ࡱ> VXUc &bjbjZZ SL8b\8b\l l d\43%:$$$$$$$$&)$$$]]]^$]$]]!."7F!$%03%",k*I k*."."hk*#]$$S 3%k*l > : Welcome to Raleigh Family Practice! We are pleased you have chosen us for your healthcare needs. Our goal is to provide quality healthcare for you and your family. We want to let you know what you can expect from our practice and give you the information you need to understand our office policies. Please take time to review this form and feel free to ask questions. Website www.rfppa.com Our website provides information about our practice, access to the patient portal and helpful self-management tools for patients with chronic conditions. Hours of Operation Our doors are open Monday- Friday from 7:45am-4:00pm. Our phones are available from 7:45-1:00pm & 2:00pm-4:00pm. Our regular appointment hours are from 7:00am 4:00 pm. After Hours Calls/Hours A provider is on-call 24 hours, 7 days a week, for emergencies. If you need this service, call 875-6941. Our Doctors and PAs do not prescribe antibiotics for infections for which we have not evaluated you in the office. They also will not prescribe narcotic or controlled medications after hours. Appointment Availability Our providers current appointment availability is: Dr. Babcock: MTThF 7:30am-4:00pm W 7:00am-12:15pm Dr. Bean: M-F 8:30am-4:00pm Dr. Patel: M-F 8:00am-4:00pm Mr. Allen: M-F 8:00am-4:00pm Ms. Clarke: MTWF 7:00am-3:30pm, Th 7:00am-1:00pm We offer Same Day Appointments for acute needs. Cancellation Policy If you are unable to keep a scheduled appointment, please call our office as soon as possible to cancel. We charge a no show fee of $45 when 24 hours notice is not given prior to cancellation. Secure Patient Portal Our portal allows secure communication and provides an efficient alternative to phone calls. You can ask a question of your provider, request a refill, view lab results, receive information from your health record, request appointments and pay your bill. Insurance Plans We currently participate with and file claims for the following insurance companies: Aetna, BlueCross BlueShield, State Health Plan, Cigna, MedCost, *Medicare, *Medicaid, *Tricare and United Healthcare. (*indicates that we are no longer accepting new patients on these insurances). Uninsured patients A discount of 15% will be given on office visits and labs which are paid for in full at the time of service. If you are a self-pay patient who needs medical assistance, please let us know and we will share information about resources with you. Hospital Care The hospitalists at Duke Health Raleigh Hospital, Rex Healthcare and WakeMed offer care for our patients while they are in the hospital. They will notify us regarding your stay. Medical Records Our staff will handle medical record requests for a charge of .75 per page 1-25, .50 per page 26-100, .25 all others, with a minimum fee of $10. Postage will also be applied to the bill. Faxing or providing minimal information is done so with no charge. Forms and Letters If a provider must fill out extensive paperwork including disability forms, letters to an attorneys, etc. there will be completion charge determined by the provider of $25.00-$100.00. Prescription Requests The most efficient way to get your refills is to have your pharmacy send an electronic request to us. We also have a refill request voicemail box that you can reach by calling 875-0539, option 4. All prescriptions will be refilled within 24 hours. Once you have made your request, please contact your pharmacy for status. We will call you if there is a problem. When you check In When you visit our office please make sure to Bring your current insurance card to each visit. Alert us of any changes so that we may notify you of matters concerning your health or your account. Our receptionist will ask you to verify your demographic information. Be prepared to pay your copays at check-in. Laboratory Most of our lab work is processed in-house, however some are sent to Labcorp. If your insurance company requires that you use another lab, please notify us at check in, and we will provide an order for you to go to that site and have the labs drawn. Notification of results In most cases you will hear from our practice within 72 hours of having your blood work done. There are some labs such as cultures, specialized labs, Pap smears, and pathology that take longer. Please ask your nurse when you can expect to hear back. Patients who have portal accounts will be notified through the portal. Questions for Providers or Nurses If you have a question for a provider or nurse, the most efficient route is through the portal. You may also leave a detailed message with our operator, who will ensure that your message goes to the appropriate person. If you have called our office before 3:00pm you can expect a returned call that day, calls received after 3:00 may be handled the next business day. If you are calling after 3:00 and must receive a call that day, please notify our staff. Referral/Prescription Authorizations We participate with the following plans that require referrals for participating specialist visits: Aetna, Carolina Access, Cigna HMO, United HMO. If we do not schedule these appointments for you, please notify our office in advance of the appointment so that we can obtain a referral and fax it to the specialist. There are also insurance plans which require authorization for certain procedures such as CT scans and MRIs. Aetna, BCBS, CIGNA, Humana, MedCost, Medicaid, and United Healthcare all have plans that require such. If your prescription requires an authorization, please have your pharmacy fax (875-9488) the rejected claim to our office so that we will have all of the information needed to get the medication approved. Testing & Specialty Appointments If your provider suggests a referral, we will contact the specialist and provide the appropriate information. Most often you will hear directly from the specialist about scheduling an appointment. Urgent referrals will be scheduled that day; all other referrals will be handled within 3 business days to allow our staff time to contact the other office/facility and obtain authorization if needed. A Patient Centered Medical Home Patient Centered Medical Home is a designation earned by primary care physicians who work to improve quality and patient experience through quality measures and health information technology. It uses automation to provide efficient care and communication to its patients as well as track clinical measures to ensure we are offering the best care possible with the best outcomes for our patients. *SeeWhat is a Medical Home brochure for more information. Self-Management We encourage our patients to take an active role in their healthcare. We will support you by providing the most up-to-date clinical advice as well as tangible self-management resources. Resources for Diabetes, High Blood Pressure, High Cholesterol and Health Screening/Maintenance can be found on our website. Contact Our Office Main Line: (919)875-0539 7:45am-1:00pm & 2:00pm-4:00pm Fax: (919)875-1051 Refills: (919)875-0539, option 2 Appointments: (919)875-0539, option 3 Questions for doctor or nurse: option 4 Medical Records - x237 / x245, option 5 Prior Authorizations - x241, option 6 Billing x231 / x235, option 7 Office Administrator - x222 Kristin Fisher, RN -  HYPERLINK "mailto:kfisher@rfppa.com" kfisher@rfppa.com Administrative Manager - x252 Frankie Smeltzer -  HYPERLINK "mailto:fsmeltzer@rfppa.com" fsmeltzer@rfppa.com Clinical Manager x225 Janell Pool, RN -  HYPERLINK "mailto:jpool@rfppa.com" jpool@rfppa.com Welcome To Raleigh Family Practice A Patient Centered Medical Home Updated 1/23/18 $%% + - L s t u ) * = A K W e h o r s   n õãthhihN5>*CJhih135>*B* phphihN5>*B* phph13hhN h{h{hih{5>*B* phph}ghih}g5>*B* phph}g5>*B* phph~9hvCJh~9h}CJh~9hn(CJ h}gCJhihn(5>*B* CJphp'$%t u ) * =  n 2 3 L - > n gd{$a$gd{$a$gdNgdNgdRgd}g$a$n / 1 2 3 L Y Z          # % * - / 1 4 8 ; > m n o t ÿǿǿÿϻϿϿÿϿ˿ǿ˿ǿǿ˰ॗh!hihN5>*B* phph}g5>*B* php h~9h{h%hh13h}ghh|"hNh{hih{B* CJphph{5>*B* phff h~9hN hih! hihN:n o p q r s t MNdfgx`aqrstgd@}$a$gd@}gdQgdNgdR IMNd:Pcefgpx  !"#,ACŸؙ؝ؤqmh@}hih%%5>*B* phph%%hn(h]M h~9hQ hQhQh h~9h} h~9hn(hih}B* CJphphihn(B* CJphp h~9h!hQh{h!bhThih{5>*B* phph135>*B* phff h~9hNh!*`aqqrsx  28@DE[TĹᐇyhih}5>*B* phph@}5>*CJh~9h@}5>*CJh@}5>*B* phffh}ghih@}5>*B* phph}g5>*B* phphT5>*B* phffh~9h@}5>*hhThih@}B* CJphp h~9hn( h~9h@}h@},tuvwxDE[ >gd$a$ & F & FgdR & FgdHz$a$gd@}gd@},:;=>?z{01!霠unngn h~9h13 h~9hBWhihR5>*B* phphihtr5>*B* phphFI5>*B* phffhFI h~9hn(hihn(B* CJphphihkZB* CJphphfF>*B* CJphff h~9hqz h~9hQS h~9hHz h~9hhh`h]MhQ h~9h}%!345>#+6s 1Qv ˾tgtXQ h~9h_ hihn(>*B* CJphphihtrB* CJphphihn(B* CJphph~9hY B* CJphffh%h5>*CJhVU5>*CJh}5>*CJh5>*CJh~9hY 5>*CJhihY B* CJphp hhhB* CJphp h~9htrhQ h~9hRh h~9hBW h~9hB^67. F"""dD-DM gd!gdgd!gd%hgdx$a$  cv{7Fv  $P]hz#ñññh! h~9hxhih |B* CJphphihyB* CJphphihxB* CJphp h~9htr h~9h]h | h~9h | h~9hBW h~9hn( h~9hhQ h~9hR h~9hBhh] h~9h_ h]M/#-./w !!E"F"G"J"K"a"b"c"d"""""""## # #L#N#slhdhhhdhk)h3_ hk)hk)hih`5>*B* phphih!B* php h136h13h136h13h 6hhih}5>*B* phphih!5>*B* phph5>*B* phph%h5>*B* phphih%hB* phphx h~9hBh%hhh! h~9hy'""######$+$L$r$$$$% % %&%w%x%%%%&K&L&$a$gd$a$gdVw -DM gdk)N#O#########$$$"$3$4$9$I$K$X$Y$Z$_$o$q$r$v$w$$$$$$$$$$$$ % %%%&%4%ʼxq h 6hkZ h 6hfF h 6hVU h 6hh} h 6h- h 6h#m h 6h} h 6hQh%hh h 6hVwhihK35>*B* phphihVw5>*B* phphih5>*B* phphk)5>*B* phff hk)hk)hk)h3_,4%8%;%<%b%c%d%u%v%x%%%%%%%%%%%%& &&&&&9&:&I&J&L&M&W&X&[&ņ}wodwh!hK3CJaJh!CJaJ hK3CJh 6h}0Jjh 6h}Uhh 6hQ0Jjh 6hQU h 6hQjh 6hQU h 6hK3 h 6h}h 6hVw0Jjh 6hVwU h 6hVwjh 6hVwU h 6h-h 6#L&M&X&Y&Z&[&\&]&^&_&k&&&&&&&&&&&&&&&&$a$gd@}$a$gd!$a$gdK3[&]&_&g&h&j&k&&&&&&&&&&&DzDzǝs^I60 hK3CJ%h!56B* CJ OJQJaJ phff(h!hK35B* CJOJQJaJphff(h!h!5B* CJOJQJaJphff(hih135B* CJOJQJaJphp(hih!5B* CJOJQJaJphp(hih!5B* CJ(OJQJaJ(php(hih~95B* CJ(OJQJaJ(php(hihK35B* CJ(OJQJaJ(php"h!5B* CJ(OJQJaJ(phff"h}5B* CJ(OJQJaJ(phff&&&&&hihkZB* CJphph%h6B* CJOJQJphp$hih@}6B* CJOJQJphph!6B* CJOJQJphffQ0:py= /!"#$% P0 DyK kfisher@rfppa.comyK Jmailto:kfisher@rfppa.comyX;H,]ą'cDyK fsmeltzer@rfppa.comyK Nmailto:fsmeltzer@rfppa.comyX;H,]ą'cs02 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH 8`8 Normal_HmH sH tH D@D  Heading 1$$@&a$ 5>*CJ>@>  Heading 2$@& 5>*CJ<<  Heading 3$@&6CJ88  Heading 4$@&6DA`D Default Paragraph FontViV  Table Normal :V 44 la (k (No List 2B@2 Body TextCJ6U`6 8 Hyperlink >*B*phV^V !0 Normal (Web)dDCJOJQJ^JaJH"H %h Balloon TextCJOJQJ^JaJN/1N %hBalloon Text CharCJOJQJ^JaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VvnB`2ǃ,!"E3p#9GQd; H xuv 0F[,F᚜K sO'3w #vfSVbsؠyX p5veuw 1z@ l,i!b I jZ2|9L$Z15xl.(zm${d:\@'23œln$^-@^i?D&|#td!6lġB"&63yy@t!HjpU*yeXry3~{s:FXI O5Y[Y!}S˪.7bd|n]671. tn/w/+[t6}PsںsL. J;̊iN $AI)t2 Lmx:(}\-i*xQCJuWl'QyI@ھ m2DBAR4 w¢naQ`ԲɁ W=0#xBdT/.3-F>bYL%׭˓KK 6HhfPQ=h)GBms]_Ԡ'CZѨys v@c])h7Jهic?FS.NP$ e&\Ӏ+I "'%QÕ@c![paAV.9Hd<ӮHVX*%A{Yr Aբ pxSL9":3U5U NC(p%u@;[d`4)]t#9M4W=P5*f̰lk<_X-C wT%Ժ}B% Y,] A̠&oʰŨ; \lc`|,bUvPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!R%theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] Ln ! #N#4%[&&&!"$%n t"L&& #;cu9IXXX8@0(  B S  ?-/  GO .533333$%deko#,-//148;otMM#,CC s x E E >  0145#+  OQw{.JJ  "49Z_$%deko#,-//148;otMM#,CC s x E E >  0145#+  OQw{.JJ  "49Z_$d banoh ^`o(hH. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.$d          -? ddJ /1P1 o!O iM-<dd00f}itjdd0DKiM/1?`DoVJDK o!OOj p?\P1 itjJ ddOjf} `Do<;-@}{k)fF`13!n(K3~9FIhQRVU VkZ!bykVwHzqzR%%N]_ BWBQS}g8 yQtrQTRW|"#mv!%h%}xh |}]MY 2i3_l 6@@UnknownG*Ax Times New Roman5Symbol3. *Cx Arial7NPapyrus3*Ax Times9. ")Segoe UIA$BCambria Math"qhagagag*7*7!243w3QKP?2!xx "Welcome to Raleigh Family Practiceinsurance if office charge fileAmie L. ClarkeKristin Fisher Oh+'0(8 P\ |   $Welcome to Raleigh Family PracticeAmie L. Clarke insurance if office charge fileInsurance/Billing (office manager) Appointment Availability Specialist Referral Authorizations All other insurance companies will be billed through our office.NormalKristin Fisher2Microsoft Office Word@@H7@ڀl7@ڀl7*՜.+,D՜.+,d  hp  Raleigh Family Practice7 #Welcome to Raleigh Family Practice Title 8@ _PID_HLINKSA<Bfmailto:jpool@rfppa.comZ`mailto:fsmeltzer@rfppa.com-mailto:kfisher@rfppa.com  !"#$%&()*+,-.0123456789:;<=>?@ABCDFGHIJKLNOPQRSTWRoot Entry F07YData '1Table/{*WordDocumentSLSummaryInformation(EDocumentSummaryInformation8MCompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q