P 480-614-5808 | F 480-614-5809

Please download the following forms and bring them with you to your first appointment.

Click here to download the New Patient Forms

Office Policy for Patients

HIPAA Notice of Privacy Practices
Please see the front desk receptionist for a copy to review.

Office Hours and Appointments
Our offices and telephones are open Monday thru Thursday hours are 8am to 5pm, and Friday 8am to 12:00pm. Lunches are taken from 12:30pm to 1:30pm.

Scheduling an Appointment
When scheduling an appointment, please describe your needs to our staff so that an appropriate length of time can be reserved for you. We attempt to schedule appointments to accommodate our patient’s needs. We also make every effort to see patients at scheduled appointment times, as we realize that your time is valuable. However, sometimes we do fall behind schedule and rarely we may be called out of the office to attend to emergencies. Our staff will attempt to notify you by telephone so that you can choose to either keep your appointment time or reschedule it.

Canceling an Appointment
If you cannot keep your appointment, please notify us at least 24 hours in advance (For Mondayappointments, please call by 12 noon the previous Friday) that you will not be able to make your scheduled appointment, we “may” charge you $40. Additionally, if you will be unavoidably late for your appointment, please call and let us know. If you arrive later than 15 minutes, we will need to reschedule your appointment and a $25 fee “may” apply. There will be a $40 charge for “no-shows” or missing your appointment without canceling. If you are late for a medication appointment, and “if” we need to reschedule your appointment we “may” charge you a late-cancellation fee of $40.

HIPAA and Record Requests
Confidentiality – Your medical information is strictly confidential. We will not release it to anyone without your written consent. A family member may, however, accompany you to your appointments if you wish. If you want a copy of your records sent to another physician, we will require a written authorization from you. Additionally, if you are requesting your records, we will provide you, upon written request OR signed medical release form, a paper copy of your medical record. We will charge a base fee of $10 plus $.10 per page. This fee applies to copies of medical progress notes, laboratory requests, and other medical reports obtained at a time other than an office visit. There is no fee if you are requesting your records be sent to another specialist.

Prescription Refills
Please call the pharmacy that filled your prescription for any refills FIRST, even if there are none refills remaining. Do not wait until you are out of your medication. Please allow at least two working business days for the provider to approve refills. Please do not call the office for refills. If there are no refills remaining, the pharmacy will contact our office for authorization. If the doctor has concerns, he/she will deny the refill and ask you to call the office.

Due to Medical/Legal compliance reasons, the physician will need to examine the patient in the office before giving a diagnosis or offering treatment. We will not accept refill requests on Fridays after 12pm. It is the policy of Scottsdale Medical Center that we DO NOT prescribe antibiotics over the telephone. An office visit is required to determine medical necessity. Where applicable, 90-day prescription forms are patient’s responsibility to obtain and fill out, or have them faxed to us by your mail order pharmacy. No prescription refills will be made after office hours or on weekends. Narcotic and Controlled Substances: Patients requiring sustained ongoing narcotics and /or other controlled substances will be referred to specialists for their particular needs.
Fees and Payment

Fees and Payment
Our fees are based on the usual and customary professional fees for family practice in Arizona. For services not covered by insurance, we accept cash, personal checks, VISA and MasterCard. For other payment arrangements, please see our office manager prior to your appointment. Account balances not paid within 60 days will result in a $5 per month late fee. this fee can be avoided if you contact the billing department to establish a payment plan. Your co-pay is due at time of service. If you cannot afford your co-pay or do not bring it with you, your appointment may be rescheduled, and you may be subject to a $5 collection fee to bill your copay. If you pay by check, and your check is returned for any reason, you will be subject to a $35 returned check fee and future checks will “not” be accepted.

Emergency Care – Please limit after-hour calls to urgent and emergency needs only. Please be aware our office may be charged with a $30 after hours call charge. If you have an urgent medical situation, call our office at 480.614.5808 to reach our answering machine for more information.

Telephone Calls – When calling with a problem or question, describe the situation in detail to our staff. This will help the doctors determine the nature of the problem and respond quickly and accurately to your request. A staff member or doctor will return your call as soon as possible after the provider reviews your chart.

Unless the situation is very urgent or an emergency, calls will usually be returned before or after lunch or after the last patient appointment of the day. Please make sure you leave a number where you can be reached at these times.

Referrals
Many insurances now require referrals. Scottsdale Medical Center PLC realizes these can be cumbersome and sometimes complicated.  Our office requires 48 hours notice for a referral to be processed. If you fail to give us 48 hours notice, you will be asked to reschedule your appointment or test. Please remember requesting the referral is your responsibility, not the responsibility of our office staff or the other physician’s office staff. It is also not our responsibility to know which tests or specialists require the referral. If you do not know if you need a referral please contact the number on the back of your insurance card.

Prior Authorizations – Prior authorizations for non-emergent services such as MRI, or CT require 72 hours notice. Once you schedule a CT or MRI, you must let our office know so we can attempt prior authorization through your insurance company. If you do not give us proper notice or your insurance company denies the request and we must resubmit, you will need to reschedule the test.

E-mail Policy
E-mail is fast, convenient, and ideal to communicate with your doctor for NON-URGENT issues. If you use the secure encrypted e-mail system at Scottsdale Medical Center, your communication with Scottsdale Medical Center will be confidential. However, using e-mail does have some inherent risk of hacking, no matter how secure the system; the encryption in our system is placed there to help prevent this. If you choose not to use our system and use your own standard, non-encrypted (Hotmail, Yahoo, Gmail, msn, etc) e-mail address instead, please know that anyone who also has access to that account (such as a family member) may see your messages. Your employer may legally own all messages sent to or from a company e-mail account.

The following are examples of types of communication appropriate for e-mail
Appointment scheduling concerns or questions, non-urgent medical advice or follow-ups (including some types of test results), billing or insurance questions.

The following are NEVER appropriate for e-mail
Any urgent medical problem or emergency, mental health issues, drug and alcohol problems, HIV and other sexually transmitted disease information. As noted above, Scottsdale Medical Center, PLC, does not control the security of incoming messages from patients. Any e-mail with personal health information is sent at your own risk.

Please keep in mind, that while E-mail is an effective tool, it is not a substitute for a physical exam or in person counseling with your family doctor. Thank you for your cooperation in these matters. We strive to serve you better and the above policies will enhance our ability to do so.