There is usually only a copay that applies for a visit. Deductible usually applies for other services done in the office like EKG's (CPT 93000) or in office small surgeries (ex. Ingrown toenails or incisions and drainages) or injections. If there will be a procedure done in office, feel free to ask us what the procedure codes are so that you get the right benefits in case customer service asks.

acknowledge that I have
Received a copy of the “Notice of Privacy Practices” and “Patient’s Rights andResponsibilities” to read and that I fully understand its contents as written. I have also been provided with information regarding the procedures to follow when filing a complaint to the Texas Department of Insurance or the Texas Board of Medical Examiners.

As a patient you have certain rights and responsibilities. We recognize that a respectful relationship between
the healthcare provider and the patient is the foundation of proper medical care. Copies of this statement are
available in our office.
Patients have the right to:
-Receive humane care and treatment, with respect and consideration. Confidentiality of your health records.
-Not be discriminated against on the basis of race, color, national origin, disability, or age.
-Privacy and confidentiality when seeking or receiving care except for life threatening conditions or situations.
-Be informed of and to exercise the option to refuse to participate in any research aspect of your care without
compromising access to medical care and treatment.
-Receive accurate information concerning diagnosis, treatment, risks involved, and prognosis of an illness or
health related condition.
-Ask about reasonable alternatives to care. A second professional opinion regarding one’s health care and
treatment.
-Participate actively in decisions regarding one’s health care and treatment. Accessible information regarding
the scope and availability of services.
-Be informed about any legal reporting requirements regarding any aspect of screening or care.
Patients have the responsibility to:
-Provide complete information about one’s illness/problem to enable proper evaluation and treatment.
-Ask questions so that an understanding of the condition or problem is ensured.
-Show respect to health personnel and other patients. Use prescription or medical devices for oneself only.
-Reschedule/cancel an appointment so that another person may be given that time slot. If appointment is not
cancelled 24 hours in advanced a fee will be charged.
-Pay bills or file health claims in a timely manner.
--Inform practitioner if one’s condition worsens or an expected reaction occurs from a medication.
-Designate an emergency contact whom may be contacted in case of an emergency or change in the patient’s
condition.