Office Policies and Forms
Insurance Participation*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. *
Communication and AppointmentsGetting in touch with us:
Labwork and ResultsBloodwork / Lab Appointments:
Third Party FormsWe 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.
Payment / FinancialPayment is due at the time of service. We accept Cash, Check, Money Order and Credit / Debit Card payments.
Not yet a patient? Start here.
If you are interested in becoming a patient of our office, we would love to see you! After visiting our insurance participation page to see if we accept your insurance, please visit our secure New Patient Questionnaire form at our Updox portal and complete the form to get the process started. Once this is completed and you are scheduled, we will need the following "New Patient" forms completed.
New Patient FormsAll new patients *who have already scheduled an appointment*, please print and complete the following forms and bring them to your first appointment. Otherwise, you can arrive 15 minutes before your first appointment so we may give you the forms to complete in our office:
Obtaining Medical RecordsThere are two different forms to use to obtain medical records.
Your privacy is very important to us.
- We are unable to release any information regarding healthcare, appointments, billing or insurance information to your spouse, parent, family members, significant others or friends without written authorization from the patient.
- If you would like us to speak to anyone other than yourself regarding any of these issues, please print the medical release to family member form and return it to our office.
- Patients over the age of 14 years must sign for themselves.
When our Medicare patients schedule your wellness exam, please fill out the Wellness Health History form and bring it with you to your wellness check. Otherwise, please arrive in time to fill it out in our office before your appointment.
An advance directive is a written instruction that you make while you are mentally competent that states how you want your health care decisions to be made if you become incapacitated or cannot express your wishes. Advance directives guide your physician and other health care professionals, and relieve your family from the burden of guessing what types of care and treatment you would want to receive.
We've been serving the medical needs of the Tennessee Valley for quite a while now, and we continually strive to achieve a positive patient experience. While there are some things we can't control (like insurance changes or regulations that we are required to meed), we look forward to hearing your thoughts about how we are doing and how we may improve.
- Insurance Participation
- Communication and Appointments
- Labwork and Results
- Third Party Forms
- Payment / Financial
- Prescription Refills More
- Not yet a patient? Start here.
- New Patient Forms
- Obtaining Medical Records
- Privacy / Information Release
- Wellness Health History
- Living Will / Advance Directive More
- Patient Survey
Frequently Asked Quesitons
We forward our phones to our answering service from 12:00 to 1:00; however, our office is usually open during this time.
Unfortunately, not all insurance companies cover Nurse Practitioner visits. Our office staff will do it's best to help you determine if your policy covers nurse practitioner visits. We will make every effort to inform you of this prior to scheduling appointments.
No, Dr. Wallace has elected to use Dr. Misra to oversee her patients while in the hospital. The Hospitalist will keep Dr. Wallace informed on status her patients health.
We are typically closed New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the day after Thanksgiving, Christmas Eve and Christmas Day and at times the day after Christmas.
We do require appointments, however we do have same day appointments worked into the schedule for patients with acute health issues such as sore throats, colds urinary tract infections, etc.
Yes. In order for your insurance carrier to process claims for laboratory tests they have to be ordered by the physician or nurse practitioner and submitted with a diagnosis. Scheduling an appointment also helps to ensure we have staff in the office to perform the test.
We have a 48 hour turn-around time on all prescription requests. Some prescription requests require an appointment with the physician or nurse practitioner. Please note, we will not write prescriptions for antibiotics without an examination by the physician or nurse practitioner. Please contact our office 1 to 2 weeks prior to taking your last dose of medication to ensure you do not miss taking any of your medications.
If you have an emergency call 911. All other calls may be directed to the physician on call by calling our office at 256.533.5211.