web messages for the Providers or medical Assistants Our phones are answered and web messages are checked by our staff from 8:30 to 5:00. Our trained staff accepts all calls/messages from patients, enabling the provider to spend more time with the patients in the office.

5 A medical assistant will return all calls/messages received before 4:00 pm by the end of the day. Calls/messages received after 4:00pm will be returned by the end of the next business morning. After hours Emergency Calls Our providers are always available after office hours, 5:00 pm to 8:30 am, for emergency calls. Night and weekend coverage is shared with other qualified area physicians. Call our main number, 817/329-8364 for instructions. In a life-threatening situation, go to the nearest Emergency Room or call 911. Prescriptions your medical record is needed to determine whether a refill should be issued, therefore refills cannot be approved after normal business hours. During your visit your Doctor will give you prescriptions in amounts to last until you need to be seen again. Follow up appointments are scheduled so that your provider can monitor your condition and adjust medications accordingly.

6 To ensure appointment availability, please make this appointment at the time of your current visit or at the time you get your last refill. Prescription requests received after 4pm will be processed by the end of the next business day. If you do find yourself in need of more medication prior to your appointment, please call your pharmacy, who will call us for any additional refills. Limited refills may be given to allow time for you to make your appointment. Referrals Some managed care plans require your primary care doctor to obtain authorization to be referred to another provider. If your managed care plan requires this, we will obtain authorization from your insurance company within 3 business days. Please do not make an appointment with the specialist until you have received a call from our referral department. Outpatient Procedures We will obtain authorization from your insurance company and you will be contacted by the facility to which you are being sent to within 5 business days to schedule your procedure.

7 your results will be discussed at your follow-up appointment. Lab Results Acute illness lab results: o All Labs Results will be discussed at your follow-up appointment. Chronic disease results: o Labs are drawn 1 week prior to your appointment with the Provider. Results are reviewed at this appointment. Physical lab results (including pap smears): o Labs are drawn after your physical exam either the same day or the next morning. A physical follow up appointment should be made for 2-4 weeks after the physical. Results are reviewed at this follow up appointment. Surgical Biopsy result: o You will either be called in 10-14 days or the results will be reviewed during suture removal appointment Treatment of a Minor A minor is a person under the age of 18 who has never been married and never been declared an adult by a court. Generally, minors do not have the legal capacity to consent to medical treatment.

8 In order for us to treat a minor we must have a written consent from a parent or legal guardian including a statement as to the nature of the medical treatment to be given on a specific day. Minors age 15 and under MUST be accompanied by an adult (18yrs old and older) With the written consent, we will perform the following: Examination X-Rays Other testing Noninvasive procedures We will not perform: Invasive procedures Immunizations Injections Lab Draws Managed Care We accept dozens of insurance plans with various deductibles, co-pays, and coverage s. We cannot know all of the coverage limitations and rules of your plan. It is important that you read and understand the provisions of your insurance policy. Co-Pays All co-pay payments are due at check in. Please bring your insurance card to every visit. Responsibility for ensuring Insurance Coverage You are responsible for ensuring that we are providers on your insurance plan and for knowing what services you have coverage for including but not limited to office visits, labs, x-ray, procedures, physicals and immunizations.

9 You will be responsible for paying for all services not covered by your insurance plan. Motor Vehicle Accidents (MVA) We do not file charges for MVA insurance policies. All charges for services rendered due to a MVA are payable in full at the time of your visit. You will need to submit your charges and seek reimbursement from the MVA insurance company. Third Party Liability Third party liability means that someone else s insurance is to cover your illness/injury. For example, a fall at a grocery store, where the grocery store s insurance will pay for your medical bills. We do not file charges for payment to attorneys or any other third party payor. All charges for services rendered are payable in full at the time of your visit. You will need to submit your charges and seek reimbursement from the third party insurance payor. Workman s Compensation We do not file workman s compensation insurance, therefore we cannot treat you for any work related illness or injury.

10 Due to State Laws, you could be denied benefits if you claim your condition is not work related but it actually is. You are invited to join our HIPAA compliant, secure, all-in-one personal 24/7 anywhere, anytime health record and patient portal that you can access via computer, smart phone or smart pad. We encourage you to use the portal so you may save hold time and avoid telephone tag: To request a non-urgent appointment o You will receive text and/or email alerts and reminders To securely contact o your provider with non-urgent questions o your provider for refill requests o Our front desk to update your demographic information To allow you to check your personal demographic information To view past test and lab results To receive email care reminders Getting Started is Easy!!! All you need to do is sign the Invitation Form at your appointment. That s it!! Within a day or two you will receive an invitation via email to complete the connection to your personal health record and all of the benefits of the 24/7 patient portal.