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THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
In the course of your care as a patient, we may use or disclose personal and health related information about you in the following ways:
· Your personal health information, including your clinical records, may be disclosed to another healthcare provider or hospital if it is necessary to refer you for further diagnosis, assessment or treatment.
· Your healthcare records as well as your billing records may be disclosed to another party, such as an insurance carrier, an HMO, a PPO, or your employer, if they are or may be responsible for the payment of your services.
· Your name, address, phone number, and healthcare records may be used to contact you regarding appointment reminders, information about alternative to your present care, or other health related information that may be of interest to you. If you are not at home to receive an appointment reminder, a message may be left on your answering machine. Furthermore, you have the right to inspect or obtain a copy of the information we will use for these purposes. You also have the right to refuse to provide authorization for this office to contact you regarding these matters. If you do not provide us with this authorization it will not affect the care provided to you or the reimbursement avenues associated with your care. Under federal law, we are also permitted or required to use or disclose your health information without your consent or authorization in the following circumstances:
· If we are providing healthcare to you based on the orders of another healthcare provider. · If we provide healthcare services to you in an emergency.
· If we are required by law to provide care to you and we are unable to obtain our consent after attempting to do so.
· If there are substantial barriers to communicating with you, but in our professional judgment we believe that you intend for us to provide care.
· If we are ordered by the courts or another appropriate agency.
Any use or discloser of your protected health information, other than as outlined above, will only be made upon your written authorization. We normally provide information about your health to you in person at the time you receive chiropractic care from us. We may also mail information to you regarding your healthcare or about the status of your account. If you would like to receive this information at an address other than your home or if you would like the information in a different form, please advise us in writing as to your preferences. You have the right to inspect and/or copy your health information for seven years from the date that the record was created or as long as the information remains in our files. In addition you have the right to request an amendment to your health information. Requests to inspect, copy or amend our health related information should be provided to us in writing. We are required by state and federal law to maintain the privacy of your patient file and the protected health information therein. We are also required to provide you with this notice of our privacy practices with respect to your health information. We are further required by law to abide by the terms of this notice while it is in effect. We reserve the right to alter or amend the terms of this privacy notice. If changes are made to our privacy notice we will notify you in writing as soon as possible following the Information that we use or disclose based on this privacy notice may be subject to re-discloser by the person to whom we provide the information and may no longer be protected by the federal privacy rules. If you have a complaint regarding our privacy notice, our privacy practices or any aspect of our privacy activities you should direct your complaint to: Dr. Randy Woodward. If you would like further information about our privacy policies and practices please contact: Janel Jones, FNP. This notice is effective as of January 1, 2017. This notice, and any alterations or amendments made hereto will expire seven (7) years after the date upon which the record was created.
My signature acknowledges that I have received a copy of this notice._____________________________________ Name (Print) ________________________________________________ (Signature Date)____________________
Guardian Healthcare Centers is growing! This has been made possible due to your continued business and loyalty. We deeply appreciate the privilege to care for you and know that trust is not easily won.
With growth comes the arrival of change. Here at Guardian Healthcare Centers we want to continue to offer excellent services. To do this we will be changing our hours of operation. Beginning January 1, 2017 we will be open Monday – Wednesday from 8 am to 5pm. Thursday we will be open from noon-5:00pm and on Friday we will be open from 8:00am-noon. This will allow us to complete all administrative work and speed referrals on Fridays.
To further speed administrative work and allow Janel greater time with patients we will begin requiring the payment or co-payment to be paid at the time of service. Any payment due after insurance is billed is due promptly after you receive the first invoice. Please realize that there will be no exceptions. This may seem stringent but it is helping to reduce postage and keep you out of collections.
Our prices will be altering marginally but will stay within a local affordable budget and maintain their competitiveness with nearby clinics.
Here is a list of prices:
Self-pay quick care/sick-established patients $75.00
Self-pay quick care/sick-new patient $95.00
New patient (with and without insurance) $145.00
With the influx of business we now expect 24 hours prior notice for any appointment cancellation. This allows us to see as many people a day as possible and allows us to have space in our appointment book for sick people who need same day care. Please remember to call and cancel. Any cancellation without 24 hours notice will be billed to the patient.
Your time and Janel’s time is valuable. When Janel is not seeing patients she is still busy with administrative tasks that provide the continuity of care patients deserve. If you have a simple request please leave your messages with the receptionists and we will be sure to pass them along to Janel. If you have medical questions, health issues, or are inquiring about test results please schedule an appointment to discuss them with Janel. You can schedule an appointment in person, via phone consult or an e-visit (depending on insurance). All scheduled appointments will be billed accordingly. Scheduling an appointment allows you optimal one on one time with Janel.
Please remember that if you are going to need medication for the weekend to request it by noon on Thursday. We cannot guarantee requests received after that will be filled until the following Monday. Medication refill requests need to be called in during business hours (Monday-Thursday 8am-5pm).
We have provided an after hours phone line to provide emergency help for patients in dire need. This phone line is not to be used for medication refills or NON-emergency problems. Medication refills are not an emergency problem. Family time is crucial to Janel’s wellbeing. Please be mindful of this. If a call is made for a non-emergency problem you will be personally charged for a phone visit. The price is $75.00. This cannot be billed to your insurance.
Finally, we are no longer a walk-in-clinic. We want to be able to provide the best possible service for all of our patients. Having walk-ins deducts scheduled patients valuable appointment time. If you need to be seen please call (406) 361-1882 to schedule an appointment. We will do our best to schedule you as quickly as possible. Our goal is to offer exemplary services in a place where you can heal the whole self.
Thank you for all of your support.
Guardian Healthcare Centers