Š Welcome to Our Office s1

WELCOME TO OUR OFFICE

This information has been prepared to acquaint you with our office policies and procedures.

Our medical specialties are Nephrology (Kidney Diseases) and Hypertension (High Blood Pressure). We are Board Certified by the American Board of Internal Medicine for Nephrology.

Our desire is for you to feel comfortable about your medical care and your relationship with us. The office staff has been carefully selected and trained to support us. You can have every confidence in their abilities and professionalism. The following information will help to acquaint you with our office policies and procedures.

OFFICE HOURS

Monday through Friday: 8:00 a.m. to 5:00 p.m.

The office is closed on week-ends and most national holidays.

APPOINTMENTS

Office visits are by appointment only. Appointments should be made as far in advance as possible. Please inform the office at least 24 hours in advance if you can not come in as scheduled, so we can make the appointment available to another patient. Return appointments will be made before you leave the office.

In case of acute illness, our staff has specific instructions on scheduling and will assist you. Patients are seen by order of their appointments. On rare occasion, a patient may be seen out of turn only due to acute illness. Please be assured that we realize your time is valuable and that we appreciate your cooperation and understanding should this happen.

PRESCRIPTIONS

If medication is prescribed, we will give you a prescription with refills as necessary for your specific condition. Medication can not be refilled time and again without a return appointment to check your condition. This policy reflects your best interests as our patient by ensuring that you have the proper and most current medication for your condition. Please call for refills during regular office hours only.

LABORATORY TESTS

Should you require blood work, you will be having blood drawn in our office laboratory. If you would like copies of your lab results sent to another physician, please advise the phlebotomist at the time of your lab draw.

All test results are reviewed on receipt and discussed with you on your return visit. We will notify you of any abnormalities and instructions prior to your follow-up visit, if necessary. Should a further lab test be required, you will be advised at one of the times above.

TELEPHONE CALLS

We are on call 24 hours a day, seven days a week and may be reached by the office staff during office hours or by the office answering service during non-office hours. Please call and leave your name, telephone number, and a brief description of your problem. Your call will be returned as soon as possible.

We receive many phone calls during office hours. Our staff is here to assist you. Generally, they should be able to help you. Should you need to speak directly with one of us, they will take your name, telephone number, question, and description of your problem. Unless your call is urgent, and in fairness to patients being seen at the time, all calls returned by us are done at specific times during the day. Should we have a break between patients, we will try to call you then.

ON CALL COVERAGE

Vacation, week-nights and week-end call coverage is shared between:

James D. Baker, III, M.D.

James B. Smart, Jr., M.D.

Michael B. Brumback, M.D.

Deborah A. Price, M.D.

Craig J. Shapiro, M.D.

Aalok Kuthiala, M.D.

Muhammad Salahuddin, M.D.

David H. Michal, M.D.

Ramesh M. Kotihal, M.D.

Waqas Ahmed, M.D.

PHYSICIAN EXTENDERS

Our physician extenders are certified and have received specialized training in diagnosing and treating illness and providing health care maintenance. They can work independently in their own health care offices or in collaboration with physicians as in this practice. As healthcare providers, they are trained and qualified to obtain health histories, perform physical exams, diagnose and treat common illnesses and injuries, manage chronic medical conditions, order and interpret diagnostic tests, prescribe medications, and other treatments, and give advice on how to prevent disease. Nephrology Associates of NE FL has both physician assistants and nurse practitioners on staff.

REVISED 3/27/2015

FINANCIAL INFORMATION

We will file your office and hospital charges with Medicare, Medicaid, and any HMO plans or PPO plans with which we are participating consulting physicians.

You are responsible for your co-pay and yearly deductible, if applicable, or any uncovered services at the time of service.

Personal checks and cash are accepted forms of payment. We accept Master Card and Visa. You will be given an itemized receipt containing all information required by your insurance carrier to process your claim and reimburse you.

If hospitalization is required, we will file your charges with your primary and secondary insurance companies. You are responsible for any balance unpaid by your insurance.

All HMO patients must have an authorization / referral number, effective date, number of visits authorized, and expiration date from their primary physician prior to being seen. It is the patient’s responsibility to obtain pre-authorization from their primary physician’s office prior to visits here. HMO contracts will not cover expenses incurred if proper authorization has not been obtained in advance of the services rendered and we are instructed to collect the entire fee for services from the patient in such a case. Additionally, if we do not have a current authorization, we are unable to order out-patient testing (lab work, x-rays, etc.), as the HMO will not cover them. HMO co-pays are collected prior to being seen by the physician.

Monthly dialysis maintenance fees are handled the same as hospital fees above.

FINANCIAL ARRANGEMENTS

Should you need to make financial arrangements or have any questions regarding insurance or billing, please address them to our billing department at 904-389-5333 X23

If you have any questions regarding our office policies, privacy policies or any questions not addressed, please feel free to discuss them with our manager.

We hope this information has been helpful to you. Be assured that your health and well-being are of the utmost concern to us. Any suggestions are always welcome.

FLORIDA OFFICES

JACKSONVILLE

MAIN OFFICE

2 Shircliff Way

Ste 415 DePaul Bldg

Ph 904-389-5333

Fax 904-387-2928

DOWNTOWN OFFICES

Baptist – Pavilion Bldg

836 Prudential Drive Ste 804

915 W Monroe Street 2nd Flr

NORTH JACKSONVILLE

11513 N Main Street

1215 Dunn Avenue Ste 3

1760 Edgewood Ave Ste B

FERNANDINA BEACH

1340 South 18th Street Ste 104

HILLIARD

551616 US HWY 1

ORANGE PARK

1895 Kingsley Ste 303

Ph 904-272-6161

Fax 904-272-9797

MIDDLEBURG ST. VINCENT’S CLAY

1658 St. Vincent’s Way, Suite 340

Nephrology

Associates

of

Northeast

Florida

James D. Baker, III, M.D.

James B. Smart, Jr., M.D.

Michael B. Brumback,M.D.

Deborah A. Price, M.D.

Craig J. Shapiro, M.D.

Aalok Kuthiala, M.D.

Muhammad Salahuddin, M.D.

David H. Michal, M.D.

Ramesh M. Kotihal,M.D.

Waqas Ahmed, M.D.

Laurie Buschini, MSN,ARNP

Joseph Ernst, PA-C

Sara Preston, A.R.N.P.

Cindy Anderson, pa-C

Alexandra Michaelis, ARNP