Office Policies and Procedures

Office Hours by Appointment Only (Phones answered between 9am-12pm and 1pm-4:00pm):

Monday               8-5

Tuesday              8-5

Wednesday         9-5

Thursday             9-6

Friday                 9-3:30

 

Scheduling appointments:

We aim to offer same-day appointments for urgent problems.  For this reason, please observe the following guidelines when scheduling:  

  • If you need a same-day appointment, please call early in the day.  There will be less flexibility in scheduling as the day goes on.    
  • Schedule any routine visits well in advance.
  • If you have chronic health problems (such as hypertension, high cholesterol, asthma), you should have routine “follow-up” visits to monitor these conditions.  Please schedule these visits in advance so you have the greatest choice in appointment times.  Please do not wait until your medications are running out to schedule your appointment.
  • Appointments can now be made online!    To do so, please log in to your Patient Fusion Account.

 

Financial Policy:

  • Co-pays and balances must be paid at the time of the office visit.
  • If you cannot provide an accurate insurance card at the time of the office visit, you will be responsible for payment in full. 
  • You must provide us with the most up to date insurance information, address, phone, etc.  If there are any changes, please let us know at the time of your visit.  If you do not provide accurate insurance information at the time of the visit, we cannot re-submit claims on your behalf, and you will be responsible for payment in full. 
  • For a visit related to an auto accident or a work-related injury, the full fee must be paid at the time of the visit.  We will give you a copy of the necessary paperwork to seek reimbursement from your auto or workers comp insurance company; these claims cannot be submitted to health insurance companies.
  • If Dr. Simon does not participate with your insurance company, the fee must be paid at the time of the visit.  We will give you a copy of the necessary paperwork to seek reimbursement from your insurance company.  Patients paying the entire fee at the time of service are entitled to a discount of 15% off the usual fee (not including vaccines and supplies).
  • All claims will be first submitted to your insurance company; you will receive a bill for any amount of the fee which is not covered by your insurance.  It is your responsibility to know the details of your own insurance policy.  If you have received a bill for something that you feel your insurance should cover, please note that you are still responsible for the balance due to our office.  You may contact your insurance company regarding any dispute.
  • There is a $30 fee for all returned checks.
  • Balances overdue by more than 90 days are subject to an interest surcharge of 5% per month.
  • To cancel an appointment, you must give 24 hours notice, or you will be charged a fee ($30 for most visits, $60 for a routine physical).  This fee is not billed to insurance.
  • If you need any forms filled out (employment, daycare, school, etc.) we will be charging the patient a flat $10 fee per form.  This service is not covered by your health insurance.  Please bring all forms to the desk before your appointment.  We cannot promise to fill them out at the time of the appointment, but will try if time allows.

 

 

If you just had a baby:

Congratulations!  If your baby was born at GBMC, then the hospital will notify the office, and Dr. Simon will see your baby either that day or the following morning.  If your baby was born at another hospital, then he or she will be examined by the hospital pediatrician, and you may schedule an initial visit with Dr. Simon between one and two weeks of age.

For after-hours emergencies:

If you have a life-threatening emergency, call 911.  If you have a problem and you are not sure whether you need to go to the Emergency Room, call the office and follow the instructions on the answering machine; on the weekends and holidays, you will hear instructions for reaching the on call physician.

Prescription refill policy:·        

  • No refills will be given for patients who have not been in the office within the last 12 months. 
  • No refills will be given over the phone for a medication prescribed by another physician.  You will need to schedule an appointment for any new medication prescription.
  • Have your pharmacy notify us for refills; the office accepts electronic refill requests.
  • Please allow 24 hours to process a medication refill.
  • Please check your medications prior to a routine appointment, so that written prescriptions can be given to you. 
  • If your insurance company denies payment for a prescription drug, you may be asked to schedule a separate appointment to review your options or complete a new prescription. 
  • If you prefer to send prescriptions to a mail-away pharmacy, you will need to have written prescriptions.  We no longer can fax new prescriptions to Express Scripts, Medco, etc. 
  • Monitoring of some medications requires periodic office visits.  Please discuss the recommended frequency with Dr. Simon.   We cannot give over the phone refills if you have not kept up with regular visits.

 

Referrals to specialists:

If for any reason Dr. Simon recommends a diagnostic test or consultation with a specialist, your insurance company may require a written authorization from our office.  This is known as a “referral.”  We will help deal with the paperwork as much as possible, but ultimately, it is your responsibility to know for which services your insurance company requires a referral.  Some specialists will not see you if you do not have this referral, so please allow our staff as much time as possible (at least a week) so that we may complete the insurance paperwork accurately.  New insurance rules do not allow back-dating of referrals.  Of course, any urgent specialist referrals will be handled urgently.

 

Filling out of forms:

  • If you need forms filled out, please give them to the front desk before your appointment with your portion completed . 
  • We attempt to fill these out at the appointment if time allows, but this is not always possible, so you may be asked to pick up forms at a later date.
  • If you need forms filled but do not need an appointment, please drop off forms with the front desk and we will call you when forms are completed.
  • We are no longer able to mail forms, prescriptions and lab orders.
  • Form fee ($10) is due when forms are dropped off.