Policies

  • Labwork and Results

    Bloodwork / Lab Appointments:

    In order to provide you with proper care, all lab work is to be ordered by the practitioner.  There may be times when the practitioner feels it is in the best interest of the patient to schedule a return appointment to review these lab results.

    Test Results:

    Please allow 5-7 days for test results.  We will contact you by mail or phone.  At times appointments may be required by the practitioner to review these results with you.

  • Communication and Appointments

    Getting in touch with us:

    If you are contacting our office with a pressing issue and a message cannot be left on our staff's voicemail you may press 0 at anytime to be connected with our front office.  If you need to leave a message to schedule future appointments, request prescriptions refills or have questions regarding your account, please leave a message for our staff to return your call.

    Missed Appointments: 

    Appointment reminders are now sent out via email and can be verified through your secure patient portal.  It is not necessary to log in to your portal account and confirm your appointment, but is welcomed by staff members if done.  If you would like to cancel your appointment online, a login to your secure portal account is required.  If you are unable to keep your scheduled appointment please contact our office 24 hours prior to your scheduled visit.  

  • Third Party Forms

    We realize that special forms are sometimes necessary to provide documentation of medical conditions.  Completing forms is time consuming and generally falls outside the contractual relationship between you and your insurance company.  All forms requested without an appointment will need to be reviewed by the office to determine if an appointment is necessary.  Please drop them by the office with a phone number so we can contact you when a determination is made.  Fees for these types of forms will vary according to the complexity of the paper work.

    FMLA papers:

    ALL FMLA papers require an appointment with Dr. Wallace.  Fees for completion of FMLA papers will vary according to the complexity of the case.

    Blue Forms for School:

    Blue cards needed for school may also require an appointment with the practitioner.

    Work/School Excuse:

    Please notify the nurse or medical assistant at the time of your visit if you will require an excuse.

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    Insurance Participation

    MedicareBCBS.jpgNAMCIAetnaLogo

     

    We are happy to welcome new patients! At this time, however, our relationship with  United Health Care, Cigna, Humana, and a few other insurance networks is limited to existing patients only. If you have any questions about your insurance, please refer to the list below or contact us to ask. 

    To verify our physicians' participation with your insurance carrier, you may visit your insurance provider's website or call the telephone number on the back of your insurance card.

    We participate in many managed care plans and see patients with traditional insurance. Below is a list of plans we are currently accepting new patients under.

    • BCBS of Alabama
    • NAMCI
    • Aetna

    Many plans require that you make a co-payment at the time of your visit. To make it as easy as possible for you, we accept cash, checks, and most major credit cards at our office.

    Please bring your insurance card with you for each visit and notify our front desk prior to seeing the practitioner or lab anytime your insurance coverage changes.

    If you have other insurance feel free to contact our office to verify participation.

  • Payment / Financial

    Payment is due at the time of service unless arrangements have been made in advance with written approval by the office manager and Dr. Wallace.  We accept Cash, Check, Money Order and Credit / Debit Card payments.

    Insurance Coverage:

    Please keep in mind that your insurance policy is basically a contract between you and your insurance company.  We have made prior arrangements with many insurance companies and other health plans to accept an assignment of benefits. We will bill them, and you are required to pay all co-payments, deductibles and non-covered services at the time of your visit.

    If you are insured by a plan that we do not have a prior arrangement with, we will file the claim for you on an unassigned basis as a courtesy to you, provided we have accurate claims filing information. Your insurance carrier will send the payment directly to you. Therefore, our charges for your care are due at the time of service.

    Please review our Insurance Participation page to see what insurance we accept.

    Non-covered services:

    Not all insurance plans cover all services. In the event your insurance plan determines a service to be "not covered", you will be responsible for the complete charge.  We will try and inform you prior to your visit if we believe a service may not be covered but as all policies are different this may not always be possible.  Health plan coverage varies significantly by carrier, by employer, and/or by contract.  We cannot know the benefits and exclusions of each patient's health plan.  It is the patient's responsibility to know and understand their plan coverage and benefits.  All questions regarding your policy benefits should be directed to your insurance carrier. 

    Nurse Practitioner Visits:

    Many insurance companies do not cover visits with the Nurse Practitioner.  If you are seeing the Nurse Practitioner please contact your insurance carrier prior to your appointment to avoid any unexpected expenses.  Do not assume your visit is covered unless your carrier confirms these visits are a covered benefit.

  • Prescription Refill Policy

    1. Before you come to your regular appointment, you should look over your medications, diabetes supplies, inhalers, etc. to determine if you need to request any new / refill of prescriptions at your appointment.
    2. We do require office visits on a regular basis for all of our patients taking prescription medication. The interval will vary depending on the condition being treated and the type of medication prescribed. Please be sure you have enough medication to last until your next scheduled visit.
    3. It is very important to request your prescriptions during your office visit.
    4. Please bring all your prescription bottles (or an updated medication list) with you to your appointment. This is important to make sure that:
      1. you are taking the correct medications and the correct doses; and
      2. we have an up-to-date list of your medications. We will carefully review your medications and write refills at your office visit. We will also ask you to review the new prescriptions to make sure that they are written correctly.
    5. As part of our new policy, we will offer the following options for prescription refills:
      1. We can provide written prescriptions.
      2. We can call in certain medication s to your requested pharmacy
      3. We can fax prescriptions in to a mail-order pharmacy. You will need to provide us with completed forms provided by your mail order pharmacy.
    6. Our policy is to call in appropriate requests for prescription refills within 2 business days (not including weekends and holidays). We will have written prescriptions available within 3 business days.
    7. If you call to request a refill but are overdue for a follow-up visit and/or blood work (necessary for monitoring the safety or effectiveness of a medication), the provider may agree to call in enough medication to a local pharmacy to last until we are able to schedule an office visit (two weeks maximum). It is your responsibility to schedule an appointment before you run out of medication. You should schedule your next visit before you leave our office.  

    We understand that there might be a situation when you do have to call us for a prescription. Please look at the list below and see what you can do to avoid incurring a prescription refill fee.

    • Are you changing to a new local pharmacy? You should call your new pharmacy and request that your prescriptions be transferred from your old pharmacy. We sometimes do not have to write new prescriptions.
    • Are you going on an extended vacation and need to use an out-of-town pharmacy? You need to call the NEW pharmacy that you will be using and have them contact your hometown pharmacy to have your prescriptions transferred. When you return home, you have to reverse the process.
    • Are you changing to a new mail order pharmacy? Some pharmacies will transfer your prescriptions to the new pharmacy. If you still have refills on your current prescriptions, please check with your current mail order pharmacy to see if your prescriptions can be transferred.

    NOTES

    REFILLING A PRESCRIPTION

    Every request for a refill requires the following steps: 

    1. Phone message transcribed or fax printed
    2. Phone message or fax is brought to medical record
    3. Patient's chart is pulled from medical records and verified
    4. Request is attached to chart
    5. Chart is brought to nurse
    6. Nurse reviews chart for pertinent information
      1. Verifies chart and request
      2. Is medication a controlled substance
      3. When were last labs done?
      4. When was patient last seen?
    7. Chart brought to doctor
    8. Doctor reviews chart
      1. Verifies chart and request
      2. Reviews patient's labs and medical history
      3. Does medication itself require labs or levels to be checked
      4. Does medication have risk for dependency or abuse
      5. Is medication scheduled (use and distribution restricted)
      6. Is there a risk for interaction with other medications
      7. Does medication have new FDA guidelines or recommendations
      8. Does the benefit of continuing medications outweigh risks
    9. Doctor makes decisions about whether or not to fill prescription request and whether or not to give subsequent refills
      1. Does patient need follow-up appointment?
    10. Doctor documents decision in chart
    11. Doctor writes prescription
    12. Chart returned to nurse
    13. Nurse calls or faxes in prescription
    14. Nurse documents prescription and pharmacy in chart
    15. Chart returned to medical records.

     

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