New Patients of Robeson Family Practice:

If you are a new patient of Robeson Family Practice and have not yet had your previous medical records forwarded to our offices, please complete the form entitled “HIPAA Consent” and send this form to your previous health care provider. They will in turn, forward your medical records to our practice, providing our health care team with all your relevant medical history to ensure we deliver you the best health care to meet your needs. This form, along with other forms can be found in the forms tab.

Current Patients of Robeson Family Practice:

As a patient of Robeson Family Practice, you have the right to review the information in your medical record and may obtain a copy, at any time, for a reasonable fee. Requests for release of patient information must be made in writing with our practice by filling out a “HIPAA Consent” form. Many of our patients allow family members such as their spouse, parents or others to call and request medical (test results, discussion about medical conditions, medications, and treatment) or billing information. Under the requirements of HIPAA we are not allowed to give this information to anyone without the patient’s written consent. If you wish to have your medical or billing information released to family members you must also complete the “Authorization to Release Information to Family Members” form. This form should be completed and mailed, faxed or brought back in person to our Medical Records Department. For an appointment to review your medical record or for more specific details about obtaining a printed copy, please contact our Medical Records Specialist at (910 )843-3311.

Appointments:

When scheduling an appointment with our office please explain the reason for your visit when requesting your appointment. This will allow us to schedule the appropriate time needed to address your healthcare needs. If this is your first visit with us, please arrive 15 minutes prior to your scheduled appointment time so that you may obtain and complete the required registration forms. All patients must complete all the required forms before seeing the medical provider. If you are a new patient or have not been seen in our practice in over a year, you will be required to complete the following forms:

• Authorization to Release Information to Family Members
• HIPAA Consent
• New Patient Initial Assessment
• Patient Demographics
• Patient Financial Policy
• Patient Portal User Agreement and Consent
• Privacy Practice Policy
• Receipt of Privacy Practices and Consent

For your convenience, all the required forms can be found on the “Forms” tab. You can simply print them out, complete them and bring them in with you at the time of your scheduled visit. Please bring your photo I.D., insurance cards and be prepared to present them to our staff for verification and billing purposes. In addition, please be sure to bring your current medications with you to each of your visits. Walk-in visits for acute illnesses or injuries are accepted. Your wait time may be determined upon your arrival. Patients with scheduled appointments will always be seen first except in the case of emergencies, leaving walk-ins to be considered and seen on a first come, first serve basis. If you find that you are unable to keep your appointment, we do request that you notify our office as soon as possible, but no later than 24 hours prior to your appointment. Maintaining good health requires timely medical care and follow-up on your behalf. We welcome new patients and make every effort to accommodate requests for same day appointments, when available. Please feel free to contact us directly with any questions or concerns. You can call us during regular business hours so that our staff can promptly assist you with your questions, concerns or in making your appointment. You may also message us privately by using our secure Patient Portal at https://health.healow.com/rfpa. 

Upon arrival of your office visit:

• Please inform our front desk staff of any changes in address, telephone number, insurance coverage and/or employment.
• Please inform our staff of any changes in your medication or medical history.

For your convenience, we also have office hours available on Saturday’s from 8:00 a.m. – 1:00 p.m. for same day appointments and walk-ins. If you are experiencing problems with a chronic illness you will need to schedule an appointment during our regular business hours Monday through Friday.

Insurance & Billing:

We accept most insurance plans including Medicare, Medicaid, Blue Cross Blue Shield, Tricare, etc. In order to properly bill your insurance, we require that you disclose all insurance information, including primary, secondary and/or supplemental, as well as any changes in your coverage. Failure to provide complete insurance information could result in patient responsibility for your medical bill in its entirety. As a courtesy, we verify all insurance eligibility before your scheduled visit. This is NOT a guarantee of payment. Your claim will be processed according to your plan. Insurance is a contract between you and the insurance company and they will make the final payment determination of your claim. If your insurance is not contracted with us and/or we are considered an out of network provider, then you will be responsible for paying the portion not covered by your insurance, including but not limited to those charges above the usual and customary allowance. If your insurance company pays you directly, you will be responsible for payment of your visit and agree to forward the payment to us immediately. Please contact your insurance company with any questions regarding your coverage. As mentioned above, you have a contract with your insurance company. If you fail to pay your insurance premium and services are denied, you will be fully responsible for charges incurred. All co-payments and deductibles are due and collected at the beginning of each visit. Copays and deductibles amounts are determined by your insurance company and not by our practice. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Robeson Family Practice also offers convenient payment plans. All payment plans require management’s prior approval and discretion. Please feel free to contact our Billing Specialist at (910)843-3311 to see what convenient options may be available to you or for any other questions or concerns you may have.

Primary Care Provider:

If your insurance company has assigned you (or you have chosen) another doctor or facility as your primary care provider other than Robeson Family Practice, then your claim may be denied.   In some cases, you can contact the insurance company, change the provider and we can refile the claim at your request. It is your responsibility to contact your insurance company to request this change. If the claim is still not paid, then you will be responsible for the full amount owed.

Minors:

The parent(s) or guardian(s) is responsible for full payment of minors or dependents.

Self-pay Accounts:

Self-pay accounts are patients without any insurance coverage, patients covered by insurance plans in which the office does not participate, or patients that have never provided proof of insurance. Liability cases will also be considered self-pay accounts. If there is a discrepancy, a patient will be considered self-pay until proven otherwise. Self-pay patients will be required to pay the full cost of their first visit (including labs, diagnostic studies, etc.) upfront. After the initial visit, payment plans can be arranged at our discretion.   It is never our intention to cause hardship to our patients, only to provide the best care possible and the least amount of stress. However, payment must be made for services rendered. If you have any questions, please see a billing coordinator to discuss a mutually agreeable payment plan.

After-hours, Emergent, Urgent, Weekend Office Visits:

There is an additional charge for office visits on weekends, holidays, and after hours. This charge is sometimes not covered by insurance companies and depending on insurance rules may be the patient’s responsibility.

Returned Checks:

The fee for returned checks is $25.00 payable by cash or money order. This will be applied to your account in addition to the insufficient fund amount. You may be placed on a cash basis only following any returned check.

Non-covered Services:

Please be aware that some of the services you receive (such as labs, diagnostic studies, etc.) may not be covered or considered medically necessary by Medicare, Medicaid or other insurers. You will be responsible for these services if not covered by your insurance. This also applies for services you may be treated for that are outside the specified services covered by your insurance policy. For example, if a patient has Medicaid but it is classified as “Family Planning” and he/she comes in to be treated for a cold. These are services that are not covered under that Medicaid designation and the patient would be responsible for that visit.

Medical Test and Laboratory Results:

Please allow 10-15 working days for the completion of any labs or testing. For labs and any other test results, the Doctor, Nurse Practitioner or Medical Assistant will contact you directly via phone or mail with your results as soon as they are available or you will be scheduled for a follow up appointment to go over your results in person. Please understand that some test results will not be discussed by phone.

Prescription Refills:

Prescription refills will only be authorized during normal office hours. All refill requests require a 48 hour notice. When you call please have the following information readily available: patient’s name, patient’s date of birth, name of medication, name of preferred pharmacy and their telephone number. Please evaluate your medication supply prior to your scheduled office visit and ensure that you request your medication refills at the time of your visit. Our preference is to fill routine medications during your regular office visit and not over the phone. If you have not seen your healthcare provider within a 3-6 month period of time, you will need to make an appointment before any refills can be authorized and released. If you need more than three refills you will need to make an appointment to be seen. If you require a refill on any narcotics you will be required to make an appointment and be seen by our provider before a refill can be dispensed. We cannot refill any narcotics without seeing you in the office first. We do not prescribe or refill tranquilizers, sleeping aids, narcotic pain medications or any other controlled substances over the phone. If you utilize a mail in pharmacy we will write the prescription, but it becomes your responsibility to mail it in. If you should become ill or begin experiencing symptoms of illness an appointment for an evaluation is required before any medication can be prescribed. This is necessary to insure you receive the appropriate treatment course for your current illness.

Medical Records:

Your medical records are strictly confidential. The Health Information Portability and Accountability Act (HIPAA) restricts our practice from releasing any information without your written permission and signed consent. There may be times when you may request that we provide copies of your medical records to other entities, in this event you will incur an expense in order for our practice to provide you with this service and that cost will be passed on to you. In order to request your medical records, you must complete and return a “HIPPA Consent” form to our office. All medical records request are subject to a 72 hour processing. If the costs for the records are not reimbursed by the receiving entity that you have authorized to obtain these records, you will be responsible for payment before the records can be released. Charges for medical records to patients, attorneys, etc. are as follows:

Form Fees:

There will be a $25 fee for each form brought/mailed in for the medical provider to fill out. This includes disability forms, FMLA forms, etc. If multiple/separate forms are required, we reserve the right to charge $5 per page after the initial fee of $25. Meaning that we can charge $25 dollars for the first form, and if you have a second form that is only a 1 page with minimal information and time needed, we may only charge $5 for that form instead of the entire $25 fee for the second form. The maximum we will charge per form is $25.