Copayments and insurance deductibles represent the portion of our services that patients must pay out of pocket. Such payments are required by the patient’s agreement with the insurance payer, and our contracts with insurance payers require us to collect them. No waivers can be allowed. For Medicare, law requires collection of deductibles and co-payments, and waiver of such payments constitutes fraud. To comply with our contracts, AARA requires payment in full at the time of services including any co-payments and deductibles. Any payment past due must be made before the next scheduled visit can proceed. This means that if you have not paid your prior co-payment or deductible, your visit may be rescheduled until payment is made.
In an effort to serve our patients and the community well, we must utilize our time efficiently. When a patient makes an appointment, time is set aside for their needs, and work is performed to prepare their record for the visit. When a scheduled visit is not completed, there is a loss for another patient who could have used that available time, as well as wasted staff time. Therefore, we ask that when a scheduled visit cannot be met, it be cancelled at least twenty-four hours prior to the time of the appointment. For late cancellations or not showing for a scheduled appointment, a $25 fee will be charged.
A chronic shortage of rheumatologists exists throughout the US. In most practices, waiting times for a new patient to see a rheumatologist is 2 to 6 months, and many rheumatologists struggle to meet the needs for follow-up care of existing patients. The shortage is projected to worsen over the next 20 years. The American College of Rheumatology has recommended the integration of Nurse Practitioners (NP) and Physician Assistants (PA) as an important way to address this shortage and extend the ability of qualified rheumatologists to meet the demands for specialty care within their communities. As a result, AARA has created teams wherein physicians and skillfully trained and supervised NP/Ps work in a coordinated fashion see patients in a timely manner and reduce the risk of complications of delay. The expanded physician schedules provided by the NP/Ps have successfully reduced wait times substantially, while maintaining the capacity for personalized care.
The value of this integrated model of scheduling with the rheumatologist and their team NP/Ps means that when someone calls for an appointment, a visit can be provided with the minimum of delay. To maintain the success of this strategy, patients will typically see the team NP/PA as part of their first visit with the rheumatologist, and intermittently through the course of care. On any visit, if necessary, patients may be seen by both the rheumatologist and NP/PA.
Therefore, as a policy at AARA, patients are discouraged from insisting on seeing only the physician on the team as this may result in delays and inefficiency in scheduling and needed care.
All doctors at AARA are fully qualified in the practice of rheumatology. If you have a preference for a particular physician at AARA, you must tell us when scheduling the first visit. Every reasonable attempt will be made to accommodate your preference. In order to maintain continuity of care and avoid “opinion shopping” within the practice, subsequent requests for switching doctors must be approved by the physicians involved, and in general will be denied. An exception to this policy often occurs if the patient has moved to a new geographical area making such a switch most reasonable for all concerned.
At AARA, we chose to live and work in a culture of service supported by an atmosphere of mutual respect, human dignity, patience, and civility. The expression of these values is expected consistently from everyone including staff, physicians, patients and their families. Failures by our staff to follow this policy will result in corrective action and potential discharge from employment. Abusive or demeaning behavior towards our staff or physicians by patients or family may result in our withdrawal from the patient’s medical care.
It may be appropriate at times for our physicians to prescribe narcotic pain relievers or other “scheduled” drugs in the management of acute or chronic symptoms. The authority to prescribe such medicines is a privilege granted by agencies including the Drug Enforcement Agency (DEA) that regulate their use, and scrutinize prescribing practices. Accordingly, to promote proper utilization of controlled substances, AARA physicians will often require patients to execute a “Pain Agreement” acknowledging the patient’s responsibilities for the use, handling, and protection of such medicines. Abrogation of the agreement may result in interruption or discontinuation of such medications and possible withdrawal from medical care.
With the recent implementation of the Medicare Part D perscription drug benefit for medicine recipients, questions often arise concerning how eligible persons may enroll in this program. For these and other Medicare and Medicaid related questions, we direct you to helpful customer information websites:
Residents from St. Joseph and Good Samaritan Hospitals and medical students from Midwestern University may choose to spend time with us during their elective months. At AARA, this exposure provides the physician-in-training a core of basic knowledge of a wide range of rheumatologic and musculoskeletal diseases. The training environment provides experienced rheumatologists an opportunity to stimulate interest in this rapidly advancing and exciting field of medicine with the hope of developing promising new talent that may one day serve the needs of our growing population.