What if I need specialty care?
Most Private Insurance or PPO patients are able to obtain specialty care without an order from a primary care provider.
Managed care or HMO patients, however, typically need to be referred by a primary care provider (PCP) in our office and await approval from your plan’s Independent Physician Association (IPA) before you are able to schedule a specialty care appointment. This process may take up to 7 to 14 business days for routine referrals. Some services, such as mental health, do not require a PCP order or IPA approval to schedule services.
Contact your insurance plan for specific guidance on the process for receiving the specialty care you are seeking.
Will you bill my insurance directly?
Montes Medical Group is contracted with most major health plans, and we will submit claim forms to your insurance company on your behalf.
What’s the difference between a physician and a certified physician’s assistant?
Certified Physician’s Assistants are health care professionals licensed to practice medicine with physician supervision. Unlike medical doctors, P.A.-C.’s study at schools that offer specialty training programs specifically for physician assistants. P.A.-C.’s study for three years after college as compared to the four years necessary to become an MD. And, P.A.-C.’s are not required to undertake a residency program, although some do. The primary difference, however, is that physicians have complete responsibility for patient care, while P.A.-C.’s practice under the guidance of their supervising physician. P.A.-C.’s do have many of the same abilities of a physician and are able to conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventative health care, assist in surgery, and also write prescriptions.
How do I schedule an appointment?
We see all patients by appointment whenever possible and request that you call or text your local office to schedule your appointment. Please remember that due to high demand for many of our care providers, the soonest availability for routine exams, such as physicals, pap smears, or school exams, may be weeks away. It is recommended to schedule these appointments well in advance should you need them completed by a specific date.
What if I need to be seen the same day?
When an unexpected illness occurs, we will make every effort to offer you a same day appointment with either your regular physician or physician’s assistant. Please understand, however, that many of our care providers often carry a full schedule, so for prompt service, you may need to be seen by another provider.
How can I help my doctors operate more efficiently?
The more organized that you are the more you will get out of your doctor visit. Here are some ideas to help you get the most out of your time with your physician:
- Make an effort to update your contact information (phone number and mailing address) and insurance information regularly with our front office.
- Bring all of your medications with you at every visit. If you don’t feel like bringing all of them with you in a bag then at least write down the name of the medication, the name of the doctor who prescribed the medication, the strength, and the dosing instructions. Include both prescription and any over the counter medications you are taking. Your doctor will want to review your medications and may make changes when she sees you at your visit. She will want to be sure that the recommendations made are based on accurate information about what medications you are taking.
- If you are at the doctor’s office to evaluate a new symptom remember that the doctor will probably ask you several questions about the symptom. Give some thought and maybe even write down the answers to these questions:
- How long has it been going on?
- Has it changed over time?
- What makes it better?
- What makes it worse?
- What was it that made me worried enough to call the doctor?
- What other symptoms have occurred?
- Where is the location of the symptom?
- Where does the symptom extend or radiate to?
- If you are at the doctor’s office for a follow-up visit give some thought to the following questions:
- How did the symptoms change since my last visit?
- How did the treatment work?
- Were there any side effects of the treatment?
- Do any symptoms continue on?
- Bring a copy of any recent test results in case the doctor did not receive them.
- If you are going to a doctor for the first time either bring or arrange for a copy of your medical record to be sent to your new doctor.
- If you are not fluent in English and your doctor does not speak your native language, bring somebody who can translate for you or notify our office one week prior to your appointment, and we can make arrangements to have a translator available on your date of service.
- If your insurance plan limits you to a panel of specific providers bring that information along so that your doctor can make referrals to the proper specialists if that becomes necessary.
- Make your end-of-life wishes known to your family and your doctor by completing an Advance Directive (Durable Power of Attorney) for Health Care. The best time to make decisions about what you want to happen in case you can’t make decisions for yourself is right now. All adults, regardless of age, should consider completing an Advance Directive
What happens if I don’t cancel an appointment or don’t show up for my appointment?
Because we reserve the appointment time specifically for your appointment and we cannot use it for another patient if you don’t cancel the appointment in advance, we have had to institute a cancellation fee for appointments canceled without sufficient notice. There is no charge if you call at least 24 hours in advance of your scheduled appointment to cancel. However, failure to cancel an appointment at least 24 hours in advance will result in a charge of $50 for an extended visit such as a physical or PAP smear, and $25 for a routine visit.
What if I need to reach my doctor by telephone?
- During regular office hours:
All patients are encouraged to call with any questions they may have about the care we provide. In order to minimize the interruption to patients who are in the office that day for a scheduled appointment, we try not to interrupt physicians, except for true medical emergencies, during their regular patient hours. Our staff has been trained to answer many of the questions you may have, and for those that need to be answered by your doctor, the staff will relay the information to the doctor and your call will be returned at the earliest opportunity.
For simple medical questions, such as a medication clarification, questions about lab results, whether you should be concerned about a particular symptom, etc., your doctor or the staff will most likely be able to answer your question over the phone. However, for more complex medical issues, your doctor may request that you set an appointment and come in to the office, as he or she may feel that you need to be seen in person for proper diagnosis and care.
- After hours:
If you have a life-threatening emergency, please call 911. Otherwise, call your doctor’s office and you will be connected with one of our on- call providers.
What is the best way to get my prescription refilled?
To refill a prescription, call your pharmacy with the refill request and they will contact your physician for approval. We will make every effort to meet your request as soon as possible. Unfortunately, these requests often take longer than expected because strong regulations imposed by the Medical Board and the Drug Enforcement Agency require that we treat each prescription refill request with great care.