Neurological Associates of West Michigan, P.C.- Patient Information

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Patient Information

Our front office staff

Introduction
Appointments and Cancellations
Medical Information and Confidentiality
Notice of Privacy Practices
Points of Information

Patient Forms
Prescriptions and Refills
Hospital Affiliations
Billing and Insurance

Introduction

There are three physicians practicing in our Grand Rapids office.

Our physicians are board certified and continue to update their knowledge each year by taking additional courses and attending professional meetings.

Instead of, or in addition to a neurological evaluation, you may have been referred for a diagnostic test which is done in this office. These include electromyogram (EMG electrical activity of muscles) or nerve conduction studies (electrical activity of nerves). The performance and interpretation of these tests requires a trained neurologist.

After completion of the evaluation and/or testing, a detailed report will be mailed to your doctor. If, in our opinion, your neurological condition requires our continued service and care, we will be pleased to serve you with the permission of the referring physician and in association with his/her continued care.

Problems concerning your general medical health, other than those related to your neurological complaints, should remain under the care of your personal physician.

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Appointments and Cancellations

Of necessity, the doctor must work by an appointment basis. This gives him an opportunity to allocate his time and proves to be more convenient for the patient. Emergencies do occur, and delays in schedules are inevitable. A sincere attempt is made to adhere to the schedule as much as possible.

We see patients only by request from another physician. Because your neurological evaluation may take over an hour, it is essential that your appointment be made in advance. If you cannot keep an appointment, reasonable notice should be given to this office to cancel the appointment. This courtesy makes it possible to give the appointment to another patient. There will be a $10.00 charge for broken or canceled appointments, unless 24 (working) hours notice is given.

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Medical Information and Confidentiality

Medical records initiated in this office belong to this office. Information will not be provided to a third party, (non-referring physician, attorney, insurance company, or government agency) unless we have written authorization from you. Information to any physician will be issued without charge. If you wish information about your condition to be provided to a third party, they must request the information in writing and provide us with your signed written authorization. A charge is necessary, since this service requires a review of your records by a doctor, preparing a narrative summary if requested, photo-copying and secretarial help. If the third party refuses to pay for this service, the charge will be your responsibility.

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Points of Information

Office hours. Regular office hours are 8:15 a.m. to 4:45 p.m., Monday through Friday.

What to bring. If your appointment is for a neurological evaluation, it would be helpful to the physician to have any pertinent neurological information available for review at the time of the examination, such as:

X-ray films
List of medications and dosages currently in use
Brief summary of your medical history

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Patient Forms

You can view and/or print the necessary patient forms for your appointment by using the links below.
[ You will need the free Adobe Reader to view these forms. It is available here. ]

Please note that not all forms are used by all physicians.

Patient Information - used by all doctors
Adult Systems Review - used by all doctors
General Patient Information - used by Doctors Neuman and Varda
Authorization for Release of Medical Information - used by all doctors

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Prescriptions and Refills

Prescription refills are taken during the hours of 9:00 a.m. and 4:00 p.m., allowing your physician to review your chart.

Please have the name of your pharmacy, telephone number, name of medication, dosage and frequency taken available when you call for a refill.

Controlled substances and pain medication will not be prescribed after office hours.

Often your physician will not be available over the weekend to make the judgment regarding refills.

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Hospital Affiliations

Our physicians have admitting privileges at the following hospitals:

Spectrum Hospital (Blodgett campus)
- Dr. Wiley, Dr. Neuman, Dr. Varda
Hauenstein Parkinson's Center
- Dr. Neuman

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Billing and Insurance

Fee and payment policies. In general, fees charged by this office are comparable to those charged by other neurologists in this area. Electromyography (EMG) requires additional charges depending on their cost to the doctor and the skill required.

Co-pays are required at the time of service.
Payment in full is expected if your services are considered out of network or self-pay, unless prior arrangements have been made with the billing office.
We accept your payment in the following ways: Cash, Check, MasterCard, Visa, Discover, Debit Card
We attempt to reach all patients by phone for appointment reminder, two days prior to the scheduled visit.
We charge $10 for appointment no shows or appointments not cancelled within 24 hours, unless emergency.
Please present your insurance cards at every visit.

Insurance coverage. As healthcare providers, we realize how important it is for you to utilize your health benefits with the least amount of our of pocket cost. For your convenience, below is a list of insurance companies and/or networks that we currently participate with. (List current as of 7/2007.)

click here

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Detailed information about insurance. For detailed information about insurance participation, feel free to review the information and links below or contact the billing department at 616.957.4090. Contact our billing department if your insurance company has not made payment within 60 days.

COMMERCIAL INSURANCE.

As a courtesy, we will send a claim to your insurance company, however, payment is expected on the date of service.

HMO INSURANCE.

Many HMO's require authorization from your primary care physician. You must contact them prior to your appointment.
Unauthorized visits may result in increased out-of-pocket expenses to the patient/subscriber.

MEDICARE PART B - MEDICARE ADVANTAGE.

We will submit your charges to Medicare for payment. You are responsbile for any deductible applicates and/or your co-payment.

BLUE CROSS BLUE SHIELD.

If you have a Master Medical Policy, you will be requested to pay your office visit charge. We will bill your Master Medical policy as a courtesy.
BCBS pays all Master Medical benefits to the policy holder only.

MEDICAID

Your MiHealth card and HMO card (if enrolled) must be presented at every visit, along with authorization fro your primary care physician.
Please report all other insurance coverage upon arrival. All other insurances must be billed before a claim can be submitted to the state.

WORKERS' COMPENSATION.

In order to file a Work Comp claim, you must have filed an injury report with your employer (104A).
Bring with you the following information: Employer Name, Address, Contact Person and Phone, Work Comp Insurance Carrier, Claim Number and Date of Injury.
We require a copy of your insurance card on file.

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Neurological Associates of West Michigan, P.C.
2855 Michigan Street NE
Grand Rapids, MI 49506-1296
Tel: 616.957.4090
Fax: 616.957.4095
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