Office Policies

Emergencies:

Coverage for emergency situations is available after normal office hours. When facing a life threatening situation, please dial 911. Otherwise, call our main office number, 303-346-8828, to reach the answering service. Answering service personnel will direct your call to the on-call provider who will then return your call in a timely manner. Please do not use this service for prescription refills or referrals as those requests need to be handled during normal office hours.

Prescription Refills:

Prescription refills require 48 hours to process. If you need medications for the weekend, please call your pharmacy by Thursday morning. This will afford the pharmacist sufficient time to contact our office to verify the prescription and to fill your request. Our provider, who is on-call during the week-end, will not be able to refill your prescriptions. Whenever possible, please call a few days before you run out of medicine so that adequate time is available to fill your prescriptions.

Prescriptions That Require Prior Authorization:

Prescriptions requiring preauthorization need 4-5 days to process. Prior authorization is a process by which your insurance company determines whether a specific medication prescribed by your doctor is allowable under your plan.

When your pharmacy is notified that a prescription requires pre-authorization, your doctor may need to contact your insurance company to discuss your prescription history (failure of previous medications), medical diagnosis, and medical necessity).

If authorization is granted, prescription costs will be covered according to your insurance plan. When authorization is not granted, you have two choices:

a. You may still have the prescription filled by paying the entire retail cost of the drug yourself, or;

b. You may ask your doctor to prescribe an alternate drug covered by your insurer, if one is available.

Prior Authorization differs by plan. Please refer to your benefit plan to see whether Prior Authorization applies to you.

Referrals:

Referrals to another office or specialist require 4-5 days to process and cannot be handled after hours or on the weekend. To ensure adequate processing time, please notify us at least 5 days prior to your appointment. Failure to obtain the required referral could cause denial of benefits by your insurer, making you responsible for any fees associated with your visit.

Insurance:

We require a copy of the front and back of your insurance card to process your claim. If your insurance changes at any time, it is your responsibility to provide our office with the new insurance information.Without your insurance information, we will not be able to file a claim on your behalf and you will be responsible for any chargesyour insurer requires that a PCP (primary care physician) be listed on the claim form, it is important for you to contact the insurance carrier to verify that a doctor from our office is an approved provider under your plan.

Not all insurance plans cover all services. In the event that your insurance plan determines a service to be “not a covered benefit” or “not medically necessary”, you will be responsible for the complete charge. Payment is due upon receipt of a bill from our office.

Keep in mind that we do not know which benefits are covered by your policy. It is important for you to take the initiative to learn about your personal insurance coverage so that you are not surprised in the event that payment of services is declined by your insurer. Occasionally, we have been asked to change diagnostic or procedure codes to permit insurance payment of a claim or to reflect topics not discussed during an office visit. Legally, these actions would constitute fraud and we will not do this.