Practice Information and Procedures

Practice Information and Procedure

Date: 05/01/17

Purpose: To ensure access to care both during and after regular business hours, and to facilitate effective communication as well continuity of care.

Scope: Applies to site personnel.

  • All patients will be assigned to a primary care physician in the practice.
    1. To be considered an “active” patient, the patient will need to be seen by one of our providers within the last 3 years.
  • Our intent is for each patient to see his or her primary care physician. When a physician visit is required, deference will be given to the patient’s primary care physician, except under the following conditions:
    1. If the patient’s problem is too urgent to wait for the next available opening with their primary care physician.
    2. The patient’s primary care physician is out of the office.
  • Our goal is to have 100% of the patient’s visits be with their assigned PCP, but at least 60% of the patient’s last 10 visits will be with their assigned primary care provider to maintain that provider as their assigned PCP.
  • New patients calling for appointments will be offered the first available new patient appointment. Patients may request to see a specific provider and will then be offered that providers first new patient appointment. The provider that the appointment is scheduled with will be assigned as the PCP for that patient unless the patient requests otherwise.
  • New patients will be required to have new patient paperwork completed prior to their appointment time. Patients may complete this by:
    1. Showing up to appointment 15 minutes early to complete all paperwork prior to the scheduled visit time
    2. Going to our website, downloading and completing paperwork prior to coming to the office for appointment.
  • New patient appointments will address the following aspects of care:
    1. Acute illness and injury: includes visits for illness onset less than 1 week. This is a focused visit for illness/injury-medical history will be reviewed but long term/chronic health problems are not addressed at this visit.
    2. Long term illness/injury: illness or injury longer than 1 week which other medical care may have been obtained-focused visit that includes medical history, review of previous care of illness/injury and plan for treatment
    3. Establish care/review medical history: visit will include a thorough documentation of previous medical history, chronic illness, medications, and long term heath concerns.  Provider will make recommendations and establish plan to improve health
    4. All patients must have established care prior to scheduling an annual well visit (AWV).
  • New patients will be directed to our website for information on hours, patient expectations, information on patient centered medical home, policies and practice expectations.
    1. Patient Centered Medical Home: The Patient-Centered Medical Home (PCMH) is an approach to providing comprehensive, continuous healthcare that is based on the foundation of a personal relationship between a patient, their physician, and members of a proactive, collaborative care team. The Patient-Centered Medical Home is a model of care that puts patients at the forefront of care. PCMHs build better relationships between people and their clinical care teams. Research shows that they improve quality, the patient experience and staff satisfaction, while reducing health care costs – See more at:
      • As a PCMH practice we will commit to providing:
        • Strong patient-provider relationships: personalized, comprehensive coordinated care managed by a single provider and care team.
        • Proactive preventive health care: We commit to making sure our patients understand what screening exams are recommended for them based on age, gender, medical history, and risk factors.
        • Care that helps lower overall medical costs: by managing chronic conditions, setting goals, having good outcomes, and access to primary care overall medical costs decrease.
        • Coordinating care across medical settings including specialty visits, hospital visits, and behavioral/mental health.
        • Patients can expect providers to use evidence practice guidelines and use self-management tools in patient care.
  1. Family Care has three medical providers:
    • Sabrina Mentock, MD
    • Elaina Lee, MD
    • Sarada Schossow, PA-C
  2. Family Care is open for regular business hours on Monday through Friday from 8:00am to 5:00pm. We offer extend hours on Monday, Tuesday, and Thursday from 5:00pm to 7:00pm.
  3. All patients will be assigned to a primary care physician in the practice. Our intent is for each patient to see his or her primary care physician. When a physician visit is required, deference will be given to the patient’s primary care physician, except under the following conditions:
    • If the patient’s problem is too urgent to wait for the next available opening with their primary care physician.
    • The patient’s primary care physician is out of the office.
  4. All patients will have access to the patient portal unless they decline this service. Patient portal provides patient the opportunity to
    • Manage medication
    • Obtain lab results
    • Receive health alerts and messages from their provider
    • Access the personal health record and receive visit summaries with instructions.
    • Request appointments and see past appointments.
  5. A charge will be made for broken appointments (unless 24 hour notice is given), or if the patient arrives more than 10 minutes late for their appointment. A missed appointment charge is $25 and is due prior to the patient’s next appointment at our office. This includes appointments cancelled on the same day of the exam or times where the patient arrives more than 10 minutes late for their scheduled appointment.
  6. All patients are expected to be on time for appointments. It is requested that patients presenting for an AWV arrive 10 minutes early to update medical history over the last year.  All patients arriving more than 10 minutes late will be marked as a no-show and will need to reschedule their appointment.
  7. Medical Records: All patients will be expected to sign a release for medical records from previous providers for continuity of care. This includes information on chronic disease, blood work, diagnostic imaging, urgent care or emergency room visits, and medications. All patients will be expected to notify all medical providers/specialist outside of our office that we are patients PCP and request that records get sent after each visit.  Records should be sent through mail or fax to the Attention of “Receptionist”.
  8. All Patients will notify PCP of all medications that are prescribed or changed by another provider; they may update this on their patient portal or call the office to update. Patients are expected to take all medications as directed; they are only to change dosage or amount of medication without first consulting their medical provider.
  9. Patients requesting controlled prescriptions: Requests for controlled substance refills will not be given until prior records of usage have been obtained and the Rx controlled database checked for Rx abuse. Controlled substances will only be refilled by the ordering provider and will not be filled after hours or on weekends. Patients requesting controlled prescriptions must pick up a paper prescription in the office; prescriptions will not be mailed to patient, faxed to pharmacy, or called in to pharmacy.  Patients requesting such medication agree to random drug screening at the provider’s request.
  10. Patients should request medication refills by contacting their pharmacy. The pharmacy will send us e-request for medication refill.  Patients should contact pharmacy at least 3 business days prior to needing refills.
  11. Medical Advice: Patients may request medical advice either by calling the office or sending an e-message through the patient portal. Telephone and E-messages will be triaged by clinical staff and then sent to the providers as needed for advice. Clinical staff will return patient calls/web encounters to relay advice to patients. During normal office hours telephone and web encounter will be returned within 24 hours. Calls and web encounters received after hours during weekdays will be returned during the next 24 hour day period. Calls and web encounter received after Fridays, at 5p and on weekends and holidays will be return within 72 hours of the call.
  12. Results: All results must be reviewed by a medical provider prior to results being given to patient or uploaded to patient portal, with the exception of normal pap smear results which may be released by the medical assistant prior to provider sign off. Patients may obtain bloodwork/diagnostic imaging/pap smears in several ways.
    • Normal results will be uploaded to the patient portal with any medical advice within one week of testing. Patients who are not portal enabled will receive a letter issued to the patient within one week of testing.
    • Critical abnormal results, or STAT results, will be called to patient within 24 hours.
    • Abnormal results with clinical advice will be relayed to patient either by phone or portal message depending on severity of results.
    • Patients who have not been contacted with results after 1 week should call the office to ensure results have returned to office
  13. Behavioral/Mental Health: Medical Providers at Family Care, PA do treat behavioral/mental health illness. Patients may referred to Psychiatry for uncontrolled psychiatric conditions and formal evaluations for certain medical conditions such as ADHD. Family Care, PA medical providers will resume care for these conditions once patients are stable and formal diagnoses have been made.
  14. Accepted Health Insurances:
    1. Family Care accepts the following in-network insurance plans:
    2. Blue Cross Blue Shield:
      • State Employees Health Plan
      • Federal Employees Program (FEP)
      • Blue Advantage & Options
      • Blue Value
    3. Cigna:
      • Open Access Plus (OA Plus)
      • PPO, POS, HMO
      • Choice Fund PPO
      • Cigna Care Network (CCN)
    4. United Healthcare:
      • Choice
      • Choice Plus
      • Health Savings Account (HSA)
      • Employer-Based Plans
    5. Family Care is out-of-network with:
      • Aetna
      • Medicare / Medicaid
      • Blue Local
      • Coventry
      • Humana
    6. All deductibles and copays for patients with in-network insurances are expected to be paid at the time of visit.
    7. Patients with out-of-network insurance will be required to pay the cost of the visit at the time of service. Family Care will still file all claims for out-of-network insurances.
    8. Patient without insurance will be considered self-pay patients and expected to make payment at the time of service. Payment plans are available based on income and account history at our office. Patients will need to contact the office manager for approval and make payment arrangements before the appointment.
  • At the age of 18 a patient is no longer considered a pediatric patient at this time their legal status and guardian of record will be updated at our practice.
  • Prior to their first visit after turning 18 years old, patients will sign their own practice policies, privacy policies, record releases and financial policies.
  • As part of their first appointment after turning after 18, medical staff will review and explain all their current medications and conditions to ensure the patient understands directions and care management.
  • Privacy will be discussed with both patients and parents prior to first appointment after turning 18 regarding privacy policies so both parties understand what health information the parents can, or cannot, access.
    • The patient be given the opportunity to sign a release of medical records that will indicate whether they grant permission for their parents to continue to manage their health care affairs and to what level of access to medical records the parent will be allowed.
  • The patient will be responsible for scheduling their own appointments, following up on phone calls, and managing their prescriptions. They may receive help from their parents, if a release of information is on file.
  • We understand that adolescents also require privacy when discussing sensitive topics. Adolescents that have been deemed to have decisional capacity may make appointment for these services.  Appointments will still be billed through insurance unless patient pays for service out of pocket at the time of service.  North Carolina, G.S. 90‐5 authorizes a physician to accept the consent of a minor for medical health services for the prevention, diagnosis, or treatment of venereal diseases or other reportable communicable diseases, pregnancy, abuse of controlled substances or alcohol, or emotional disturbance. However, the statute does not authorize a minor to consent to abortion, reproductive sterilization, or admission to a 24‐hour mental health or substance abuse treatment facility. The minor must have the decisional capacity to consent. A health care provider must not accept a minor’s consent if the minor lacks decisional capacity.  A health care provider who treats a minor pursuant to North Carolina’s minor’s consent law ordinarily must not notify the minor’s parent, guardian, custodian, or person standing in loco parentis about the treatment without the minor’s express permission. The exception to this if in the opinion of the attending medical provider, notification is essential to the life or health of the minor.