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Our Financial Policy

Please read the following information regarding our practice's financial policy. Our main concern is in providing excellent medical care to our patients. Clear communication and understanding of the expectations regarding the payment of our fees helps us focus on the reason you came to our practice-your good health.

At the time of service, all co-pays, deductibles and past-due balances are due. We accept all major credit cards and personal checks as methods of payment. A $25.00 fee will be charged for any returned checks.

As courtesy to our patients, Atlanta Center for Gastroenterology, P.C. and Atlanta Endoscopy Cetner, Ltd. will gladly file an insurance claim on your behalf for payment of our charges. However, you are still the person responsible for your account; not your insurance company. We will file a claim for our charges within 48 hours of providing services. In most cases, if your insurance carrier has not paid the claim within a reasonable length of time, (usually 60 days) we will bill you directly for the charges. We will continue to assist you in getting your claim paid in any way possible.

Appointments cancelled without a 24-hour prior notice will result in a $50.00 fee; due and payable prior to your next visit.

If your insurance company requires you to get a referral prior to seeing our physicians, you are responisble for obtaining that referral- not our office. At the time of service, if no referal has been issued, you may still be seen but you will be responsible for payment of the charges, at the end of that visit.

If any account requires professional collections activity, the patient will be billed for all accrued interest, collection costs, court and attorney fees incurred. In the course of our collection activity, we will use information from credit bureaus to collect a debt, as well as reporting delinquent payment activity to these creit bureaus.

Statement of Privacy Practices (HIPAA)

Examples Of Disclosures For Treatment, Payment And Health Operations:

We will use your health information for treatment.
Information obtained by a nurse, physician or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her expectations of the members of your healthcare team. We will also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating you once you are discharged from the hospital.

We will use your health information for payment
A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

We will use your health information for regular health operations
-Quality Improvement: Members of the medical staff, the risk of quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare service we provide.

-Business Associates: There are some services provided in our organization through contacts with business associates. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we have asked them to do and bill your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.

-Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location and general condition.

Communication with family: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person's involvement in your care or payment related to your care.

Funeral Directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.

Marketing: We may contact you to provide appointment reminders of information about treatment alternatives or other health related benefits and services that may be of interest to you.

Food And Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Workers Compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Law Enforcement: We may disclose health information for law enforcement purposes by law or in response to a valid subpoena.

Federal Oversight Agency: Federal law makes provisions for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public.

Understanding Your Health Record/Information

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnosis, treatment, and a plan for future care of treatment. This information, often referred to you as your health or medical record, serves as a:

-Basis for planning your care and treatment

-Means of communication among the many health professionals who contribute to your care

-Legal document describing the care you received.

-Means by which you or a third-party payer can verify that services billed were actually provided.

-A tool in educating health professionals

-A source of data for medical research

-A source of information for public health officials charged with improving the health of the nation

-A source of data for facility planning or marketing

-A tool with which we can access and continually work to improve the care we rendered, and the outcomes we achieve

Understanding what is in your record and how your health information is used helps you to:

-Ensure its accuracy

-Better understand who, what, when, where, and why others may access your health information.

-Make more informed decisions when authorizing disclosure to others.

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the right to:

-Request a restriction on certain uses and disclosures of your information.

-Obtain a paper copy of the notice of information practices, upon request

-Inspect and/or receive a copy of your health record (a fee may be applied)

-Request an amendment or correction to your health record

-Obtain an accounting of disclosures of your health information

-Request communications of your health information by alternative means or at alternative locations

-Revoke your authorization to use or disclose health information except to the extent that action has already been taken.

Our Responsibilities

The organization is required to:

-Maintain the privacy of your health information

-Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you.

-Abide by the terms of this notice

-Notify you if we are unable to agree to a requested restriction

-Accommodate reasonable requests you may have to communicate health information by alternative means or alternative locations

**We reserve the right to change our practices and make new provisions effective for all protected health information we maintain. We will not use or disclose your health information without your authorization, except as described in this notice.

Atlanta Center For Gastroenterology: (404)-296-1986 - Atlanta Endoscopy Center: (404)-297-5000
2665 North Decatur Rd. Suite 550 Decatur, GA 30033
© 2008 ACGAEC

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