A Detailed Overview of Payment & Referral Regulations

Julie L. Reihsen, M.D., P.A.
Board Certified Family Physician

PRACTICE INFORMATION
Thank you for choosing Dr. Reihsen for your family’s medical care. We are committed to providing you with quality personal health care. As a part of our professional relationship, it is important you have an understanding of our policies. Other than for true medical emergencies, agreement with this policy is required for all medical care.

PAYMENTS
Co-Payments Policy

  • All co-payments and current balances are due and payable PRIOR to services being rendered and are required by your insurance to be paid at each visit. Patients who do not have their co-payment may have to have their appointment rescheduled.
  • Deductibles and co-insurance are due and payable at checkout after services are provided on the day of service.
  • If you do not know your co-pay, we will collect a minimum fee of $30.00. Our billing department will bill or credit your account accordingly after your insurance pays its portion.

Cancellation/No Show Policy

  • While understanding there may be times when you miss an appointment due to emergencies or obligations, Dr.Reihsen requires at least 24 hours prior notice on all canceled appointments to avoid a fee of $20.00 to $75.00 (depending on the type of appointment requested).

Prescription Refill Policy (without a scheduled appointment)

  • New prescriptions will not be issued without seeing Dr.Reihsen.
  • Renewed prescriptions may require an office visit before further prescriptions are authorized.

Form Completion Policy (without a scheduled appointment)

  • All forms requiring physician signature and medical review – i.e., school, daycare, and camp physicals; prior authorizations; FMLA; disability or other paperwork – will be assessed a fee of $25.00 for completed forms. The patient is responsible for payment.

Return Check Policy

  • There is a $35.00 charge for return checks added to your original balance. In addition, we may seek all additional legal remedies provided to us under Texas law.

Patient Balance Policy

  • Julie L. Reihsen, M.D., P.A., after filing with insurance companies, will mail you a Patient Balance Statement. Payment in full is due upon receipt of this statement. If you have any questions or dispute the balance, it is your responsibility to contact the billing office within 30 days. Past due accounts will be subject to a 5% monthly late fee (minimum of $5.00 per month) and may be referred to a collection agency.
  • If you are not able to pay your balance in full, you must contact our billing office to discuss a payment schedule. Any late fees already incurred on past due balances will be included in any mutually agreed upon arrangements.

PRESCRIPTION REFILL POLICY
Prescription Refill Policy

  • Refills are prescribed at office visits. Our provider will prescribe a quantity adequate to provide for your next appointment. If you do not schedule or keep your recommended appointment, your refill will be denied, and you will be required to see our provider to receive your medication.
  • Please contact your pharmacy, as they will communicate directly with our office concerning refill requests.

REFERRAL POLICY
Referral Policy

  • Referrals are necessary before your specialty recommended appointment. The process allows us to get the necessary information to your Specialist prior to your appointment.
  • Our Providers may make suggestions for Specialists they are familiar with. Please note it is your responsibility to make sure the Specialist is part of your individual network and accepts patients.
  • Please contact our office with your Specialist name and number.
  • We will then complete the necessary paperwork and fax the information to your office.
  • If you have not been contacted by the Specialists office in 7 days, please contact our office.