Common use of Managed Care Clause in Contracts

Managed Care. If you are enrolled in a managed care insurance plan (i.e. HMO), you must have a current referral from your primary care physician’s office to see a specialist (Pediatric Consultants patients). We will be unable to see you if you do not have a referral at the time service is rendered. It is your responsibility to ensure that all of your referrals are up to date. Please see our website (xxx.xxxxx.xxx) for fees associated with forms. Missed appointments represent a cost to us, to you, and to other patients who could have been seen in the time set aside for you. Cancellations are requested 24 hours prior to the appointment. We reserve the right to charge for missed appointments or appointments not cancelled within 24 hours. Effective February 27, 2017, the charge for missed appointments is $25 for a single missed appointment Monday through Friday 8:30 a.m. to 5 p.m. and $50 for a single missed appointment during our extended hours 7 a.m. to 8:30 a.m. Monday through Friday, and for all Saturday appointments. The missed appointment fee will be $100 for double appointments and $150 for triple appointments that are not cancelled within 24 hours. Excessive abuse of scheduled appointments may result in discharge from the practice. If the practice orders any medical supplies or products related to the scheduled appointment with a provider in our office, the patient and/or the guarantor will be responsible for the cost of the supplies/products in addition to the fee imposed for missed appointments/late cancellations. Under HIPAA, the Pay out of Pocket Provision states:

Managed Care. If you are enrolled in a managed care insurance plan (i.e. HMO), you must have a current referral from your primary care physician’s office to see a specialist (Pediatric Consultants patients). We will be unable to see you if you do not have a referral at the time service is rendered. It is your responsibility to ensure that all of your referrals are up to date. FORM FEE CHARGES: Please see our website (xxx.xxxxx.xxx) for fees associated with forms. Missed appointments represent a cost to us, to you, and to other patients who could have been seen in the time set aside for you. Cancellations are requested 24 hours prior to the appointment. We reserve the right to charge for missed appointments or appointments not cancelled within 24 hours. Effective February 27, 2017, the charge for missed appointments is $25 for a single missed appointment Monday through Friday 8:30 a.m. to 5 p.m. and $50 for a single missed appointment during our extended hours 7 a.m. to 8:30 a.m. Monday through Friday, and for all Saturday appointments. The missed appointment fee will be $100 for double appointments and $150 for triple appointments that are not cancelled within 24 hours. Excessive abuse of scheduled appointments may result in discharge from the practice. If the practice orders any medical supplies or products related to the scheduled appointment with a provider in our office, the patient and/or the guarantor will be responsible for the cost of the supplies/products in addition to the fee imposed for missed appointments/late cancellations. Under HIPAA, the Pay out of Pocket Provision states:

Managed Care. If you are enrolled in a managed care insurance plan (i.e. HMO), you must have a current referral from your primary care physician’s office to see a specialist (Pediatric Consultants patients). We will be unable to see you if you do not have a referral at the time service is rendered. It is your responsibility to ensure that all of your referrals are up to date. date Please see our website (xxx.xxxxx.xxx) for fees associated with forms. forms Missed appointments represent a cost to us, to you, you and to other patients who could have been seen in the time set aside for you. Cancellations are requested 24 hours prior to the appointment. We reserve the right to charge for missed appointments or appointments not cancelled within 24 hours. Effective February 27, 2017, the charge for missed appointments is $25 for a single missed appointment Monday through Friday 8:30 a.m. to 5 p.m. and $50 for a single missed appointment during our extended hours 7 a.m. to 8:30 a.m. Monday through Friday, and for all Saturday appointments. The missed appointment fee will be $100 for double appointments and $150 for triple appointments that are not cancelled within 24 hours. Excessive abuse of scheduled appointments may result in discharge from the practice. If the practice orders any medical supplies or products related to the scheduled appointment with a provider in our office, the patient and/or the guarantor will be responsible for the cost of the supplies/products in addition to the fee imposed for missed appointments/late cancellations. Under HIPAA, the Pay out of Pocket Provision states: