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Office Policies

Provider Schedules

Because of the nature of our services, we may need to leave the office for deliveries or emergency surgeries. We greatly appreciate your understanding if we need to reschedule your appointment or have another provider see you.

Appointments

Please note that if you are more than 15 minutes late for an appointment, you may be asked to reschedule. If you are unable to keep an appointment, advanced 24 hour notification is required. Two missed appointments could cause termination of your medical care at our office, so please call to cancel appointments prior to the visit to avoid this. We certainly appreciate you as a patient and respect your time, and these policies are to reflect that.

Financial Policy

Thank you for choosing our practice as your healthcare provider. Your understanding of our financial policy is important to our professional relationship. Payment of your bill is considered part of your treatment. In an effort to provide you with the best possible care and minimize healthcare costs, we have adopted the following policies.

At each Visit our staff will request you to:
• Verify Your Personal Contact Information
• Present Current Copy of Your Insurance Card
• Provide Payment for Your Present Visit

Fees and Payments

Co-payments and outstanding balances are due at time of service. Please have your current insurance information with you at the time of your appointment.

If you have a question about your insurance, we will be happy to assist you. Specific coverage issues however, should be directed to your insurance company’s member service department as indicated on your insurance card. Not all services are a covered benefit in all policies. It is very important that you understand and confirm the provisions of your individual policy.

Patents without insurance may be afforded an adjusted fee if payment is made on the day of your appointment. You will be given these policies should your care warrant.

Medicaid Policies

Please note that we do not accept Medicaid, Molina or Caresource insurance. If your insurance changes to one of these plans, please let the office know, and we will be happy to offer suggestions for practices that do accept these insurance plans and facilitate the transfer of your care.

Paperwork for Maternity/Medical Leave

We are happy to fill out FMLA and disability paperwork for maternity leave, surgical leave, or other medical leave. We ask that you leave the paperwork at the front desk. Please allow us one week to complete the paperwork. There is a $15 fee for completing the paperwork. Thank you.

Annual Exams

Most insurance companies pay for one annual in a 12-month period. Check with your insurance company prior to your appointment to see if your insurance company requires a co-payment on yearly well woman visits. Patients that are seen for an annual exam and require additional treatments for illnesses or problems will be charged separately for each service rendered that day.

Surgeries

When your surgery is scheduled we will check with your insurance company for coverage on the procedure you are having done. We will estimate how much your surgery will cost and what your responsibility will be. Checking your benefits does not guarantee payment. The patient is ultimately responsible for payment. If your insurance company does not pay within a reasonable time, you will be billed for services. (Please note that hospital charges and services provided by other hospital related providers will be billed separately from our services, contact you insurance provider to determine specific coverage and benefits).

Maternity

After your first OB visit, we will contact your insurance company and verify your benefits. Routine office visits are included with the delivery. Ultrasounds, Non stress tests, Lab, Facility Fees, and non pregnancy related office visits are billed separately and will require separate co payments, deductibles and/or co insurance amounts. We will estimate how much you will owe for the delivery only. This amount is expected to be paid by week 40 of your pregnancy. You may pay it all at once, or make payments per a payment agreement and schedule we will provide you. Any amounts for non included services will be billed to you separately. We will reimburse you for any overpayment that we may have received within 30 days of receipt of payment from your insurance company.

Download the information above here. This document is also available on the Patient Center page.

Download Our Notice of Privacy Practices here. Northside Women’s Health understands that your information is highly personal and we are committed to safeguarding your protected health information. This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please read this Notice of Privacy Practices thoroughly. This document is also available on the Patient Center page.