Advancing the Possibilities

Your Guide to The Emory Clinic Advancing the Possibilities

W E L C O M E to The Emory Clinic Dear Patient, Thank you for choosing The Emory Clinic and entrusting us with your health-care needs. We do not take your choice or your trust of us for granted. We are dedicated to bringing Emory s expansive world of medical knowledge to you on Emory s campuses and in your neighborhood. By choosing an Emory Clinic physician or facility, you have become a partner with us in pursuing the most appropriate, medically advanced treatment available to you today. Our mission is to offer you the highest quality patient care and service that is compassionate, efficient and effective. Our partnership with you depends on it. Our history of high standards demands it. A Checklist of What to Bring to Your Appointment 1. Ensure we have accurate identification and contact information. If you have a change in home address, phone number, medical insurance, employer, etc., please notify us. The accuracy of your medical record and the billing process depends on this information. 2. Bring your insurance card to every visit. 3. Bring any referral authorization required by your insurance company. 4. Copayments are expected at the time of service for insured patients. A payment deposit may be required for uninsured patients. 5. Bring your current medications in their pharmacy containers or a current and complete list with dosing information. Please include both prescription and non-prescription medications on your list. 6. Bring all materials that may be helpful to your provider. This includes, but is not limited to, previous test results and X-rays from outside providers. 7. On pages 8 and 9 are maps of our facilities. If you need additional information, please call 404-778-3497 or visit our Web site, www.emoryhealthcare.org. 8. Parking in the patient/visitor deck is $5 (max), and valet parking is $7 (flat rate). Cash only. Tipping is not expected. 9. Please visit our Web site, www.emoryhealthcare.org, for more information on your physician or the department you are visiting. We thank you for choosing The Emory Clinic for your health-care needs. Sincerely, Donald Brunn Chief Operating Officer The Emory Clinic, Inc. S. Wright Caughman, MD Clinic Director The Emory Clinic, Inc. Advancing the Possibilities 1

E M O R Y Getting to Know Us H E A L T H C A R E A Comprehensive System of Services and Facilities EMORY HEALTHCARE is part of Emory s Robert W. Woodruff Health Sciences Center, which focuses on patient care, education of health professionals, research addressing health and illness, and health policies for prevention and treatment of disease. The backbone of this system is the Emory University School of Medicine, which has been at the forefront of medical knowledge and research, pioneering many advances and procedures that have changed the face of medical history. The EMORY HEALTHCARE system encompasses The Emory Clinic; Emory University Hospital; Emory Crawford Long Hospital, Emory s Midtown hospital; Emory-Adventist Hospital at Smyrna; Emory Children s Center; Wesley Woods Center; and the Emory HCA Hospitals (Emory Johns Creek Hospital and Emory Eastside Medical Center). Emory also benefits from a close working relationship with the Veterans Affairs Medical Center, Children s Healthcare of Atlanta and Grady Memorial Hospital. The Emory Clinic provides the following specialty services: Allergy Ambulatory Surgery Anesthesiology Audiology Bariatrics Breast Center Cardiac Imaging Cardiology Cardiothoracic Surgery Dermatology Emergency Services Endocrinology Executive Health Family Medicine Gastroenterology General Surgery Genetics Geriatric Medicine Gynecology Hematology Infectious Disease Infertility Infusion Center Internal Medicine Interventional Radiology Medical Oncology Nephrology Neurology Neurosurgery Obstetrics Oncology (Emory Winship Cancer Institute) Ophthalmology Oral Surgery Orthopaedics Otolaryngology (ENT) Pain Medicine Pathology Pediatric Otolaryngology Plastic & Reconstructive Surgery Psychiatry Pulmonary Medicine Radiation Oncology Radiology Refractive Surgery Rehabilitation Medicine Rheumatology Sleep Therapy Spine Services Sports Medicine Surgical Oncology Transplant TravelWell SM Urology Vascular Surgery Call the Emor y Children s Center at 404-778-2400 for more information about pediatric ser vices. M a p s a n d a d d r e s s e s fo r a l l f a c i l it i e s c a n b e fo u n d o n p a g e s 8 a n d 9. 2 For questions about our clinical ser vices, please call Emor y HealthConnection SM at 404-778-7777 or 1-800-75-EMORY.

PLANNING Your First Visit Insurance Information Remember, please bring your insurance card or necessary insurance information. Be familiar with your insurance benefits. It is the patient s responsibility to know the insurance carrier s requirements and procedures. Make sure you know if your physician is listed as a participating provider in your insurance plan s provider book or Web site. If your treatment is covered by Workers Compensation, bring a letter of authorization from your insurance carrier. Most managed care insurance companies, health maintenance organizations (HMOs) or pointof-service plans (POS) require a referral or authorization from your primary care physician for you to see a specialist. If your insurance carrier does require a referral authorization, it is your responsibility to obtain that authorization prior to scheduling your appointment. If your insurance carrier requires a primary care physician referral and one is not obtained, you will be responsible for payment of services rendered. Most referral authorizations are good for a certain number of visits and have an expiration date. If your specialist requires more visits than your specified amount or if the date of the visit has expired, it is your responsibility to contact your primary care physician to extend the referral prior to going back to the specialist. 3

Pre-Registration You may receive a telephone call from The Emory Clinic offering pre-registration. This service will expedite your check-in process on the day of your appointment. B I L L I N G and Insurance Patient Information Form: If you received a medical history form from your specialist before your appointment, please complete it and bring it with you. Medical Records: Please have your medical records from previous physicians transferred to your Emory Clinic physician s office in advance of your scheduled appointment or obtain copies and hand carry to your office visit. X-Rays and/or Scans: If appropriate to your visit, please bring any available X-rays or scans or have them sent to arrive by the time of your appointment. A List of All Medications/Allergies/Drug Reactions: Please bring your current medications (whether over-the-counter or prescription) in their pharmacy containers or a current and complete list with dosing information. A List of Personal Health Questions or Concerns: Sometimes we forget all the things we want to tell or ask the doctor, so make a list of your symptoms, questions and concerns before you come to your appointment. Don t forget to bring it with you! Payment for Services I f yo u have q u e s t i ons, c on t a ct t h e C u st o m e r S e r v i c e Depar tment at 404-778-7318. All payments will be the responsibility of the patient/guarantor and will be due and payable when services are rendered. As a courtesy, The Emory Clinic will accept assignment of benefits and submit a claim for payment to any third party where verifiable benefits can be determined. This assignment does not relinquish the patient/guarantor of ultimate responsibility for payment, except where required by federal or state laws. Non-emergency and non-urgent patients may be asked to postpone services in the event of previous unpaid balances or the inability to establish satisfactory financial arrangements. 4 We accept the following methods of payment: Cash MasterCard American Express Personal Check Visa Discover

Managed Care Insurance I f yo u have q u e s t i ons, c on t a ct t h e M a n a g e d C a r e D e p a r t m e nt a t 4 0 4-7 7 8-5 0 01. If you are covered by a managed care company accepted by The Emory Clinic, we will file a claim to your health plan. We will collect co-pays and deductibles at the time of service, and we may bill you for any charges not covered by your insurance plan. We will wait 30 days for payment by the company. If after this time The Emory Clinic has not received payment, we will require payment from you unless otherwise stated in our contract with your carrier. Federal and State Governmental Programs (Tricare, Medicare, Medicaid) If you are covered by one of the above governmental programs, we will file your claim to the appropriate program. We will collect co-pays and deductibles at the time of service, and we may bill you for any charges not covered by your program plan. If The Emory Clinic accepts your secondary insurance, a claim also will be filed to that provider. Usual and Customary Charges Most health plans (insurance plans) establish unique fee schedules with medical providers. These fee schedules are referred to as usual and customary charges. The Emory Clinic s fees reflect costs based on services rendered in our practice. If you have a health plan that does not participate with The Emory Clinic, then your charges most likely will differ from your health plan s usual and customary charges. In this event, you are responsible for The Emory Clinic s fee in its entirety, regardless of your plan s level of reimbursement. Please make sure you know what services your plan covers so we can calculate your payment responsibilities. The Emory Clinic is a physician office practice and is not covered under any health plan s hospital coverage. Charity Care/Community Benefits If you have any questions regarding your insurance coverage, please contact your insurance carrier. If we can help you understand your coverage, let us know. The Emory Clinic is a not-for-profit entity that provides charitable care to those who meet certain financial criteria when compared to the Federal Poverty Guidelines. In order to receive charitable care, a patient must complete the application in full, provide the appropriate financial verification documents and find a physician who will sponsor and manage his/her care. If qualified and approved, charitable care assistance is for the current episode of care and lasts six months as listed in the EMORY HEALTHCARE Charity Care/Community Benefits Policy. Collection If you have questions, contact the Customer Ser vice Depar tment at 404-778-7318. As a patient of The Emory Clinic, you may receive a courtesy call from the billing office within one week of receiving your invoice. The purpose of the call is to clarify all charges on the bill and to answer any questions you may have. We attempt to contact you on outstanding balances multiple times through letters and phone calls. If all reasonable attempts of collecting payment fail, The Emory Clinic reserves the right to use the services of collection agencies or attorneys. Your account may be reported to a national credit bureau. In addition, your credit status may impact your ability to schedule future appointments. 5

CO N N E C T I N G with Emory Emory HealthConnectionSM By calling Emory HealthConnectionSM, you ll have access to: 404-778-7777 The latest information on services 1-8 0 0-7 5 - E M O RY provided by EMORY HEALTHCARE Registration for classes, events, seminars 404-778-2000 and health screenings (specifically for services at Emory Crawford Long Hospital) Assistance in choosing a physician Biographical information on Emory 7 a.m. to 7 p.m., Monday Friday physicians, including education, experience and languages spoken Information regarding Emory health centers, including directions Information on services for older adults (Senior Resource Line) Information on children s health issues (Emory Children s Center Helpline) AF T E R Your Visit Patient Concerns At The Emory Clinic, we value your opinion and welcome your feedback regarding your visit. Please forward any comments or concerns to Manager of Patient and Guest Relations, 1365 Clifton Road, NE, Atlanta, GA 30322. Or, you may call us at 404-778-3539 or e-mail us at patient relations@emoryhealthcare.org. Following your visit, you may receive a survey to give us your feedback regarding your visit. Please complete this survey and return it in the enclosed envelope. We appreciate your evaluation. After your visit, you should be given information on how to reach a physician after hours and on weekends, should a medical need arise. Should You Need to Go to a Hospital Our physicians admit patients primarily to the following hospitals: 6 Emory University Hospital Emory Crawford Long Hospital, Emory s Midtown hospital Wesley Woods Geriatric Hospital Emory-Adventist Hospital at Smyrna Children s Healthcare of Atlanta Emory Eastside Medical Center Emory Johns Creek Hospital

O U R Web Site www.emoryhealthcare.org Visit www.emoryhealthcare.org to learn more about EMORY HEALTHCARE s physicians and facilities. You also will find extensive information on health-related topics. Below is just some of the information available on the EMORY HEALTHCARE Web site: About Us Learn about each of the EMORY HEALTHCARE facilities and the Woodruff Health Sciences Center at Emory University. Health Library Search for information in our medical library. Patient Guide Find everything a patient needs to know from scheduling an appointment and getting directions to obtaining billing information and reading answers to frequently asked questions. Departments View specific information on all EMORY HEALTHCARE departments and services. Contact an Emory Nurse Speak with or e-mail an Emory nurse to obtain information about physicians and to get health-related advice. Find a Physician Search the database of all EMORY HEALTHCARE physicians. You may search by name, specialty, area of interest and location. News and Events Find links to Emory news releases, events and video news releases. 7

L O C A T I N G Our Facilities 1 The Emory Clinic at Emory University s Campus 9 (Buildings A & B) 1365 Clifton Road, NE Atlanta, Georgia 30322 2 The Emory Clinic at 1525 9 1525 Clifton Road, NE Atlanta, Georgia 30322 3 The Emory Clinic at Emory Crawford Long Hospital 9 (Medical Office Tower and Glenn Building) 550 Peachtree Street, NE Atlanta, Georgia 30308 4 The Emory Clinic at Emory Johns Creek Hospital 9 6325 West Johns Crossing Duluth, Georgia 30097 5 The Emory Clinic at Decatur 9 2801 North Decatur Road, Suite 295 Decatur, Georgia 30030 6 The Emory Clinic at Flat Shoals Parkway Trinity Office Park 4153 Flat Shoals Parkway Decatur, Georgia 30034 Other Emory Clinic facilities: 13 Emory Orthopaedics & Spine Center 59 Executive Park South Atlanta, Georgia 30329 14 Emory Facial Center 993-C Johnson Ferry Road, Suite 215 Atlanta, Georgia 30342 15 Emory Audiology & Hearing Aid Center at Johns Creek 4045 Johns Creek Parkway, Suite C Suwanee, Georgia 30024 16 Dialysis Access Center of Atlanta 552 Ponce de Leon Atlanta, Georgia 30308 17 Emory Children s Center 2015 Uppergate Drive Atlanta, Georgia 30322 18 Emory Winship Cancer Institute Building C 1365 Clifton Road, NE Atlanta, Georgia 30322 9 Heart & Vascular Center locations. 7 The Emory Clinic at Perimeter 9 875 Johnson Ferry Road Atlanta, Georgia 30342 8 The Emory Clinic at Smyrna 9 (Located at Emory-Adventist Hospital at Smyrna) 3903 South Cobb Drive, Suite 200 Smyrna, Georgia 30080 9 The Emory Clinic at Sugarloaf 9 1845 Satellite Boulevard, Suite 500 Duluth, Georgia 30097 10 The Emory Clinic at Wellstar Kennestone Hospital 9 61 Whitcher Street, Suite 4100 Marietta, Georgia 30060 10 8 12 7 14 13 4, 15 9 1, 2, 11, 17, 18 3 16 5 8 11 The Emory Clinic at Wesley Woods 1821 Clifton Road, NE Atlanta, Georgia 30329 12 Emory Family Practice at Dunwoody 11 Dunwoody Park, Suite 150 Atlanta, Georgia 30338 6

Emor y Hear t & Vascular Center Locations outside Atlanta See map on previous page for Heart & Vascular Center locations inside Atlanta. 2 8 1 7 NC GA 5 10,11 SC 6 9 12 4 Emory Campus Emory Midtown Campus 3 For additional information about our facilities, call Emory HealthConnection SM at 404-778-7777 or 1-800-75-EMORY, or visit our Web site at www.emoryhealthcare.org. 1 Emory Heart & Vascular Center at Blairsville 214 Hospital Circle Blairsville, Georgia 30512 2 Emory Heart & Vascular Center at Cartersville 907 Joe Frank Harris Parkway, Suite 280 Cartersville, Georgia 30120 3 Emory Heart & Vascular Center at Columbus 2122 Manchester Expressway Columbus, Georgia 31904 4 Emory Heart & Vascular Center at Eastside 1800 Tree Lane, Suite 250 Snellville, Georgia 30078 5 Emory Heart & Vascular Center at Habersham 207 Adams Drive Demorest, Georgia 30535 7 Emory Heart & Vascular Center at Hiawassee 110 Main Street Hiawassee, Georgia 30546 8 Emory Heart & Vascular Center at Murphy 4188 East US 64, Suite 1 Murphy, North Carolina 28906 9 Emory Heart & Vascular Center at Royston 930 Franklin Springs Road Royston, Georgia 30662 10 Emory Heart & Vascular Center at Toccoa 15 Rock Quarry Road Toccoa, Georgia 30577 11 Emory Heart & Vascular Center at Toccoa 800 East Doyle Street Toccoa, Georgia 30577 6 Emory Heart & Vascular Center at Hartwell 125 W. Gibson Street Hartwell, Georgia 30643 12 Emory Heart & Vascular Center at Villa Rica 690 Dallas Highway, Suite 104 Villa Rica, Georgia 30180 9

The Emory Clinic, Inc. 1365 Clifton Road, NE Atlanta, Georgia 30322 404-778-5000 www.emoryhealthcare.org Emory Healthcare, Inc. TEC 1701 10/07