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        Operating Policies And Procedures

        Welcome to Peter E. Franklin, M.D.’s office where we pride ourselves in offering the highest quality of care so that you can live your BEST LIFE.

         

        Please read through the following Policies and Procedures so as you move forward on your journey of health with us, you will be aware of what to expect from our office. Knowing what to expect when becoming a patient of Dr. Franklin’s is the first step to excellent quality of care.

        New Patient Policy and Procedure

        All New Patients are required to have a New Patient Appointment. This appointment is an introduction to the practice, as well as, an introduction to you as a patient. Based on your New Patient appointment, the provider will start a personalized health plan. Dr. Franklin requires all patients to have a Wellness Exam / Physical annually. Both providers will start you off with some labs and a physical to see where you are metabolically so they can make the best medical assessment. Dr. Franklin requires all New Patients to have blood work and a physical completed before filling any medications.

        Remember as a New Patient it is important to come early for your appointment so we can take care of any intake information. Below is a list of what you need when you’re coming into your first appointment:

        • Physical Insurance card or printed insurance card
        • List medications
        • Last Physical Date
        • Last Colonoscopy date
        • Last Mammogram / Bone density
        • Last PAP Smear
        • Last labs within the last 6 Months
        • Any relevant diagnosis

         

        Please call with any questions in regards to becoming a new patient. We look forward to meeting you!

         

        Hours of Operation

         

        Monday                8:30-5:00 PM

        Tuesday               8:45-4:00 PM

        Wednesday          8:30-5:00 PM

        Thursday              8:30-5:00 PM

        Friday                   9 AM-12 PM

         

        Closed for lunch daily 12-1:30 PM (Doors are locked and we do not answer the phone during this time)

         

        • Hours are subject to change
        • Closed all Federal Holidays

         

        *Any appointment made outside these hours are by special arrangement only.

         

         

        Late Arrival Policy

        Patients are only given a 5-minute grace period before being rescheduled. We are attempting to reduce wait-times by requiring patients to come on time to their appointment. This policy has shown a dramatic reduction in wait-times.

         

        On occasion the patient will still experience a wait before being seen this is due to patient emergency only. If there is a patient emergency, we will accommodate that patient in distress. We thank you in advance for your patience and cooperation, as we will afford you the same quality of care if you are ever in need.

         

        *Unless other arrangements have been made.

         

        No Show Policy

        1st one is Free

        2nd one is $35

        3rd one is $50

        4th one may result in a dismissal from the office

        Please cancel or reschedule your appointment 24 hours prior to your scheduled appointment day and time.

        Insurance does not cover no-show-fees

         

        Insurance Policy

        We participate in most health insurance plans and as a courtesy we will bill your insurance company for you. All insurances require that we collect co-payments (if that applies to your insurance) at the time of service. We accept cash, checks, Visa, Master Card, Discover and American Express.  If you are not enrolled with one of our contracted insurance plans, you will be responsible for all of your charges at the time of service. We will also be billing you (the patient) for any part of the charges that are your responsibility; such as deductibles, co-insurance or services that your insurance does not cover. It is your responsibility, not that of the insurance company, for payments of all non-covered services rendered in our office. Please bring your insurance card with you to every visit.  We will need to scan/review your insurance card every time you are seen in our office in order to effectively bill your insurance.  Also, please provide us with any updated personal information such as a change in address or phone number each time you visit. Accurate personal information is essential for us to serve you well. 

         

        A few important points:

        • We never guarantee insurance coverage.
        • We don’t guarantee your insurance will cover Preventative Care.
        • Some procedures are NOT covered (Example: labs, x-rays, referrals and copays)
        • Insurance companies don’t fully cover New Patient Appointments (New Patient Appointments are not considered by insurance companies as Preventative care)
        • It is up to the patient to know and understand their own insurance.

         

        If you have any questions requiring our insurance policy please call the office and speak with our biller, Janie Franklin.

         

        Fasting for Blood Work Procedure

        No alcohol for 24 hours prior to your blood draw (Example: 8 AM-8 AM)

        No food or drinks, only plain water for 12 hours prior to blood draw (Example: 8 PM-8 AM)

         

        • Outside laboratories offer a drop-in option, as well as, online appointment scheduling.
        • Outside labs we currently work with are LabCorp, Quest Diagnostics,
          Bio Reference, Chomp / Hartnell

         

        *If you have any doubt as whether to fast or not to fast, please fast as it will never hurt your blood draw but not fasting might. 

         

        Medication Policy

        Please allow for at least one week for a refill. We pride ourselves in refilling medication, as quickly as possible, but there can be many complications in the process of a refill. Please read through the following basic points of our medication policy. 

         

        • All New Patients are required to have blood work and a physical completed before filling any medications.
        • All medications do require at least a semi-annual follow-up appointment. Some medications may require additional appointments and/or labs.
        • All patients must have a future appointment on the books to receive a refill of any kind.
        • Patients are required to first call their pharmacies for a refill even if they are out of refills… This will speed up the process.
        • There can be many complications in the process of a refill. Patients should always give at least one-week time for a refill.
        • All controlled substances generally require a 1 Month follow-up appointment and original diagnosis on file for a refill.
        • Controlled prescriptions cannot be called into the pharmacy. Patient is required to come in for an appointment.
        • It is our policy that we never prescribe a 1-year supply of medication at one time due to our Standard Quality of Care. There are no exceptions!

         

        If you have any questions or concerns regarding the Medication Policy please call the office for assistance.

         

        Referral Procedure

        Call your insurance

        Please call the 1-800 number on the back of your insurance card (usually marked as “customer service”) ask them for the in-network facility or provider suggested by the clinic (i.e. Provider/lab facility/x-ray facility)

        Covered California only…

        Check with the in-network facility or provider after confirming with your insurance company please call the in-network facility or provider suggested by the clinic (i.e. Provider/lab facility/x-ray facility) to confirm covered California coverage.

        Call the office

        Call the office with the in-network facility or provider suggested by the clinic (i.e. Provider/lab facility/x-ray facility). You can ask for Nikki or leave a message on the clinic answering machine.

         

        *Referrals calls are answered once a day in the afternoon.

         

        Wait for a return call from the office

        Nikki will call you when your referral has been sent to the in network facility or provider supplied by you. Please do not call the facility or provider before you receive a call from our office to notify you that the referral has been sent.

         

        *Please allow for 5-7 business days for processing a referral.

         

        *If you are Tricare and need approval/authorization please allow for an additional 5-7 business days.

         

        For the best quality of care we require an appointment for all referrals and referral re-ups.

         

        Why are referrals important?

        Most specialists require referral to be seen. Referral(s) connect your specialists with your primary care doctor, us. Having a referral will prompt your specialist to keep your primary care doctor up-to-date with labs and reports, so your primary care physician can see the “whole picture” of your health.

         

        Why we require appointments for referrals?

        Specialists require chart notes to backup referrals. The chart  notes need to be up-to-date with the most current diagnosis. Old referrals may require appointment due to an outdated note(s).

         

        Records Release Policy and Procedure

        You have the right to inspect and copy your health information, with limited exceptions. To access your medical information, you must submit a written request detailing what information you want access to, whether you want to inspect it or get a copy of it, and if you want a copy, your preferred form and format. We will also send a copy to any other person you designate in writing.

         

        • All medical records require a signed release form. These forms can be found at our front desk or at your new doctors office.
        • Patients are required to give the office at least one week to copy all records, please plan accordingly.
        • There will be a charge for records per State regulations (Health and
          Safety Code, section 123110)
        • All current Tricare Patient records will be free of cost unless patient needs records mailed. (Charge applied for postage)
        • Completed records are to be faxed, picked up or mailed (Charge applied for postage if mailed)

         

        Release of Results Policy (Labs, imaging, pathology, etc.)

        We do not give results over the phone. The only exceptions are for PAP results and acute x-ray results. Records that have not been reviewed by a provider in our office can only be released to a physician.

        Please call to make an appointment with a provider to go over any testing completed.

         

        Appointments Policy

        The average appointment length is 15 minutes. Physicals, PAPs, procedures and abdominal issues are 30 minutes in length. If you feel that you will need additional time please let the patient coordinator know when you are making your appointment.

         

        The following require an appointment:

         

        • New patients all patients are required to have minimum of two visits a year, one being a Wellness Exam / Physical exam.
        • All referrals require an appointment and a follow-up
        • Follow-ups appointments after appointments with Specialists (i.e. Cardiology, Neurology, Dermatology etc.)
        • Medications require a follow-up appointment (1month, 3 month, 6 month)
        • New ailments require an appointment

         

        Labs, testing and radiology require an appointment.