Charlotte 704-544-0050

Monroe 704-635-7418

Charlotte Location: 17232 Lancaster Hwy, Ste 102 Charlotte, NC 28277

Monroe Location: 349 Venus Street Monroe, NC 28112

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BROADVIEW HEALTH PA 

STATEMENT OF POLICIES

Center for Sleep Disorders and Behavioral Medicine

Phone Monroe office   704-635-7418 

Phone Charlotte office 704-544-0050

 

 

We strive to provide the best care for our patients. In order to do so, we need to make sure all our patients are aware of these policies. Please review them carefully and sign at the bottom. We thank you for your understanding and cooperation.

  1. Scheduling appointments:

  • It is your responsibility to schedule appointments with Dr. Onafuye or any of our other providers 

  • We request a 48 hour advance notice for appointment cancellation

  • Patients with missed appointments or cancellations occurring less than 48 hours in advance are billed $100.00 for the time that was reserved for them, which must be paid in full before any other appointments are scheduled

  • We reserve the right to refuse care to any person at any time without cause or explanation

  • The first encounter with us is only an assessment to determine eligibility into our practice. It does not guarantee continued care. 

    2. Prescription refills: 

You will be given an adequate amount of medication at each visit, until the physician's requested follow-up appointment. If you miss or reschedule an appointment your refill may be denied. Approved refills are subject to a $25 charge. NO REFILLS WILL BE GIVEN ON WEEKENDS AND THERE ARE NO EARLY REFILLS, EVEN IF THE PRESCRIPTION IS LOST OR BECOMES EMPTY

    3. Forms/Letters:

 If you have forms or letters that need to be completed outside of your appointment, a form fee of $100 is required prior to completion and allow 10 business days for processing. DISABILITY FORMS WILL BE ADDRESSED AFTER THE PATIENT HAS BEEN SEEN A MINIMUM OF 3 MONTHS. Completion of such documents remains at the discretion of the physician/provider. 

 

    4. Calls for the Doctor: 

Questions called in for our providers will be returned AFTER all patients scheduled for the day have been seen. It will likely be after 6pm before your call is returned, and we may ask one of our staff to call with directions for the patient. If a provider is out of the office, it may be up to 24 hours or the next business day before you receive a return call.

 

 

   5. The Following May Lead to Termination from Treatment: 

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  • Repeated failure to keep an appointment without notice. 

  • Failure to pay for services rendered. 

  • Failure to follow mutually agreed treatment plan. 

  • Refusal to comply or tampering with pharmacological screening in any form. 

  • Unruly, rude, or aggressive behavior or speech to any provider or employee of the practice. 

   6. Payment instructions/financial policy: 

  • Payment for services rendered is due in full at the time of each appointment. This includes co-payments and co-insurance. 

  • If you have insurance, it is your responsibility to call your insurance company prior to your appointment to verify your benefits and learn what is covered under your plan. You are also responsible for learning if any pre-authorizations or pre-certification is required by your insurance company prior to your first visit.

  • If you have Medicaid, you MUST have your current card for EACH appointment. Medicaid regulations dictate our office must have a current card on file to see you. If you don’t have a current card, you need to reschedule your appointment. 

  • Our office charges $25 for a returned check, after which patient agrees to pay in cash for subsequent services

  • We will try our best to assist you in any way possible with your bills. Any balance that is over 60 days may be transferred to an outside collections agency for credit reporting. A patient that has been placed in collections must pay any prior balance owed to the practice and the COLLECTIONS AGENCY FEE and any attorney fees in cash.

  • You allow our office and affiliated agencies to contact you on any phone numbers provided (example: home, work, cell, etc.) regarding medical and billing issues.