Office Policies

Referral Policy - 48 hours notice is required for referrals to allow for proper preparation.  Referrals are not guaranteed when less than 48 hours notice is given.  You also will be responsible for providing the name of the specialty doctor and your diagnosis at the time of the referral request.  Referrals can be requested online or by phone.

Retroactive Referrals cannot be issued so please get your referral prior to your specialty appointment.

Prescription Refills - when contacting the office for a prescription refill by phone or online, the correct name of the medicine, dosage, and instructions on how you are taking the medicine must be provided.  Pharmacy information including the pharmacy name, phone number, address, including zip code is also necessary for completion. Please allow 24 - 48 hours for processing of prescriptions.  Prescription refills will not be called in outside of normal business hours, including weekends and evenings after the office has closed. 

Physician Emergency On Call Policy - when the office is closed a physician is on-call 24 hours a day for true medical emergencies.  The physician is to be contacted when the office is closed for MEDICAL EMERGENCIES ONLY.  Because of the increased risk of missed diagnoses, delay in treatment, and possible serious medical consequences of treating patients over the telephone, the on call physicians will not provide any medical recommendations, treatments, or prescriptions over the telephone.  This is in accordance with the policy of The American College of Emergency Physicians that advises against providing any diagnoses or treatment recommendations by telephone.  If you wish to make an appointment, have prescriptions refilled, obtain x-ray or lab results you will be required to contact the office during normal office hours.  Prescription refills will not be called in over the weekend or when the office is closed.  It is the patient's responsibility to monitor his or her supply of medication and request refills at least 48 hours before needed.  Anyone contacting the office after hours for prescription refills will be instructed to pay cash for enough medication at their local pharmacy until the next business day.   When attempting to contact a physician after office hours please remove any Caller I.D. or Call Intercept features that are operating on your phone line.  Otherwise the physicians may be unable to contact you.  In case of a true life threatening emergency call 911 or seek treatment at the nearest emergency room.  Medical advice is not provided to patients during non business hours

20 Minute Late Policy  - if you are 20 minutes or later for your appointment you may be asked to reschedule.  Evening appointments are expected to arrive prior to the scheduled appointment time.  Failure to arrive at the scheduled time may result in rescheduling of your evening appointment.  Patients scheduled for physical appointments are expected to arrive on time or you may be rescheduled.

Walk-In Policy  - City Line Family Medicine is an appointment only office.  Examination by a physician cannot be guaranteed if you present to the office without an appointment.

Annual Physical Appointments  - patients presenting to the office for a complete annual physical are required to be on time.  You may be asked to reschedule if you do not arrive at your scheduled time.  If possible, it is recommended that you arrive ten minutes early to complete the patient medical history forms.  Failure to present for your scheduled physical will result in a $25 charge.  To avoid this charge please cancel your appointment if you will not be able to keep the appointment.

Payment is expected at the time of service.  Due to the high costs of billing, patients unable to make payment at the time of service will be rescheduled.  Accepted methods of payment include cash, credit card, and debit card.  Personal checks are not accepted.  Contact our billing department with any additional questions.

Form Completion - patients requesting the completion of forms may be required to pay a $15 completion fee. 

Copying of Medical Records - patients requesting copies of their medical records will be assessed a fee of $1 per page.  There is no charge for the forwarding of medical records to other physicians providing you care.

No Show Policy - patients who schedule appointments but fail to show up are documented as "no shows."  Patients who "no show" for their appointments will be charged $10 for regular office visits and $25 for complete annual physicals.  The definition of a "No-Show" is failing to cancel a regular office visit within 4 hours or a physical appointment within 24 hours of the scheduled appointment time.  Patients with multiple "no shows" for any appointment type may be terminated from the practice.  Please be courteous to your physician and fellow patients, cancel your appointment as soon as possible.  You can cancel your appointment online.

Appointment Cancellation Policy - we understand that occasionally you may need to cancel your appointment.  Please provide us with adequate notice so that your appointment may be given to another patient.  Failing to cancel a regular office visit within 4 hours or a physical appointment within 24 hours of the scheduled appointment time is considered a no show and will subject you to a charge.  Refer to the no show policy for additional details.

Patient Termination Policy - although it is an infrequent occurrence, a patient may be terminated from the office and given 30 days to locate another medical office for their continued care.  Patient termination is at the discretion of the patients' primary care physician.  Common reasons for termination include, but are not limited to, use of foul language, chronic noncompliance with recommended therapy, abusive behavior of staff, physicians, visitors or other patients.

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