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Policies

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  • Telehealth Appointment- Most Medical Visits are on telehealth, this means you need access to video and a computer. 

    • Use www.BarbNP.com to complete the check in form prior to your appointment (night prior is optimal) and also get on video.  You can also use the links provided in your email reminder.

      • If the check in form is not completed, your appointment will likely get cancelled or moved to another day. ​

    • Be ready for your medical visit - Don't be doing errands or driving.  Sitting in your car for privacy is fine.

    • *Anytime your chart needs to be opened to be reviewed or something ordered, this is a Medical visit. To avoid this, make sure you talk about everything needed including Rx in your scheduled visit. 

 

  • Office Appointment- Office is open, primarily on Wednesday by appt only.  

    • A Physical is required yearly. The following things are assessed: heart, lungs carotid arteries, thyroid, liver, pancreas, joints, etc. 

      • All new patients a physical is required within 1st month of starting.

    • Office visits also can include PAP, skin tag removal, knee/ear/xx exam, dementia screen, or paperwork needed.

    • Do NOT come to the office if you are SICK.

    • If you are experiencing an urgent issue go to urgent care or the emergency department or call 911.

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  • Schedule - You have full access to the schedule at BarbNP.com Click on schedule, ​​options to schedule as:​

    • Telehealth: Follow up, New patient, Medicare Annual Wellness

    • Office: Physical, PAP, injection, freeze skin tag, Forms, or follow up.

    • Expedited/ After hour visit - $40 fee.​

    • We do NOT WORK 24/7 - plan if you need to be seen and need refills. Get on the schedule as needed.

    • *You will be seen as frequently as necessary, to learn your name and story, and keep you medically stable. ​

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  • Appointment Time - You are 1 of many other patients being seen. While Barbara Hoefener, NP, does try to stay on time, someone ahead of you may have needed more time or less time so your appointment may not be exact, as it is not if you were to actually go into any medical office. Please be ready 20 min prior to your appt time and 45 min after your appt time.  Telehealth appointments require you to be in the waiting room on the video, if you leave the screen you will disappear from the virtual waiting room.  If you are not getting on video, the office and Barb will prioritize the people on video and may not call you on a phone until a break happens later in the day, but will always call.    

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  • Paperwork - Medical paperwork work will be required on your medical chart throughout working together. This will get triggered by you, lab results, imaging results, your insurance, your pharmacy, another office, or a few other places. Digital clinic does not require you to be present for this "chart review" medical visit, we can usually complete this work on your behalf, you can get you an update via the medical summary in the portal and in your next visit.  Occasionally I will need to speak with you for clarity or resolution, so may call you or add you to the schedule.  A claim will be billed to your insurance. 

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  • Demographics - It is your job, not the office, to make sure the office has the correct phone, address, and insurance numbers with images at all times on file. You can see this when you log into your portal. Also, if you know you just moved or changed numbers, tell us.

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  • Billing/ Pharmacy - If you notice (or think) a bill is incorrect, contact Barb immediately (leave a voice mail) so this can be adjusted via insurance otherwise you may be paying the entire bill out of pocket.  We fill out the claims form and send them in for your convenience.  Of note: *Digital Clinic does NOT work for your insurance company nor the pharmacy.  We provide an electronic prescription to the pharmacy you last told us, you can see this in your athena portal--> reminders

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  • Quest Lab- Digital Clinic does not work for Quest. If you are paying for labs, which likely means you have a high deductible plan, you may choose to eliminate insurance via"bill the clinic" and pay the wholesale prices for labs, please refer to website for more specifics.  ​

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  • Primary Care -We have limited room for primary care.  Barbara Hoefener, NP, will keep you up to date if you need a PCP to manage your general health.  Barb is always available for a 2nd opinion. 

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  • Addiction -  Barb NP is specifically Suboxone certified and has successfully helped many people for addiction holding a less than 1% relapse rate. 

    • It is highly suggested you attend regular NA/AA meetings.

    • Only you can decide if you truly want to be clean and successful.  It is your decision alone.

    • Suboxone is a longer lasting pain medicine, a narcotic and a level 3 controlled substance.

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  • Chronic Pain -  We will see some stable chronic pain patients, however, you must have an appointment to confirm if Digital Clinic will be able will take you on.  

    • Digital Clinic providers will not write above 40MME of morphine. For example you need to take less than 40mg of Norco or 25mg of Percocet daily, or 16mg buprenorphine. If you are on a higher dose or different medication listed, you will not qualify for this clinic. 

    • Never ever = Benzo + narcotic.

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  • Controlled Medication POLICY: Everyone follows the same rules. 

    • Urines due prior to each visit, until your provider tells you it is ok to hold. 

    • Everyone starts with weekly visits for follow up. This includes a review of the week, urine drug review and refill of medication.

    • As you become stable you will progress appointment to every other week, then stabilize at monthly appointments with 3/year urines. Few people are seen every 2 months, this is based on your medial stability and dose of medication needed.    

    • At any point you become unstable, you will be brought back to weekly appointments with weekly urines. 

    • RELAPSE happens, be honest. You will NOT be discharged from the clinic, you will be considered unstable and be at weekly appointments. We do not give up on you. 

    • Instability includes: Not providing urine prior to each visit, Over taking or losing medication, you are drinking alcohol and/or using other controlled medications, including benzodiazepines - this is unsafe and completely against all medical advise and research.

    • Other providers and controlled meds - Talk with BARB first, as usually Barb will control all the controlled meds. This is to your advantage!  ​

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  • Cancel / No Show Appointments - You get 2 REMINDER emails and 2 REMINDER text messages, AND a CONFIRMATION email when your appointment is scheduled.  You have full access to the schedule to reschedule or cancel your appointment if something comes up. 

    • View or change your scheduled appointments at BarbNP.com/schedule

    • Life happens, so you get 1 freebee per year.

    • Fee:

      • Cancel within 25 hours - $100 fee. This must be paid prior to being seen next.​

      • No show- $200 fee must be paid prior to being seen next. 

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  • Payments - You are responsible for all payments due and for all charges not covered by insurance.  *Please monitor and pay your bills/ co-pays timely via phone or your patient portal - Athena Health 

    • If you feel your bill is inaccurate, please let Barbara NP know ASAP so it can be disputed with insurance on your behalf, however *if too much time goes by you will be responsible for full bill.* 

    • Digital Clinic will bill your insurance as a convenience for you, if insurance denies the bill, you are still responsible for payment due.

    • Once 3 statements get mailed, you will be sent to collections, and will owe an additional 30% for a collection fee.

    • Self Pay patients will have your payment automatically deducted 24 hours prior to appointment via saved credit card. This payment will be required prior to being seen. Thanks for understanding.

    • Insurance co-pay bill - Please pay asap.  Options are online via your patient portal or with the medical assistant during intake.

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  • Athena Portal 

    • Summary of each medical visit - please review it (My Health- care summary)

      • ​Shows: orders for lab, imaging, referral, and meds.

      •  Personalized typed summary "Patient Instructions."

      • Problem, allergy and medication list.

      • Care team

      • **If you feel anything listed is inaccurate- please address at next appointment.*

      • **GO HERE AFTER EVERY VISIT AND READ YOUR SUMMARY SPECIFICALLY MADE FOR YOU, it has all the information we reviewed, what was ordered and what is due from you.**

      • **PRINT AND GIVE THIS SUMMARY TO ANY OTHER MEDICAL PERSON YOU ARE SEEING, it will make your life easier.**​

    • Appointments- are not usually in the Athena Portal- Appointments can be seen via schedule login. 

    • Lab Orders, Imaging Orders and Referrals:  My Health--> Health Reminders  

    • Medications --> My Health -> Medications- shows date prescribed and instructions.

    • Upload a document --> Use "Have a Question."

    • Billing --> shows amount due and option to pay.

    • Test results --> Shows test results

    • Profile- under your Picture & Name- review demographics/ insurance to see if it needs updating.

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  • Text/ Phone calls vs Appointment -

    • Please call: if there is an issue with a Rx that you were just seen about.  You went to the emergency room and are now inpatient. Demographic change or insurance/ billing issue. 

    • Get on the schedule and fill out the check in form if anything needed in your medical record. This includes: ordering of medication, imaging or labs, referrals, a review BP review a new problem list a sprained ankle. Appointments ARE NOT 6 months out, you can get on the schedule. You can also get an after hours appt if you feel it is necessary with a fee.

    • Raychel, Medical assistant, can help with most things. 

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  • Refills of meds - You are generally given 6 months of non-controlled medications.

    • If you are due for a medication refill, please let Barb, NP know at your next appointment to avoid any gap or issue with meds.

    • We do NOT read any Pharmacy fax messages. We MUST hear from you in your scheduled visit.

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  • Refill / Orders the day of you appointment - You can tell when your chart has been closed and all orders & Rx have been sent as you get an email and you can see your new summary in your Athena portal.  While most Rx are signed within 1 hour of your appointment, it may take 24 hours to close your chart. 

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  • Self-Pay / HSA - Perfect for High Deductible Insurance, Health Savings Plan, or No Insurance. 

    • Option to pay with HSA or FSA

    • Pay per Visit: $300 Initial, $200 for Follow up.

    • Wholesale price for Labs --> visit "labs" for further info.​

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  • Insurance - You are ultimately responsible to make sure you are covered to see us the day of your visit. Insurance will be filed on your behalf for your convenience, however if denied, you will be responsible for payment.  ​

    • Commercial:

      • Accepted: Samaritan, Pacific Source (incl 1st choice), Providence, ​Regence/ Blue Cross.

      • Limited: Moda and ​United Health Care (which includes: UMR, GEHA).​

      • NO Longer accepting: Cigna, Aetna.

    • Medicare

      • *Limited slots*: UHC, Providence, BCBS, Medicare-OR, and Wellcare by Healthnet.

    • Medicaid

      • *Limited slots*: Medicaid-OR, Pacific Source, Trillium. 

      • Must be in LANE County.​

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  • IF YOU HAVE AN EMERGENCY OR NEED PROMPT MEDICAL APPTENTION- PLEASE GO TO URGENT CARE or THE EMERGENCY ROOM or CALL 911.

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