Office Policies

Mountain View Orthopaedics Office Policies

Mountain View Orthopaedics and Associates has several policies of which all patients should be aware.

Please review the following list of policies:

Download the policies using the button above, then print and sign the form, and take it with you to your appointment. A complete list of our office policies is also shown here on this page.

No Show Visits
If you cannot keep your scheduled appointment you must notify our office at least 24 hours in advance. If not, you will be billed $50.00. As a courtesy you will not be billed for your first missed appointment.

Prescription Refills
(1) Prescription refill requests must be called into the office before 12:00 noon on Tuesday, Thursday or Friday. Do not call on Monday or Wednesday. These are patient days and Dr. and staff are with patients all day.
(2) No refills will be called in by any on-call Dr. You must call during the hours mentioned above or your request will be delayed.
(3) No refills for narcotics will be called in at night or on weekends. No exceptions.

Referral Policy
If your insurance requires you to have a referral to be seen it is your responsibility to obtain that referral. If you do not have a referral the day of treatment it is Dr.’s discretion to reschedule the appointment.

Form Fee/Medical Records Request
Each patient will be advised as to the amount to be paid for having form/s or medical records filled out. There will also be a charge to fax/mail all forms and medical records. There is a 7-10 day turnaround time for forms and medical records requests.

Copays
If your insurance requires you to pay a co-pay it must be collected prior to your treatment. If you do not pay your copay the day of the visit it is Drs. descretion to reschedule the appointment.

Workman’s Compensation and Auto Insurance
If your injury is a result of an accident you must provide our office with information on your comp./auto carrier, as well as any other insurance you may have. Failure to do so will result in rescheduling or cancelling your appointment. If your other insurance requires a referral we ask that one be acquired from your PCP before your scheduled visit. In the event WC/Auto denies your claim then we can bill your other insurance. You may be rescheduled without a referral. This office does not schedule patients with an attorney involved or are in active litigation due to the injury they are requesting an appointment for.

Payment
Payment is expected before you leave our office. If you have insurance, we will gladly submit your claims, but we request that you pay your portion of the fee after services have been rendered. Please be aware that we call every patient’s insurance to verify eligibility, co-pays, etc. This is done so we can inform each patient of exactly what amount is owed at the end of each visit. If you pay by check and that check bounces you will be charged $25.00 plus the amount of the check. Payment is then required in cash and that account is flagged. All visits will then be required to be paid in full, in cash, before being seen. Any accounts that must be sent to collections for any reason will result in that patient being discharged from the practice. Anyone placed on a payment plan and misses one months payment will be automatically dismissed, if they do not call our billing office and inform them of the reason for the missed payment and an additional fee for the collection process will be charged.

X-ray and Lab Work
If you have had x-rays and/or lab work prior to your visit, all films and/or lab results should be brought with you. If they are not, it is the Dr.’s discretion to reschedule your visit. All results from x-rays or labs ordered by the Dr. should be considered normal unless you receive a phone call from someone on our staff stating otherwise.

Separate Appointments
The Doctor and staff would like to provide the best care possible for any new or existing problems you may have developed since scheduling your appointment. Patients will schedule separate appointments for separate problems. If you ask for a second problem to be seen and that problem was not scheduled to be seen you will be asked to schedule a separate appointment for the problem.

Privacy Practices
Please see the 2-page Notice of Privacy Practices included with this Office Policy sheet.

There are absolutely no exceptions to any of these polices!