For all new patients please print these five documents and fill them out completely and bring them to your first appointment. This will save you time at your appointment.
Our urology practice offers an outstanding combination of experienced physicians who are skilled in the care of urologic cancers, laparoscopic and robotic assisted surgery, urinary stones, urinary incontinence, pediatric urology and other aspects of urologic care. Our office policies are below.
Insurance and Patient Payment Policy
- As a courtesy service, all primary insurances will be filed with proper insurance identification. Patients are responsible for payment of copays at the time of each office visit.
- Managed care patients are responsible for obtaining referrals prior to seeing the physician. Patients should be aware of how many visits have been authorized by their primary care physician on each referral. Should a referral not be obtained, the patient is considered to be self-pay and will be charged for the appropriate level of service provided.
- For all insurances, patients will be responsible for payment of the deductible (or percentage of patient responsibility) at the time of visit.
- Patients without insurance will be responsible for payment in full when a service is provided.
- Payment methods accepted include: cash, check, VISA and MasterCard.
- Patients will be billed $25.00 for any returned checks.
- Patients will be billed $100.00 for missing an in-office surgical procedure, $150.00 for vasectomy and all hospital-based surgical procedures and $25.00 for all other office appointments. An appointment may be cancelled and rescheduled by calling the office.
- The recently implemented Health Insurance Portability and Accountability Act (HIPAA) requires physicians to obtain certification of patient identity. A drivers license or passport will suffice. Please kindly adhere to these new government regulations.
Medication Refills
All medication refill requests will require an office appointment. We will no longer perform medication refills over the phone. A provider visit to review your current medications and any change in your medical history is essential prior to renewing medicines. Please make every effort to have your prescriptions refilled at the time of your appointment. Please call our appointment line, 703-208-4200, to make an appointment for your medication refills.
Requests for Medical Records
Copies of medical records are available to patients and authorized representatives. A clerical and copy charge will be applied, payment due prior to our processing the request for records. Insurance forms, such as disability and life insurance, requiring the review of medical records by your physicians may also result in a clerical charge payable prior to the processing of these insurance forms. Please contact the business office concerning these charges.
Laboratory and X-ray Results
For most laboratory and x-ray results, we will request that you make a follow-up appointment with your provider to discuss the results. Often times, these results will require further explanation or testing that can be very difficult to do over the phone. Please call our appointment line, 703-208-4200 to make an appointment to discuss your results.
Late Policy
Any patient who is 15 minutes late for an appointment may have their appointment rescheduled for another day. If you are more than 15 minutes late, we will make every effort to see you the same day, but you may have to wait until there is a break in the schedule to be seen. Although we appreciate the demands of traveling in Northern Virginia, we also cannot inconvenience other patients who are on time for their appointments.
Referrals
If your appointment requires a referral and you do not have one at the time of your appointment, you will have two choices. You may be seen but YOU will be responsible for payment of the appointment in full. Or, you may reschedule your appointment for another day and obtain your own referral. It is not our office's responsibility to obtain your referral.
Life and death emergencies dial 911
There is a physician member of our group "on call" by pager at all times. The physician is available to answer questions of an urgent nature. The physician responding to calls after hours is often at home with his or her family and does not have access to patients' medical records. Therefore, we recommend that all routine concerns should be addressed during regular office hours. This allows your questions to be posed to your own health care provider who has then direct and immediate access to your medical record.