Policies and Procedures
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1 Policies and Procedures Thank you for choosing Dr. Daniel F Cannon as your Primary Care Physician. The staff at Cannon Family Health strives to make this office a welcoming medical home for you. We want to make your experience with us as comfortable and stress free as possible. This hand out will tell you about who we are and how we operate. Please feel free to contact our office if you have any questions concerning our policies. Office Hours: Mon Thurs 8:30am 5:00pm Fri. 8:30am 12:00pm (We are closed daily for lunch 12:30pm 1:30pm) Phone Hours: Mon- Thurs 8:00am 12:30pm, 1:30pm 5:00pm Friday 8:00am 12:00pm Our office Phone Number is An on-call physician is available to assist you after scheduled office hours if necessary. That number is In the event of an emergency do not call the on-call physician, please call 911. If you need to make an appointment, please call us during our regular offices hours. APPOINTMENTS Scheduling When calling for an appointment, please provide our staff with your name, date of birth, telephone number, chief complaint/reason for visit, and any updated contact or insurance information. If you have regular follow-up visits please make sure to schedule your next visit at check out. **If you scheduled an appointment for an illness, please note that a full check-up cannot be done at that appointment. Please schedule separate appointments for that purpose. Same Day Appointments As your medical home, Cannon Family Health offers same day/urgent appointments. We reserve 4 spots in the morning and 4 spots in the afternoon for same day/ urgent appointments. On most days, an appointment slot is available for last minute appointments. If an appointment slot is not available, we will schedule you for the next available appointment. If you feel that you cannot wait, please inform the staff and appropriate measures will be taken. Cancellations We require a 24hr notice if you need to cancel or reschedule your appointment. If you do not give us 24hrs notice you will be charged a $30 no-show fee. Late for an appointment We are a very busy practice and Dr. Cannon s time is very valuable. It is important for our office and other patients that you be on-time for your appointment. If a patient is 15 minutes late for an appointment, you will be rescheduling for the next available appointment time.
2 Missing an appointment We cannot stress enough how important it is that you come to your appointments. We try to call and remind you of the appointments 1-2 days prior to your appointment as a courtesy. However, you are still responsible for keeping your appointment time even if we cannot reach you. You will be charged a no show fee of $30 if you don t show up for a scheduled appointment and do not call. After 2 no-shows you will be dismissed from the practice. Appointment notes We do our best to run on schedule. There are many ways you can assist us in staying on time: Please be on time for your appointment Walk-in appointments are strongly discouraged. If you schedule a visit for one patient, please make it for that patient only. If you have two siblings that need to be seen, for instance, please be sure to schedule two appointments. Remember that SICK/URGENT appointments do not allow enough time for a physical to be done. ** We do make all efforts to stay on time but emergencies do occur from time to time and we might run behind as a result. We will try very hard not to waste your valuable time.** Check In When you arrive at the office please sign in at the front desk. We will verify all of your contact and insurance information. You must bring your insurance card and photo ID to every appointment. It is your responsibility to provide us with any changes to your medical coverage. Full payments for all co pays are expected at the time of service. We accept cash, check, or credit card. Returned Checks A fee of $30 will be charged for all returned checks. Co pays As part of our contract with the insurance companies, we are legally required by the terms of the contract to collect any co pays from you at the time of service. If you do not have your co-pay, we will reschedule your visit. Paperwork All new patients will need to complete a new patient packet for Cannon Family Health. The new patient packet can be accessed on our website at ww.cannonfamilyhealth.com. If you do not have internet access we can mail or fax the packet to you. All forms in the new patient packet should be completed before your scheduled appointment; otherwise new patients must arrive 15 minutes early to fill out the packet. In addition we will need a current copy of your insurance card and a photo ID.
3 Insurance As a courtesy to our patients, Cannon Family Health is happy to file insurance claims on your behalf. If you also have a secondary insurance please let our staff know. We will need a copy of all cards. It is your responsibility to call your insurance company before your first appointment and make sure our office is In-Network with your insurance. It is also your responsibility to inform our office of any changes in insurance coverage. Failure to do so will cause delays or denial of insurance payment. You will be billed for any deductible or co insurance amounts, and/or fees for services not covered by your insurance (as stated in your insurance contract). If we are unable to verify insurance coverage prior to scheduled appointments, patients will be responsible for fees associated with office visits at the time of service. Medicaid Patients If you or your children are on Medicaid, your Medicaid card must have Cannon Family Health listed as your provider. We are unable to see patients until the card is corrected. Medicare Patients If you are a Medicare patient please remember to bring your Medicare Card to every appointment as well as any supplemental insurance cards you may have. Please contact our billing department with any billing questions you may have PRESCRIPTIONS Cannon Family Health strongly recommends using only one pharmacy for all of your prescription needs. Please be sure the pharmacy and Cannon Family health are aware of any possible drug allergies you may have. If you need a prescription refill, please call your pharmacy and have them fax the request to our office at (828) Requests received after 3:00pm will be processed the next business day. Please note that narcotic medications require a paper prescription signed by Dr. Cannon. Early refills will not be given. Changes and/or new prescriptions can only be completed by the physician. Please be aware that you may have to been seen to receive a new prescription. Please do not ask staff to alter your medication(s) or dosing instructions.
4 Lab Services Cannon Family Health has an in house lab for our patients convenience. Patients with insurance coverage will be billed directly from LabCorp for any lab services performed. Self-pay patients will be charged for any labs at the time of the service. Medicare patients may be asked to sign an Assignment of Benefits. Our lab is open from 8:30am 12:30pm M-F. Please call to schedule your lab appointment, walk-ins will be rescheduled. Check Out - Follow up and routine appointments will be made at the desk during check out. REFERRALS Referrals can only be made by the physician. If you haven t been seen, for this complaint, in this office, the referral will require an office visit. Once a referral has been created by Dr. Cannon please allow 3 business days for processing. Once we send the referral to the appropriate facility that facility will contact you directly to schedule your first appointment. Please contact our office if you have not heard about your referral within 4-5 business days. MESSAGES All phones messages received before 3pm will be followed up on the same day. If we receive your message after 3pm we will follow up with you on the next business day. For all messages sent from the patient portal will be responded to within 24hrs of receiving the message. AUTOMATED CALLS Cannon Family Health uses an automated reminder system for appointment reminders, lab results, outstanding balance reminders, and important messages from our office. By signing below you agree to allow Cannon Family Health to send automated calls to your preferred contact phone number.
5 AS A PATIENT, YOU HAVE CERTAIN RIGHTS AT CANNON FAMILY HEALTH: 1. You have the right to be treated with respect, consideration and dignity. 2. We will strive to greet you with a smile and a warm welcome. 3. You have the right to high-quality medical care delivered in a safe, timely, efficient and cost-effective manner. 4. We will keep you medical information private as laid out in the guidelines by HIPPA. 5. You have the right to be a participant in your healthcare along with your doctor. 6. No procedure or treatment will be undertaken without your informed consent. 7. You have the right to know the services available at the facility. 8. You have the right to know what fees are expected and what the payment policies are. YOU ALSO HAVE CERTAIN RESPONSIBILITIES AS A PATIENT 1. You have the responsibility to accurately and completely provide all clinical personnel with the health information they need including any medications that you are taking. 2. You have the responsibility to follow the directions of the nurse or physician with regard to diet and/or medication. 3. You have the responsibility to abstain from using any drugs that have not been prescribed for you and that you have not revealed to our nurse or physician. 4. You have the responsibility to abstain from the use of alcohol as directed by your nurse or physician. 5. You have the responsibility to inform the nurse or physician if you do not understand any directions or if you do not understand the course of treatment planned for you. 6. You have the responsibility to timely pay all medical bills which are not in dispute and to forward to us any monies you receive from any insurance company for our services.
6 POLICIES & PROCEDURES ACKNOWLEDGMENT FORM By signing below, I acknowledge that I have received, reviewed, understand, and will comply with the policies and procedures explained in the Cannon Family Health, PLLC OFFICE POLICIES & PROCEDURES FOR PATIENTS. PRINTED NAME SIGNED NAME DATE Thank you! Cannon Family Health, PLLC
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