1317 W Diversey Parkway Chicago, IL 60614
Fax: 773-665-0403
Tel: 773-665-9355
Chicago Family Practice Since 1994
Patient Responsibilites & Policies
Appointment Hours
Appointment times are on Mondays and Thursdays between 10:00am and 6:30pm, Tuesdays and Wednesdays between 9:00am and 4:30pm, and on Fridays between 9:00 am and 11:30am. To schedule an appointment please call our office at 773-665-9355 on Mondays and Thursdays between 8:30am and 6:45pm, Tuesdays and Wednesdays between 8:30am and 4:45pm, Fridays between 8:30 am and 11:30am and 1st and 3rd Saturdays between 8:30am and 11:30am
Late Appointment Arrival
We strive to see all patients on time for their scheduled appointment. If you are a returning patient please plan to arrive at least 10 minutes prior to your scheduled appointment to check in. New patients please arrive 30 minutes prior to your appointment to complete the new patient paperwork. If you arrive 5 or more minutes late for your appointment time, you may be asked to reschedule for the next available appointment time.
Missed Appointment
A missed appointment is when you fail to show up for an appointment without a phone call, fail to cancel within one business day or arrive 15 minutes past your scheduled appointment time.
If you miss your appointments, you compromise the care that we are able to provide you and other patients that may have needed an appointment.
Effective May 1st 2012 all 1st time Missed Appointments will be charged a $25 fee, and $50.00 thereafter, billed to your account that is non-covered by Insurance.
Prescription Refill Guidelines
We have developed a policy for handling prescription refills in the hope that our time may be spent caring for our patients and delivering the best care possible. One way we try to keep our medical assistants available to take patient phone calls with urgent problems and questions is by limiting pharmacy and medication refill calls. Please notify your pharmacy if you are requesting refills and have them send electronically or fax your refill request to our office at 773-665-0403. Prescription refills are only done during our regular business hours and will be responded to within 72 hours. When a refill by phone is necessary, please be prepared to provide the name of the medication, strength, dosage, and the pharmacy number.
Phone Messages
In order to provide the best care possible to our patients and allow our scheduled patients to be seen by our medical providers without multiple interruptions our medical staff are available to take messages for our medical providers during office hours. When leaving a message please indicate your name, the patient’s name, the reason for your call, and phone number where you can be reached. The medical staff will alert the medical provider of a message and will call the patient back with the providers response in a timely manner. Please be aware that certain messages may require a visit with a medical provider.
After Hours
If you have an urgent issue after regular business hours, please call the main office number. The operator will take your name, phone number, reason for call, and help you reach our on-call medical provider. The on-call medical provider returns patients phone calls as soon as possible and assists them with urgent medical issues that cannot wait until regular business hours. In case of emergency, please call 911.
Laboratory Testing
Please call in advance to schedule an appointment for any lab tests ordered by a medical provider. In order to ensure accurate laboratory testing is done, a patient must have an order for lab tests from one of our medical providers in their chart, a written order from another medical provider’s office, or obtain approval for requested lab work from a medical provider in the office prior to scheduling an appointment. We use ACL for our lab services; however a patient that does not wish to use ACL must request an alternate lab service prior to any lab work. The lab service may bill your insurance separately for any test we do not bill for in our office. The turnaround time on lab results can vary, however routine labs usually take 2-3 business days, while cultures and biopsies generally take 1-2 weeks to receive the results. After lab results have been received and reviewed by the medical provider one of our medical staff will call the patient to inform them of their results. In order for some tests to be performed, a return visit with a medical provider may be required.
Patient Forms
We understand that there are forms that may need to be completed by one of our staff and/our medical providers. These forms include, but are not limited to disability forms, Family Medical Leave forms, Attending Physician Forms, school forms, itemization of charges, etc. In order for our office to properly complete any forms on our patients’ behalf we require the patient to complete all patient portions of any form and provide any information needed to assist the provider in completing the form prior to submitting the form to our office. Please allow 6 business days for our office to complete any forms.
Medical Records
In order to best serve our patients we recommend our patients request copies of their lab or test results when they are given the results by one of our staff members, or providers. A copy of a single test or a lab is no charge to our patients. Please be aware that in order to receive a copy of multiple pages of your medical records a completed release form must be submitted to our office. Records provided to other physicians are copied free of charge. Records provided to patients cost $10.00 for past two years and $25.00 for complete records.
Financial Responsibility
As a patient it is in your best interest to know and understand your insurance plan benefits and responsibility for any deductibles, co-insurance, or co-payment amounts prior to any visit. Please have your current insurance card with you at all times, as well as a photo ID. You are responsible to notify us of your insurance plan and to provide us the necessary information about your insurance policy. It is your responsibility to know your insurance company’s patient responsibilities and procedures. Not all services are covered in all insurance contracts. If your insurance plan does not cover a service, or procedure, you are responsible for payment of these charges. To find out what your insurance plan covers and what your financial obligation may be, call the customer service or member services department of your insurance company (the phone numbers are on your insurance card). If you do not have any insurance coverage for the visit please notify us when you schedule the appointment and a time of service payment will be due at the time of visit. Resolution of any outstanding balance is expected prior to obtaining additional services from Lincoln Park Family Practice. Please refer to the Lincoln Park Financial Policy which is on our website, or at the front desk of the office for more information.
Preauthorization and Referral Guidelines
Some insurance plans may require preauthorization, or referrals for services and tests. It is your responsibility to know your insurance company’s patient responsibilities and procedures. If proper insurance procedures are not followed, you may be liable for full payment of the bill. If your insurance company requires a referral and/or prior authorization you must contact our office at least 6 business days prior to seeing a specialist, or having any testing done. Please refer to the Lincoln Park Financial Policy for more information.
HIPAA Notice of Privacy Practices
Protecting the privacy of your health information of our patients is important. Within the Lincoln Park Family Physicians Notice of Privacy Practices binder we are pleased to tell you about a federal law that is designed to help protect the privacy of health information and explains our use of your medical or health information. The law is known as the HIPAA Privacy Rule. The Privacy Rule requires us to give you access and copies of our Notice of Privacy Practices. Prior to signing acknowledgment of the privacy rule you have a right to access, review, and request copies of Lincoln Park Family Physicians Notice of Privacy Practices.
Use and Disclosure Of Protected Health Information
In accordance with the Lincoln Park Family Physicians Notice of Privacy Practices, Lincoln Park Family Physicians S.C. may use and disclose protected health information about patients to carry out treatment, payment, and healthcare operations. Lincoln Park Family Physicians S.C. may call a patient’s home or other designated location and leave a message on voicemail or in person in reference to any items that assist the practice in carrying out healthcare operations, such as appointment reminders, insurance items, collection calls, and any call pertaining to my clinical care, including laboratory results among others. Lincoln Park Family Physicians S.C. may mail to a patient’s home or other designated location any items that assist the practice in carrying out healthcare operations, such as appointment reminder cards and patient statements as long as they are marked confidential. A patient may revoke their consent to disclose protected health information in writing except to the extent that the practice has already made disclosures in reliance with their prior consent and upon a patient revoking consent Lincoln Park Family Physicians S.C. may decline to provide treatment to the patient.