NORTHWEST PULMONARY AND SLEEP MEDICINE OFFICE POLICIES
Calls and Messages:
Please note that non-urgent messages will be addressed within 3 business days. This includes any test or lab results, equipment requests, refills, billing questions, or routine questions.
Urgent calls (illness or acute symptoms) will be addressed BY THE END of the business day. Please refrain from leaving multiple messages regarding the same issue. Asking for test results, medication refills, prior authorization completion is NOT CONSIDERED URGENT.
Refills for controlled substances, such as sleep aids, WILL NOT BE ADDRESSED by the on-call provider. These requests will only be addressed during business hours.
Medications will not be refilled if you have not been seen by a provider within the last 12 months.
Medication Prior Authorizations:
Some medications require prior authorizations (Pas) per your insurance requirements. There is paperwork required for this and this can take up to 5 days to address.
If your medication is a specialty drug, it may take up to 30 days to obtain a PA or an appeal if the medication is denied.
Paging the on-call provider:
Any after hours page to the on-call provider for any reason is subject to a $25 charge which will be billed to your account
Policy Regarding Forms
For efficiency and accuracy of information, the following forms require a scheduled office appointment with the NP for completion, no exceptions:
- Home Bound form
- School/Sports physical forms
- Return to work/school forms
- Certification letter of sickness to excuse absence from work/school/sports
The following form will be assessed a $10 fee for completion and will be completed within 7 days of the request:
- ComEd form
- Airplane travel form
- Letter of Explanation of Condition/Treatment, e.g. for attorney
ATTENTION NON-MEDICARE PATIENTS
Please read the following information regarding obtaining orders and scheduling CT, MRI, and PET scan imaging:
Due to insurance and document requirement changes, prior to scheduling ordered testing, we need to obtain a prior authorization from your insurance before you can schedule your ordered test.
Once we have contacted your insurance and obtained the prior authorization number, we will notify you and you will be free to schedule your test at that time. This process may take up to 7 days from the date of your appointment. Please do not call us regarding this process unless it has been AFTER 7 days since your test was initially ordered.
PLEASE NOTE IF YOU CHOOSE THE CENTER FOR DIAGNOSTIC IMAGING, THEY WILL OBTAIN THE PRIOR AUTHORIZATION ORDER FOR YOU AND YOU ARE FREE TO SCHEDULE YOUR TEST RIGHT AWAY.
Insurance / Payment / Billing
At Northwest Pulmonary and Sleep Medicine, we accept Medicare and most major insurance plans. Please contact your insurance company or you may call our office at 8154777350 to find out if we accept your insurance plan. Please be advised that if you are a new patient with commercial insurance and you have not yet met your deductible, you may be assessed a deposit at the time of consult.
If your insurance plan requires you to pay a co-payment, co-insurance, and/or a deductible, you will need to pay at the time of your visit. For your convenience, we accept cash, checks, Visa, and MasterCard. We can also set you up with Care Credit, a credit card that can be used for all health-related expenditures, www.carecredit.com
Outstanding patient balances are expected to be paid in full, or a payment plan set up with our biller, prior to your next scheduled follow-up or CPAP supply shipment.
If you have a question related to your bill or insurance, please call our office and ask to speak to the billing department.
If your insurance is an HMO/managed care plan and you are required to obtain a referral from your primary care physician, the referral must be obtained before you can be seen for an office visit.
Please coordinate this with your primary care physician in advance. Appointments will be rescheduled if required referrals are not received in the office by the time of your visit.