No Show Fee: If you intend to cancel or reschedule an appointment, you must notify the office during business hours the day before your scheduled appointment to avoid a $25 No Show Fee. We do not accept weekend cancellations. Failure to notify the office will result in a $25 No Show Fee, which will be collected over the phone that day or at your next visit. We will send reminders about your appointments the day before, but it is ultimately your responsibility to keep track of your appointments. Any patient who misses three consecutive appointments may be asked to leave the practice.
Follow-up Appointments & Refills: In order to receive routine medication refills, you are required to have follow-up appointments with Dr. Kwak every 3-6 months. Follow-ups help Dr. Kwak determine whether your medication is still working as intended and there are no changes to diet, medication, lifestyle, health conditions etc. that may interfere with its effectiveness. Refills may take 24-48 hours to be sent to your pharmacy after they have been requested, so we recommend notifying the office at least 2 business days before you are out of medicine. At the time of your request, we will need the name of the medication and the phone number and/or address of your preferred pharmacy. If your preferred pharmacy has changed, you must notify the office of this information. If you are experiencing a new condition or acute illness, Dr. Kwak will need to assess you before sending over any new medications. If you are being prescribed any controlled substances, you will be required to sign a contract outlining rules that accompany controlled substances. Examples of these rules include agreeing to receive the controlled medication from Dr. Kwak only, using only one specific pharmacy for this medication, and agreeing to random drug testing at Dr. Kwak’s discretion. Violations of this agreement may result in termination of the prescription and/or further medical care at Kwak Family Medicine.
Precertifications: Your insurance company may require approval/authorization for certain services such as imaging and out-patient procedures. We will submit the appropriate information to your insurance company or servicing facility on your behalf. If your insurance company deems the service is medically necessary after reviewing the submitted information, they will approve coverage. It is ultimately your responsibility to know which services are covered by your insurance company and which services require a precertification before they are performed.
Prior Authorizations: Certain medications may need approval/authorization from your health insurance before they are covered. Once our office receives a request from your insurance company or pharmacy, we will begin the process of submitting the prior authorization. Depending on the complexity of the prior authorization request, the level of manual work involved, and the requirements required by the insurance company, a prior authorization can take anywhere from one day to several weeks to be processed through our office and the insurance company. While we will do our best to complete the request as quickly and sufficiently as possible, ultimately it is the insurance companies’ decision whether this medication will be approved or denied.
Referrals: Referrals are required by some health insurances to ensure that patients are seeing the correct specialist providers for the correct health conditions. If your insurance company requires referrals from your PCP, Dr. Kwak must be aware of the health condition you are being referred for. You must request one from our office at least 48 business hours before your specialist appointment. For any new conditions or health concerns, you will be asked to see Dr. Kwak for an appointment before the referral can be submitted. It is ultimately your responsibility to make sure the specialist you are planning to see accepts your insurance and has received a referral from us before your visit
Forms: Completing medical forms takes time away from clinical practice and you will be charged a fee for this service. Form fees may vary depending on the complexity and time/manual work required to fill each form out. If the form pertains to a condition/issue that you have not previously discussed with Dr. Kwak, you will be asked to schedule an appointment first. Form fees are waived only during a physical exam or scheduled appointment. If you do not bring the form at the time of your visit, a fee is required. Fees are expected to be paid in full prior to form pick up.
Insurance: When you choose an insurance company/plan, you are buying their product and entering into a contract between yourself and the insurance company. This means you are agreeing to the terms of your specific insurance plan, including copay and deductible amounts. We collect these fees based on the prices set by your insurance company. Some plans have higher copays or deductibles; we do not have control over the set amount or any changes to them that may occur. If there is uncertainty whether your insurance will cover a certain service, it is your responsibility to contact your insurance company to verify this information. It is ultimately your responsibility to notify us of any changes to your insurance prior to receiving a service. Failure to provide your accurate and current insurance information may result in claim denials and subsequent out of pocket payments for you.
Balances/Collections: After your insurance company has processed your claim, you will receive a statement outlining your remaining balance which will be mailed to the most current address we have on file. As a courtesy, reminders will periodically be sent to you via text or call. After 90 days, a Final Reminder Letter will be sent to you via mail, and you will have one week after that to pay your balance. Failure to pay your balance after 90 days will result in your account being sent to a collections agency and all medical services at Kwak Family Medicine being terminated. After being sent to collections, you will have 30 days to find a new PCP. During that 30-day period, only emergency medical care will be provided.