Patient Information

Practice Policies

Appointments

In order to stay on time and provide the most comprehensive care for our patients, we require that all appointments be scheduled. You may call our office from 7:30am-4:00pm Monday through Friday.

With great effort, we try to see patients who are SICK on the same day. Please call between 7:30am-9:00am for the best chance of being seen that day.

Please be on time for your appointment. We request that you arrive 5-10 minutes before your scheduled time in order to complete the check-in process.  Our providers make every effort to be on-time during the day, but emergencies and complicated care issues do arise.  We appreciate your patience during these times.

During inclement weather please call the office or check the website to make sure we are open. We do our best to contact patients who have scheduled appointments, to inform them of any office closings.

We require 24 hour notice if you are unable to keep an appointment with our office. This is in order to be able to offer that appointment time to another patient who may be in need of care.  There is a $50 charge for any missed physical, ultrasound, surgery, or treadmill appointment.  There is a $25 charge for any missed office, nurse, or lab visit.  These charges will be your responsibility and billed directly to you.  Please help us to serve you better by keeping your regularly scheduled appointment.  Any balance accumulated because of a missed appointment fee will need to be paid before scheduling another appointment.

Messages and Call Backs

We want to provide the best in patient care and desire to have any questions or concerns attended to in a timely manner. Our message and call back policy is designed so that we can address patient messages accordingly while still allowing providers the time needed to deliver focused quality care that patients need during office visits.  Our message and call back policy are as follows:

The non-Urgent message may be left on your provider’s nurse’s voicemail. You may reach this voicemail by calling our main number at 919-858-8360 and following the prompts to reach your provider’s nurse.  We do our absolute best to return calls the same day, however, we do request 24-48 hours before you try calling back.

If you are calling because your symptoms are not improved or are worsening our providers require you to schedule another appointment in order to reassess your condition and determine if your diagnosis or treatment plan needs to be adjusted.

If you call after business hours the phone recording will provide you with information on how to reach the on-call provider. If you have an emergency, please call 911 or go to the nearest emergency room.

Lab and Diagnostic Imaging Results

We will contact you with the results of any labs or diagnostic imaging that we have ordered. We will either mail you a copy or call you with those results.

Certain testing may take up to a week to produce a result. After this, it has to be reviewed by your provider.  Therefore, we do ask if you have not been notified of your results within two weeks that you please contact our office.

All appointments for lab work must be accompanied by or followed up with an office visit unless specifically stated otherwise by the provider. Results will not be provided otherwise.

We do not perform laboratory testing for other providers. If you are given a lab order from another physician or another physician would like you to have certain testing performed you will need to go to an outpatient lab service center such as Lab Corp or Quest Diagnostics in order to get that testing done.

Prescription Refills

Prescription refill requests should be called into your provider’s nurse by the patient or the pharmacy. We do not accept fax refill requests from the pharmacy, therefore if you ask the pharmacy to request the refill make sure to inform them of this fact.  Otherwise, they will attempt to fax us causing your prescription to not be filled.  Please allow 48 hours for medication refills to be called in.  Contact our office at least a week before your medication runs out to avoid missing any doses.

Certain medications require regular monitoring in order for our office to prescribe them.  Therefore you may need to schedule an office visit for certain refills.

Our providers will not call in antibiotics over the telephone. They feel it is important that we correctly diagnose you to prescribe medications.  This requires them to physically see you in the office and perform a full assessment.

We do not call in or fax prescription refills to mail-order pharmacies. It is our office policy for the patient to mail their prescriptions themselves.  Please make your provider or nurse aware that your prescription needs to be written for a 90 day supply.

Certain controlled substances cannot be called into the pharmacy and you will need to pick up the prescription and turn it into the pharmacy yourself. In addition since these types of medications are monitored very closely if you lose your prescription or the medication itself we will not be able to rewrite a new prescription for you.

Referrals

If a provider refers you to a specialist we have a specific protocol for those referrals.

If it is a type of specialist that does not require information from our office in order to schedule your consult you will be given a list of offices that we refer to in order for you to contact that office and schedule your own appointment.

If it is a type of specialist that does require documentation from our office then you will need to be seen in our office first, if you have not been seen for the problem already. We must wait for the provider’s office note and any lab work or diagnostic imaging that you may have had to return in order to send a referral to the specialist.  They themselves will contact you to schedule a consult.  Please allow 2 weeks for this process.  If you have not heard from the specialist’s office by that time please contact our office so that we may check on the status of your referral.

Some insurance plans require authorization from our office in order for you to see a specialist. If that is true for your insurance plan please make our office aware so that we can obtain that authorization before you see the specialist.  As with the referral we must have seen you for the problem in order for us to obtain insurance authorization.  These authorizations do take time, therefore we require at minimum 3 days notice before your visit to see the specialist; otherwise, the specialist’s charges will be your financial responsibility.

Medical Records and Forms

Copying and transfer of medical records require a signed release by the patient. There is a pre-payment required before records can be copied.  The fee to pick up your medical records is $25.  If you want your medical records mail then the fee is $28.  Once payment is received please allow 7 days to copy and mail records or if you would like to pick them up we will contact you once they are ready.

We will complete forms for sports physicals, FMLA, work physicals, and short-term disability. Depending on the amount of time involved in completing the forms there may be a form completion fee of $35 that would need to be paid prior to our office completing the forms.  We will contact you once the forms are completed and ready to be picked up.

Financial Policies

Thank you for choosing us as your primary care provider. We are committed to providing you with quality and affordable health care. Your clear understanding of our financial policies is important to our professional relationship. Please ask if you have any questions regarding our policies.  It is your responsibility to notify our office of any patient information changes (i.e. address, name, insurance information, etc).

 Insurance

We participate in many insurance plans. You can check our website for a list of plans that we are in network with. It is your responsibility to verify with your insurance company if we are in-network with your particular plan.  If you are not insured by a plan we do business with, payment in full is expected at each visit. If you are insured by a plan we do business with, but don’t have an up-to-date insurance card, payment in full for each visit is required until we can verify your coverage. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.

Co-payments and deductibles

All co-payments, deductibles and/or co-insurance must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment at each visit.  We accept cash, check, Visa, Mastercard, Discover, and American Express.

Non-covered services

Please be aware that some – and perhaps all – of the services you receive may be not covered or not considered reasonable or necessary by insurers. You must pay for these services in full at the time of visit.

Proof of insurance/Coverage Changes

All patients must complete our patient information form before seeing the doctor. We must obtain a copy of your driver’s license and current valid insurance to provide proof of insurance. If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits.  If you fail to provide us with the correct insurance information in a timely manner, you will be responsible for the balance of a claim.

 Claims submission

Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.

We will submit your claims to your primary insurance carrier if we participate with your plan. We do not submit claims to a secondary or tertiary carrier.  If you have insurance that we do not participate with, then we can provide you with a claim form that you can submit to your plan for out of network reimbursement if you have those benefits.  Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. If your insurance company does not pay your claim in 45 days, the balance will automatically be billed to you. Please be aware that the balance is your responsibility whether or not your insurance company pays your claim.

Nonpayment

If your account is over 90 days past due, you will receive a letter stating that you have 20 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated. Please be aware that if a balance remains unpaid, we may refer your account to a collection agency and you and your immediate family members may be discharged from this practice. If this is to occur, you will be notified by regular and certified mail that you have 30 days to find alternative medical care. During that 30-day period, our physician will only be able to treat you on an emergency basis.

Returned Checks

The charge for a returned check is $10 payable by cash or credit card. This fee will be applied to your account in addition to the insufficient funds amount.

Workers’ Compensation

Our office does not perform any visits related to any injury sustained at work. We will not complete any paperwork or submit claims for Workers’ Compensation.  You should contact your Human Resource Department to find out where they would like you to seek treatment.

Motor Vehicle Accident and Third Party Billing

We do not do any third-party billing. Our relationship is with you and not with the third-party liability insurance (auto, homeowner, etc.)  It is your responsibility to seek reimbursement from them.  However, at your request, we will submit a claim to your primary health insurance carrier.  You may receive an accident questionnaire from them to be completed by you.  If the questionnaire is not returned to your medical insurance company and/or we receive a denial on your claim, you will be responsible for payment in full.

Our practice is committed to providing the best treatment to our patients. Our prices are representative of the usual and customary charges for our area. Thank you for understanding our financial policies. Please let us know if you have any questions or concerns.

While we accept the insurance plans listed below, you are encouraged to call the customer service number on your insurance card to verify we are an In-Network provider.

-Blue Cross Blue Shield Options/Anthem BCBS/NC State Health Plan BCBS/Blue Advantage/Blue Options/Blue Care/Classic Blue/Blue Select

We are OUT-OF-NETWORK with Blue Home and Blue Local

-Aetna

We are OUT-OF-NETWORK with Duke Basic and Duke Select

-Cigna

We are OUT-OF-NETWORK with Cigna Connect

-United Healthcare/UMR

We are IN-NETWORK with UHC Compass.  You must select one of our providers as your primary care provider in order to have services covered in our office.

-Medcost

-Maestro

-First Health

-Tricare (All Tricare Plans including Tricare Prime)

For Tricare Prime, you must select one of our providers as your Prime PCP in order to have services covered in our office.

__________________________________________________________________________

Medicare and Medicare Advantage

We are NON-PARTICIPATING providers.  We DO NOT accept new Medicare patients.

If you are an established patient (seen within the last three years) and you will be transitioning into Medicare Part B or a Medicare Advantage Plan, please read the following information on our office payment policies for Medicare patients.  Medicare Handout

Payments

To make a payment enter the amount you are paying below. Then click on the Pay Now button. This will direct you to another page to make a payment on your account.

Notice of Privacy Practices

This notice describes how MacGregor Family Physicians, P.A. may use and disclose your healthcare information and how you can obtain access to this information. Please review it carefully.

MacGregor Family Physicians, P.A. is required by law to maintain the privacy of your protected health information. This information consists of all records related to your health, including demographic information, either created by MacGregor Family Physicians, P.A. or received by MacGregor Family Physicians, P.A. from other healthcare providers.

We are required to provide you with notice of our legal duties and privacy practices with respect to your protected health information. These legal duties and privacy practices are described in this Notice. MacGregor Family Physicians, P.A. will abide by the terms of this Notice, or the Notice currently in effect at the time of the use or disclosure of your protected health information.

MacGregor Family Physicians, P.A. reserves the right to change the terms of this Notice and to make any new provisions effective for all protected health information that we maintain. Patients will be provided a copy of any revised Notices upon request. An individual may obtain a copy of the current Notice from our office at any time.

Uses and Disclosures of your Protected Health Information not Requiring Your Consent
MacGregor Family Physicians, P.A. may use and disclose your protected health information without your written consent or authorization for certain treatment, payment, and healthcare operations. There are certain restrictions on uses and disclosures of treatment records, which include registration and all other records concerning individuals who are receiving, or who at any time have received services for mental illness, developmental disabilities, alcoholism, or drug dependence. There are also restrictions on disclosing HIV test results.

Treatment may include:

• Providing, coordinating, or managing healthcare and related services by one or more healthcare providers
• Consultations between healthcare providers concerning a patient
• Referrals to other providers for treatment
• Referrals to nursing homes, foster care homes, or home health agencies

For example, MacGregor Family Physicians, P.A. may determine that you require the services of a specialist. In referring you to another doctor, MacGregor Family Physicians, P.A. may share or transfer your health care information to that doctor.

Payment Activities may include:

• Activities undertaken by MacGregor Family Physicians, P.A. to obtain reimbursement for services provided to you
• Determining your eligibility for your benefits or health insurance coverage
• Managing claims and contacting your insurance company regarding payment
• Collection activities to obtain payment for services provided to you
• Reviewing healthcare services and discussing with your insurance company the medical necessity of certain services or procedures, coverage under your health plan, appropriateness of care, or justification of charges
• Obtaining pre-certification and pre-authorization of services to be provided to you

For example, MacGregor Family Physicians, P.A. will submit claims to your insurance company on your behalf. This claim identifies you, your diagnosis, and the services provided to you.

Healthcare Operations may include:

• Contacting healthcare providers and patients with information about treatment alternatives
• Conducting quality assessment and improvement activities
• Conducting outcomes evaluation and development of clinical guidelines
• Protocol development, case management, or care coordination
• Conducting or arranging for medical review, legal services, and auditing functions

For example, MacGregor Family Physicians, P.A., may use your diagnosis, treatment, and outcome information to measure the quality of the services that we provide, or assess the effectiveness of your treatment when compared to patients in similar situations.

MacGregor Family Physicians, P.A. may contact you by telephone or mail, to provide appointment reminders. You must notify us if you do not wish to receive appointment reminders.

We may not disclose your protected health information to family members or friends who may be involved with your treatment or care without your written permission. Health information may be released without written permission to a parent, guardian, or legal custodian of a child; the guardian of an incompetent adult; the healthcare agent designated in an incapacitated patient’s heath care power of attorney; or the personal representative or spouse of a deceased patient.

There are additional situations when MacGregor Family Physicians, P.A. is permitted or required to use or disclose your protected health information without your consent or authorization. Examples include the following:

• As permitted by law.
  In certain circumstances we may be required to report individual health information to legal authorities, such as law enforcement officials, court officials, or government agencies. For example, we may have to report abuse, neglect, domestic violence or certain physical injuries. We are required to report gunshot wounds or any other wound to law enforcement officials if there is reasonable cause to believe that the wound occurred as a result of crime.
  Mental health records may be disclosed to law enforcement authorities for the purpose of reporting an apparent crime on our premises.
• For public health activities
  We may release healthcare records, with the exception of treatment records, to certain government agencies or public health authority authorized by law, upon receipt of written request from that agency. We are required to report positive HIV test results to the state epidemiologist. We may also disclose HIV test results to other providers or persons when there has been or will be risk of exposure.
  We may report to the state epidemiologist the name of any person known to have been significantly exposed to a patient who tests positive for HIV. We are required by law to report suspected child abuse and neglect and suspected abuse of an unborn child, but cannot disclose HIV test results in connection with the reporting or prosecution of alleged abuse or neglect. We may release healthcare records, including treatment records and HIV test results to the Food and Drug Administration when required by federal law. We may disclose healthcare records, except for HIV test results, for the purpose of reporting elder abuse or neglect, provided the subject of the abuse or neglect agrees, of if necessary to prevent serious harm. Records may be released for the reporting of domestic violence if necessary to protect the patient or community from imminent and substantial danger.
• For health oversight activities
  We may disclose healthcare records, including treatment records in response to a written request by any federal or state governmental agency to perform legally authorized functions, such as management audits, financial audits, program monitoring and evaluation, and facility or individual licensure or certification. HIV test results may not be released to federal or state governmental agencies without written permission, except to the state epidemiologist for surveillance, investigation, or to control communicable diseases.
• Judicial and Administrative Proceedings
  Patient healthcare records, including treatment records and HIV test results, may be disclosed pursuant to a lawful court order. A subpoena signed by a judge is sufficient to permit disclosure of all healthcare records except for HIV test results.
• For activities related to death.
  We may disclose patient healthcare records, except for treatment records, to a coroner or medical examiner for the purpose of completing a medical certificate or investigating a death. HIV test results may also be disclosed under certain circumstances.
• For research
  Under certain circumstances, and only after a special approval process, we may use and disclose your health information to help conduct research.
• To avoid a serious threat to health or safety.
  We may report a patient’s name and other relevant data to the Department of Transportation if it is believed that a patient’s vision or physical or mental condition affects the patient’s ability to exercise reasonable or ordinary control over a motor vehicle. Healthcare information, including treatment records and HIV test results, may be disclosed where disclosure is necessary to protect the patient or community from imminent and substantial danger.
• For workers’ compensation.
  We may disclose your health information to the extent such records are reasonably related to any injury for which workers’ compensation is claimed.

MacGregor Family Physicians, P.A. will not make any other use or disclosure of your protected health information without your written authorization. You may revoke such authorization at any time, except to the extent that MacGregor Family Physicians, P.A. has taken action in reliance thereon. Any revocation must be in writing.

Your Rights Regarding Your Protected Health Information

You are permitted to request that restrictions be placed on certain uses or disclosures of your protected health information by MacGregor Family Physicians, P.A. to carry out your treatment, payment, or health care operations. You must request such a restriction in writing. We are not required to agree to your request, but if we do agree, we must adhere to the restriction, except when your protected health information is needed in an emergency treatment situation. In this event, information may be disclosed only to healthcare providers treating you. Also, a restriction would not apply when we are required by law to disclose certain healthcare information.

You have the right to review and/or obtain a copy of your healthcare records, with the exception of psychotherapy notes, or information compiled for use (or in anticipation for use) in a civil, criminal, or administrative action or proceeding. MacGregor Family Physicians, P.A. may deny an access under other circumstances, in which case you have the right to have such a denial reviewed. We may charge a reasonable fee for copying your records.

You may request that MacGregor Family Physicians, P.A. send protected health information, including billing information, to you by alternative means or to alternative locations. You may also request that MacGregor Family Physicians, P.A. not send information to a particular address or location or contact you at a specific location, perhaps your place of employment. This request must be submitted in writing. We will accommodate reasonable requests by you.

You have the right to request that MacGregor Family Physicians, P.A. amend portions of your healthcare records, as long as such information is maintained by us. You must submit this request in writing, and under certain circumstances the request may be denied.

You may request to receive an accounting of the disclosures of your protected health information made by MacGregor Family Physicians, P.A. for the six years prior to the date of the request, beginning with disclosures made after April 14, 2003. We are not required, however, to record disclosures we make pursuant to a signed consent or authorization.

You may request and receive a paper copy of this Notice, if you had previously received or agreed to receive the Notice electronically.

Any person or patient may file a complaint with MacGregor Family Physicians, P.A. and/or the Secretary of Health and Human Services if they believe their privacy rights have been violated. To file a complaint with MacGregor Family Physicians, P.A., please contact the Privacy Officer at the following address:

Privacy Officer
MacGregor Family Physicians, P.A.
580 New Waverly Place, Suite 120
Cary, NC 27511
919-858-8360

It is the policy of MacGregor Family Physicians, P.A. that no retaliatory action will be made against any individual who submits or conveys a complaint of suspected or actual non-compliance or violation of the privacy standards.

This Notice of Privacy Practices is effective April 14, 2003.