Neurology of Central Georgia

Consent – Who Can Accompany Patient Into Exam Room

• If you are being seen thru Worker’s Comp, we will only allow the patient in the exam room.  If a NCM or Adjustor wants to meet with Dr. Athni, they will need to schedule a separate appointment with the front office.
• If you are an adult and are being seen thru your private insurance or Medicare or Tricare, we will allow your spouse into the exam room.
• BUT, for anyone else, we will need a Medical Power-of-Attorney (Medical POA) or a Notorized letter stating the third-party is allowed to be involved in the patient’s care.  This would include friends or a parent of a patient or an adult child of a patient.
• This is a standard practice in Psychiatric offices.  Although we are not treating Psychiatric illnesses, many of our patients have cognitive issues.  To make sure decisions are being made in the best interest of the patient, we require such a POA.  Even if you do not have any issues which involve your cognitive abilities, we have one policy for all patients.
• We hope you understand the rationale for this policy.  We are merely trying to make sure unauthorized people (who may not have the patient’s best interest) are not involved in medical decisions.

Scheduling Appointments

• We are a “referral only” office.  We require a referral from your primary care physician.
• As soon as our office receives your referral, we will first verify your insurance benefits to make sure we are part of your insurance network. (Please look at “Insurance Networks” on the web site to see our network affiliation.)
• We request you forward a copy of your medical records prior to scheduling your initial appointment.  We will review your medical records before an appointment is given.  We reserve the right to NOT schedule an appointment – after reviewing your medical records, we may decide we will not be able to participate in your medical care.
• Our office staff will then contact you directly to schedule the initial appointment.
• We try to see patients within 2 weeks of receiving the referral.
• We normally see new patients Monday mornings or Thursday afternoons
• We will try to accommodate your personal / work schedule to minimize any inconvenience.
• If the appointment involves a Work-Comp issue, we must obtain a written approval from the WC adjuster prior to scheduling the appointment.
• We request ALL new patients to arrive at the office at least 1 hour BEFORE their scheduled appointment.
• This will ensure that all paperwork issues are completed before your scheduled appointment time. Otherwise, your consultation time will be delayed.

Medication Refills

What medications will be refilled?

• Our office will only refill those medications we have prescribed, AND only if you are an active patient in our practice.

How many refills will be prescribed?

• During your office visit, we will try to prescribe medications with enough refills to last you until your next office visit
• If you cancel your follow up appointment, we will NOT refill your medications until you are re-evaluated by Dr. Athni
• If you choose not to re-schedule your appointment, you should consider obtaining all further refills thru your primary care physician

How are refills processed??

• We normally refill medications during the office visit
• We send all medication refills thru eRx (electronic prescribing system)
• The eRx system minimizes human error, and reduces prescription filling time
• Once we send an eRx prescription, an eRx is typically processed and filled within 1 hour by most pharmacies

“Calling in” prescriptions

• To minimize errors, we will NOT “call in” a refill medications
• If your pharmacy does not accept electronic prescriptions, we will give you a hand-written prescription during your office visit for you to hand-carry or mail to your pharmacy

Narcotics Pain Medications and Controlled Medications

• Many pain medications are “controlled” and monitored by the DEA (Drug Enforcement Agency) to minimize fraud and abuse
• We will NOT prescribe or refill any controlled narcotic pain medications
• We WILL prescribed non-narcotic, controlled medications.  These medications will ONLY be refilled during a face-to-face office visit

Auto Accident Evaluations

• If your medical issues are related to a recent motor vehicle accident, we will not wait for payment from your auto insurance or from your attorney.
• You will be responsible for full payment of any and all charges incurred at our office.
• You can file the claim with your auto-insurance company.
• We will NOT accept a delayed payment from “3rd party liability” benefits as a result of any auto accidents.
• We will NOT accept any “liens” or “promissory notes” from your attorney.

Insurance Network Contracts:

• We have entered into a contractual agreement with the following insurance companies. The list is NOT exhaustive, as there over 100 different insurance companies. The list only highlights the “major” insurance carriers in this area.
• Since we are not affiliated with the Medical Center, we are not allowed to be part of Secure Health, which is an insurance network owned and managed by the Medical Center of Central Georgia.
  • Tri-Care – Military (Standard, Prime, Tricare-for-Life)
  • Blue Cross / Blue Choice
  • Cigna Insurance
  • United HealthCare
  • Aetna
• If an insurance company is not listed, please call our office to verify network coverage.

Medicare:

• We are Medicare “Participating Providers”. As such, we accept the Medicare Part-B fee schedule.
• You must show proof of Medicare Part-B coverage before we can accept you as a Medicare patient.

Medi-CAID:

• We are NOT accepting any new MediCAID patients.

Expected Payments

If you are a Work Injury or IME patient – No payment is required at time of office visit

• If you are being seen as an authorized Work Injury patient or as an authorized IME, you will NOT be asked to pay anything. All your bills will be handled through your Worker’s Compensation Insurance Company or your attorney.

What is your payment if you have Medicare?

• If Medicare is your primary insurance, then we expect 20 percent of your “Medicare allowable charges” and any deductible required for the calendar year.
• Per federal regulations, the Medicare deductible for calendar year 2020 is $198.

What is your payment if you have commercial (PPO or HMO) insurance?

• We will typically verify your insurance before you arrive at our office.
• If we are a “participating provider” for your insurance plan, then we will only collect the co-pay (either a set dollar amount or percentage).
• You may also be asked to pay any deductible that may not have been met for the calendar year.

What if we are NOT in your insurance network?

• If we are not in your insurance network, you may be asked to pay your bill in-full.
  Please discuss this with our office manager prior to your office visit.

What if you have NO insurance?

• If you are a NEW patient without a valid verifiable insurance, we will NOT be able to see you as a patient
• If you are an existing patient and have lost your insurance or we are no longer in your insurance network, then we expect full payment at the time of service.

Insurance Verification:

• We will verify your insurance PRIOR to your office visit.
• This verification will inform us of your insurance contract stipulations, including any co-pays you are required to pay.

WHEN to Pay:

• We expect payment at the time of service.

TYPE of Payment:

• Our office prefers cash or credit card (MC, Visa, Discover, and Amex).
• You may also pay On-Line thru this web site. We offer a Secure Payment process, powered by Pay-Pal.
• Due to the high number of “bounced checks”, we do NOT accept checks as a form of payment.

Filing Insurance Claims

What insurance claims do we file?

• We will file all Primary insurance claims.

How do we file insurance claims?

• If your insurance company is setup for electronic filing, we will file this claim electronically through our computer system.

When do we file the insurance claims?

• Typically, we file your claim within 7 days after the office visit.

NOTE: Although we may file your claim, it is quite common for insurance companies to “lose” and “not process” the claims. They commonly state that they did “not receive” our claims.

• Hence, it can sometimes take a few months for your claim to be processed properly.
• If we have not received payment within 45 days, we will re-file your claim.

Do we file Secondary insurance claims?

• Although we file all Primary insurance claims, we generally do NOT file Secondary insurance claims.
• Some insurance companies will transfer your claim automatically to the Secondary carrier, in which case it will get processed without any further intervention.
• Else, you will be required to submit the claim to your Secondary carrier after you receive the EOB (Explanation of Benefits) from your Primary insurance company.

Monthly Statements

When do we mail account statements?

• We mail account statements only AFTER the insurance has paid their portion.
• We will wait for payment from your insurance company before we send you a “Payment Due” bill. Sometimes, it may take up to 6 months (or longer) for us to receive the initial payment from your insurance company, so don’t be surprised if you receive a statement from us many months after services are rendered.
• If your insurance does not pay us anything, you will receive a bill for the full amount.
• We normally mail account statements once a month.

What if there is a zero balance?

• If your insurance company pays “in-full”, and there is NO balance due, you will NOT receive a statement.

What if there is a “balance due” on your account?

• If your insurance company only pays us a partial amount, and there is a remaining balance, we will send you a statement during the first week of the month following payment from the insurance company, and each month there-after until the balance is paid.

How many statements are mailed?

• You will receive a total of 3 statements from our office before sending your account over to a Collections Agency.

What if NO payment is made towards an open balance?

• If no payment is made towards your open balance after 3 monthly statements, your account will be sent to a local Collections Agency for further legal action.
• A separate “collections fee” will also be assessed above and beyond your open balance to cover the cost of the collections process.

Methods of Payment

• You may pay all or part of your open balance at any time. As long as there is an open balance, you will receive a monthly statement from our office. You may mail us your payment or stop by the office to pay.
• We accept cash, credit cards (Visa, MC, Discover, Amex), or debit cards.
• You may also pay on-line using our secure payment method powered by Pay-Pal.

On-Line Payment

• If you would like to pay a portion or all of your open balance, please use the form below.
• We use a Secure Payment process, powered by Pay-Pal. Please enter your Name and Birth Date so we can credit the correct account with your payment.
• After you click on the “Pay Now” button, you will be taken to a secure PayPal driven web site, where your payment will be processed.
• After the payment process, you will have a chance to enter any “comments or instructions” regarding your payment.