My Expectations and Responsibilities as an FIM Patient
Contacting the Office: Appointments, Advice, and Emergencies
Payment of Medical Services
What may I expect as a patient of FIM?
- Have the expectation to be treated in a manner reflecting respect for their privacy and dignity as a person.
- Have the expectation to be informed regarding their diagnosis, course of treatment and prognosis in terms they can reasonably be expected to understand and to participate in decision making about their health.
- Have the expectation to receive sufficient information to enable them to give informed consent prior to the initiation of any procedure and/or treatment.
- Have the expectation to discuss their medical record with the physician and to receive, upon written request, a copy of that record.
- Have the right to expect information pertaining to their health care will be treated as confidential and will not be released without their, or their authorized representative’s written permission, except as required by law.
- Have the expectation to be informed of unforeseen delays in the provider’s schedule.
- Have the expectation to be able to make a complaint and to receive response to that complaint within a reasonable period of time.
What are my responsibilities as a patient of FIM?
- Have the responsibility to be considerate and cooperative in dealing with office staff and providers.
- Have the responsibility to follow instructions and guidelines given by those providing health care services and to weigh potential consequences of any refusal to comply with those instructions or recommendations.
- Have the responsibility to obtain and carefully consider all information needed or desired in order to give informed consent for a procedure or treatment.
- Have the responsibility to assist in compiling a complete medical record by providing or authorizing release of medical information from other providers.
- Have the responsibility to notify their primary care physician (PCP) prior to seeking consultation or emergency services, except in potentially life threatening situations.
- Have the responsibility to schedule appointments and to arrive on time for scheduled visits or to notify their physicians’ offices if they must cancel or be late for a scheduled appointment.
- Have the responsibility to express opinions, concerns or complaints in a constructive manner.
When is the best time to contact the office?
Between 8:00am and 10:00am every morning and all day on Monday are peak calling hours. For faster service, limit routine requests until after 11:00am, Tuesday through Thursday. Our phone number for both offices is 865-218-9220.
What if I need to cancel an appointment?
In order to ensure needed medical care and appropriate follow up, it is important to keep any scheduled appointment with your provider. In addition, when an appointment time is reserved for you, this time is unavailable for other patients. Advance notice, preferably twenty-four hours, is required when it is necessary to reschedule your appointment. Failure to notify in advance of a cancelation may result in a surcharge being placed on your account.
We understand situations arise in which you must cancel your appointment. It is therefore requested that if you must cancel or reschedule your appointment that you provide 24 hour notice. This will enable another person who is waiting for an appointment to be scheduled in that appointment slot.
Office appointments which are cancelled or rescheduled with less than 24 hour notification may be subject to a $25.00 fee. Any test/procedures cancelled or rescheduled with less than 24 hour notification may be subject to a $50.00 fee.
Patients who do not show up for their appointment without a call to cancel an office appointment or test/procedure appointment will be considered as NO SHOW. Patients who no call/no show two or more times in a 12 month period may be dismissed from the practice. Patients may also be subject to a $25.00 fee for an office appointment no call/no show or a $50.00 fee for a test/procedure no call/no show. Patients who show up after their scheduled appointment time are considered no call/no show and may not be seen.
The above fees are the sole responsibility of the patient and must be paid in full before the patient’s next appointment.
We understand that special unavoidable circumstances may cause you to cancel or reschedule within 24 hours. Fees in this instance may be waived with management approval.
Our practice firmly believes that good physician/patient relationships are based upon understanding and good communication.
What if I have a medical question between appointments?
We have a triage nurse during our hours of operation. If you are calling with a medical problem, medical question, or need to speak with a nurse, you may reach the triage nurse at 865-218-9220. You will be asked to leave a message. All medical advice is reviewed by the doctor and relayed to the patient by our knowledgeable medical office staff. The provider reserves the right to require an office visit for the thorough in-person examination and treatment.
What if I have a medical emergency after office hours?
A doctor is on call after office hours, during weekends, and on holidays. We ask that you limit these calls to emergencies or serious illnesses. There may be a $25 charge for after hour calls. Please note, medications will not be refilled by the on-call doctor. For severe situations, go immediately to the nearest emergency room and have your physician contacted.
How are my medical records maintained and handled?
At Faculty Internal Medicine, reliable access to our patients’ medical records has been secured through a computerized patient record, improving office efficiency and patient safety. The relationship between the doctor and patient is confidential and any information exchanged will be held in the strictest of confidence. Confidential medical information will be released only with the express consent and authorization of the patient.
- Auth-Info-Release-FORMSutherland-mar2015 (Fill out form)
- Auth-Info-Release-FORMTurkeycreek-mar2015 (Fill out form)
How are medication refills handled?
To facilitate prescription refills, we usually provide a 30 or 90-day prescription with 1 year’s refills at the time of your visit. We request you bring in all prescription medications at each visit so we may update your medical record. Please let your provider know if you are willing to accept generic products or if you desire “name brand” only.
In the event you need a refill prior to your next appointment, please contact your pharmacy to take full advantage of the electronic connectivity between the pharmacy and our practice. You may choose to contact our office at 865-218-9220 and ask for the triage nurse. Please be prepared to give the following information:
- Physician’s Name
- Patient’s name
- Patient’s date of birth
- Patient’s contact number(s)
- Medication requested
- Dosing and how you take the medicine
- Pharmacy name and phone number.
Mail order prescriptions will be mailed directly to the patient’s home. Refills are processed within 48 hours of the initial request.
What is your procedure for payment of fees?
Faculty Internal Medicine participates with several health insurance plans for which the patient is required to make a co-payment and a claim is filed with the insurance company for the remaining balance. Co-payments, annual deductibles, and coinsurance amounts are the responsibility of the patient and are due at the time of service. These payments will be collected at the time of your appointment. Be sure to inquire about the participation status of your health insurance plan when scheduling appointments. The patient is responsible for informing FIM of changes in insurance and other information. Also, we file Medicare claims and accept allowable fees. For patients without insurance, full payment is due at the time of service. If paid at the time of service, the patient will receive a 30% discount. Payment may be made with cash, check, or credit card.
What if I have a medical form that needs to be completed?
Our practice receives many requests to complete various patient forms such as, FMLA, employment/pre-employment forms, application for insurance, nutritional programs, exercise programs, and disability forms. Completion of these forms requires medical expertise and review of your medical record. For this reason, a fee of $25 will be collected prior to releasing the form. Forms that are completed at no cost includes: diabetic shoe forms and handicap plates and sticker applications.
It is the patient’s responsibility to complete their portion of the form and submit it to the requesting party. Please allow up to 2 weeks for processing.