Policies

Telehealth Appointment- Most Medical Visits are on telehealth, this means you need access to video and a computer.
- Use www.BarbNP.com/video or click on the link in the reminder text to get on video.
- Be ready for your medical visit - Don't be doing errands or driving. Sitting in your car for privacy is fine.

Office Appointment- Office is open, primarily on Wednesday by appt only.
- A Physical is required yearly for all new patients within 1st month of starting.
- Office visits also 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.

Schedule - You have full access to the schedule at BarbNP.com/schedule with 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.

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.

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.

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.

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

Quest Lab- Digital Clinic does not work for Quest. The clinic does have wholesale cash prices for labs, please refer to website for more specifics if quest isn't billing or your insurance isn't paying appropriately.

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.

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.

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.

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 times to every other week, then monthly. Few people are seen every 2 months. This is based on your medial stability, medication needed, and insurance.
- At any point you become unstable, you will be brought back to weekly appointments and 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.

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

Payments - You are responsible for all payments due and for all charges not covered by insurance. Please monitor and pay 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.

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.*
  - **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.

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 schedule: if anything needed from Barbara NP in your medical record- order medication, order imaging or labs, 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.

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.

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.

Self-Pay - Perfect for High Deductible Insurance Plan or if you have No Insurance.
- Option to pay with HSA or FSA
- Pay per Visit: $300 Initial, $200 for Follow up.
- CASH price for Wholesale Labs (blood work) at Quest. -DigitalClinicians.com/lab

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: Samaritian, Pacific Source, Providence, Regence/ Blue Cross, United Health Care/ UMR/ GEHA/ 1st choice, Moda/ Healthnet, Aetna, Cigna (limited)
- Medicare: UHC, Moda/ Healthnet, BCBS, Tricare.
- Medicaid: Medicaid-OR, Pacific Source, Trillium (limited). Must be in LANE County.

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

Sign the 2024 Digital Clinic Policies