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Frequently Asked Questions

 

What are your office hours?

Our office hours are Monday – Thursday from 8:00 a.m. to 5:00 p.m. and Fridays from 8:00 a.m. to 12:00 noon. We are closed daily between 12:00 noon and 1:00 p.m for lunch. 

 

Do you close for holidays?

We have six (6) holidays per year for which we close our office. Those holidays are: New Year’s Eve, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas. On the day before Thanksgiving, Christmas, and New Year’s, we close our office at 12:00 noon. If Thanksgiving, Christmas, or New Year’s fall on a weekday, we will be closed the day immediately following the holiday. Additional holiday closures may occur depending upon where the particular holiday falls on the calendar for the year. If in doubt, please call our office at

972-596-6400 and select option 4 to speak to one of our front office team members. We also post all early closures and holiday closures on our Facebook page. 

 

Where are you located?

We are located at 4682 McDermott Road in Plano, Texas 75024. The major cross streets are Ohio & McDermott and we sit off of the southeast corner. From Highway 121, the Rasor/Hillcrest exit is the closest exit to our office.

 

What types of payments do you accept?

We accept cash, personal in-state checks, MasterCard, Visa, Discover & American Express. There is a $35 service charge for returned checks. We have also upgraded our credit card terminal to accept "chip & pin" cards in order to be compliant with new laws. You can pay your bill conveniently and securely online by clicking on, "Pay My Bill," on the menu bar.

 

Do you accept insurance?

We accept most major commercial insurance plans including, Blue Cross Blue Shield, United Healthcare, Humana, Cigna, and Aetna. We do accept United Healthcare, AARP Secure Horizons Plan 1 and Plan 2, which work with the WellMed care model. Individual plans vary greatly, so if you are uncertain if your plan is accepted by our office, please call the customer service number on the back of your insurance company and inquire if Dr. Shadle is “in-network,” with your plan. A comprehensive list of the insurance plans we accept can be found under the, "Patient Resources," tab on the menu bar.

 

Are you accepting new patients?

Yes!! Please call our front office at 972-596-6400, and select Option 4 to speak to one of our team members for help scheduling your appointment. Dr. Shadle is not accepting any new Medicare Part B patients. New Medicare Part B patients will be scheduled with Rakhi Sarkar, MD. 

 

If you are new to our practice, you may print the necessary paperwork from our website, fill it out in advance, and bring it with you to your appointment. Please bring your insurance card with you to your visit, and arrive 30 minutes prior to your actual appointment time. This allows our staff sufficient time to enter all of the necessary data into your patient chart so that we may provide you with an exceptional experience in our office. If you are a new patient and you are a "no call/no show" for your initial visit, your chart will be deactivated and you will not be able to schedule again with our office. 

 

Am I required to pay for my visit at the time of service?

All co-payments must be made prior to the time of service. Deductibles and co-insurance will be estimated using the last verified amount of your deductible. It is your responsibility to know what portion of your deductible has been met. By contractual law, protection of your insurance benefits requires us to charge for, and you to pay for, all required co-payments, co-insurances, deductibles and non-covered services.

 

If we do not participate with your managed care plan, payment in full is required at the time of service unless other arrangements have been made in advance. We may be able to bill your plan as a courtesy to you and credit your account if we receive any additional payment. If you are without health insurance, Premier Healthcare of North Texas will discount your office visit 15% and your lab fees 20% if you pay your bill in its entirety at the time of service.

 

What does my insurance plan cover?

As a courtesy to our patients, our staff verifies your basic eligibility and coverage. Knowing your insurance benefits, including eligibility, covered benefits and medically necessary procedures is your responsibility. Please contact customer service at your insurance company for questions you have regarding your coverage. You are responsible for any services not covered by your plan, including lab fees associated with covered visits and procedures.

 

Do I need to bring my insurance card with me to my visit?

You must present valid and up to date proof of insurance coverage at each visit. If you provide false or expired insurance information, you will be responsible for the balance of the claim. Please notify us of any changes in insurance prior to the time of service. Insurance denials for termination of coverage will be automatically billed to you.

 

Why did I receive a bill if my insurance paid the claim?

We will submit your insurance claims and assist you in any reasonable way to help get your claim paid. Your insurance company may need you to provide information directly to them. It is your responsibility to comply with their request in a timely manner. Texas insurance law requires your insurance company to provide timely payment. Please be aware that the balance of the claim is your responsibility to pay whether or not your insurance company has paid. We are not a party to the contract between you and your insurance provider.

 

Your office referred me a specialist, and after I made an appointment with them, I received a bill from them because they were out of network. What gives?!

If your managed care plan requires approval or authorization for referrals to a specialist, radiological imaging, medical facility care, etc, it is your responsibility to inform the office of this requirement prior to the referral. Our staff makes every effort to ensure that the specialists to whom we refer are in network with your benefits, but we cannot guarantee it.

 

Why do you charge a “no-show” fee for missed appointments? 

In order to sustain our practice for the benefit of all of our patients, appointments MUST be canceled more than 24 hours in advance of the appointment time so another patient can fill that slot. No shows, cancellations, and appointments rescheduled less than 24 hours in advance of the scheduled time are charged a cancellation fee of $75. Please note that there will be an additional charge of $25 in addition to the $75 for each subsequent missed appointment. In order to ensure that your cancellation or reschedule request is received, please submit your cancellation or reschedule request  by emailing info@premierntx.com. If you choose to call to cancel or reschedule, please document the date, time, and staff member to whom you speak so that we can verify your call through our call logs. 

I have some forms that need to be filled out by my healthcare provider. Will he/she fill them out for me?

All forms requiring medical review and physician signature, including school, day care and camp physicals, prior authorization forms, FMLA, disability or other paperwork, may be subject to a $25 to $50 administrative fee. Administrative fees may be waived at the discretion of the physician or PA if the patient has a scheduled appointment in conjunction with, and related to, the forms being completed and the forms can be completed within the time constraints of the scheduled appointment.

 

My insurance company says I have to have a “prior authorization” for a prescription. Can your office take care of that?

We will honor prior authorization requests from the patient, but the patient will be responsible for contacting their insurance company to have them forward the prior authorization form to our office. The patient will need to ask their insurance company what “alternative medications” are covered by their plan. There is $15 fee for completion of a prior authorization form. Medication changes WILL NOT be handled over the telephone. If a medication change is requested, the patient must see their physician or PA.

 

I need a prescription refilled. What do I do?

We strongly urge our patients to contact their pharmacy for ANY prescription refill requests before contacting our office. Your pharmacy will notify us of your request and we will either process the refill or notify you that your request can not be approved until you are seen for a medication check with your physician or PA. Requests for refills will be handled between 8:00 a.m. and 3:00 p.m., Monday through Friday. Any refill requests after 3:00 p.m. will be handled on the next business day. Please allow 48 hours for prescription refills.

 

I need a new prescription. Can your office call it in for me?

New prescriptions will not be sent to your pharmacy without you first seeing your healthcare provider.

 

Why do I need to use the Patient Portal?

As the healthcare industry continues to rapidly change, so do the administrative requirements of your Primary Care Physician. One of the most helpful tools for physicians is an Electronic Medical Record (EMR), which she/he uses to document your visits, track your lab work, update your immunization records, and much more. It is a contractual requirement of your insurance company that our EMR provides a way for our patients to access their records, and therefore, we utilize a patient portal hosted by www.yourhealthfile.com. Your lab results are transmitted electronically to our EMR by the lab that processed your specimen, and upon notification that your results have been received, your provider reviews them, and posts them to your patient portal. Your lab results, as well as any other clinically significant documents will be posted to your portal for you to access at any time. The portal also gives you control over your personal health information and allows you to update your allergy list, family history, insurance information, address, and more. It’s an incredibly valuable tool which enables you and your physician to communicate regarding your health.

I’m signed in to my patient portal, but don’t see my lab results. How can I find them?

If you’ve received an email letting you know that lab results are available in your patient portal, and you’ve signed in to www.yourhealthfile.com, navigate to the large, aqua block labeled, "Review Medical Record." A new page will open, and you will see a row of options down the left side of the page. Near the bottom is a tab labeled, "Orders." Click on the Orders tab, and you will be able to view your lab results. If your healthcare provider has not yet reviewed the results and electronically signed the order, you will not be able to view the results. Our lab results are received electronically from the laboratory, and then reviewed by your provider before the results are available to view in your patient portal. This process typically takes 24-48 hours from the time your blood is drawn in our office. For step by step assistance with viewing your results, see "Patient Portal Assistance" here

                                                                                                                                           

Why do you need to take my picture when I come to your office?

The reason we take your picture for your chart is two-fold. First and foremost, taking your photo greatly assists your healthcare provider in detecting subtle changes in your physical appearance, and helps him/her establish a “baseline.” Health issues affect a person’s physical appearance, and physicians find photographs particularly helpful in diagnosing certain conditions. Secondly, having your photograph in your chart helps our staff ensure they are speaking to the correct person. Many names are similar, some are gender neutral, and occasionally, exactly the same. Being able to have a photo to match with a name, helps us protect your privacy and enables us to provide you with a more personalized experience in our office.

 

What is a “medication check,” and why do I need it?

If you have been prescribed medications by your healthcare provider for a diagnosed condition, your provider will ask that you schedule medication checks every 3 months, OR every six months, depending on the medications, your age, your health and your compliance with taking the medications as prescribed. When a medication check is scheduled, in most cases, you will be asked to fast and have your blood drawn (i.e., fasting blood work) at least one week prior to your scheduled appointment. Fasting blood work needs to be scheduled, and you need to fast for 10-12 hours prior to having your blood drawn. When fasting for blood work, please consume only water, unsweetened tea or black coffee until after your blood is drawn. The draw station is open from 8:00 a.m. until noon and from 1:00 p.m. until 3:00 p.m., Monday through Thursday, and from 8:00 a.m. until 11:30 a.m. on Friday. For medication checks, your blood is drawn prior to your appointment, so that your provider has the opportunity to receive the results of the blood work and review them so that he/she can discuss the results with you at your appointment. Any changes or adjustments to your medications will be made during this appointment and any required renewals on your prescriptions will also be taken care of. Be sure to discuss any and all medications of concern with your provider at this visit. Please understand that your provider can NOT diagnose or treat you for an illness or problem during a medication check.

 

What do I need to know about routine physicals and wellness exams?

Most, but not all, major insurance companies pay for one physical every 366 days for men. For women, most insurance companies pay for one physical AND one well-woman exam every 366 days. Check with your insurance company to verify your eligibility and coverage for wellness exams.  Please understand, that per insurance guidelines, physicals and wellness exams will be covered by your insurance ONLY if you discuss NO complaints, your healthcare provider does NOT diagnose a problem during your visit and does NOT treat you for an illness or problem during your visit. If you have a health concern or illness that you feel needs addressed, we cannot code your visit as a wellness visit per insurance guidelines. Most, but not all, major insurance companies are now covering the office visit portion of your wellness exam 100%. In some cases, however, your particular insurance plan may not cover all of the tests and/or blood work that are considered to be a routine part of a wellness exam. Please check with your insurance company to verify your eligibility and coverage for wellness exams. You will need to let us know prior to your exam, if your insurance company has limitations on what kinds of tests and blood work can be performed by your healthcare provider as a part of your wellness exam. In some cases, your healthcare provider may want to conduct additional tests that he/she feels are necessary to properly evaluate your medical state, but that might not be covered by your insurance. Therefore, it is imperative that you arrive at your appointment well informed of your benefits and coverage. If your healthcare provider feels that additional testing is necessary, he/she will discuss the tests with you and together you will determine how to proceed. Please arrive fasting to your wellness exam because your blood will be drawn. Also, please arrive 15 minutes prior to the exam so that your healthcare provider’s Medical Assistant will have ample time to review your medical history, record your vitals and have you in the exam room to see your provider at your scheduled time.

 

The following list consists of routine tests that MAY be conducted during your wellness exam, or ordered by your healthcare provider as a part of your exam. Some tests may not be applicable to you based on our age, sex and appropriateness to your state of health:

 

Vitals- (height, weight, temperature, blood pressure, pulse & vision) – are basic parameters that can be used to detect immediate problems or to be used as a baseline for future reference.

Urinalysis – Used to test for factors relating to the urinary system. This test can be an indicator of other organ or body conditions.

Complete Blood Count (CBC) – Exam of red & white blood cells used to provide information regarding condition such as anemia, infections, leukemia, etc.

Comprehensive Metabolic Panel (CMP) – This is a computerized test that examines 14 blood chemistries relating to diabetes, electrolytes, gout, liver & kidney function,  muscle, bone and calcium metabolism.

Lipid Profile – Tests for your cholesterol and triglycerides, the

“good” HDL and “bad,” LDL fractions. Also includes a risk ratio for cardiovascular events.

Homocysteine – Test that is a marker of your risk for heart attack.

Thyroid – Basic screen of the glandular/metabolic condition.

Electrocardiogram (ECG) – A non-invasive procedure that shows rhythm and electrical abnormalities of the heart. This is a necessary baseline test. One-third of heart attacks are diagnosed during routine ECG’s.

Pap Smear (women only) – A simple, but very useful test that screens for cervical cancer, infections, abnormalities, etc. This test should be performed annually after the age of 18.

Prostate Specific Antigen or PSA (men only) – A blood test for males which helps detect prostate cancer.

 

Other tests that your healthcare provider may outsource as a part of your routine wellness exam include, but are not limited to:

 

Chest x-rays, Spirometry, Mammograms, Bone Density, Stool Hemocult, Colonoscopy, and Stress ECG.

 

If you have any questions regarding any of the above tests, please contact our office and ask to speak with a Medical Assistant. We believe that providing information to our patients greatly aids in their understanding of the process and results in a more successful examination.

 

Can I get a copy of my medical records?

In accordance with Texas law, Premier Healthcare of North Texas requires written requests for the release of all medical records. We can provide you with the appropriate form at your request. The administrative fee associated with copying medical records is based on current Texas law and allows up to 15 business days to deliver the requested medical records. Please take this in to consideration when requesting copies of your medical records. The fee for copying medical records is $25 for the first 20 pages and $.50 (fifty-cents) per page thereafter. Expedited requests will be charged an additional $25 fee. If you would like an electronic copy of your medical records, the fee to provide them is $25 for up to 500 pages of records.  If you are transferring your care to another physician, we are able to electronically transmit your records to another medical office. There is no fee for electronically transferring your medical records to another physician.