Q: I have a new insurance and would like to see Dr. Kaim. Do I have to call my insurance first?
A: If your insurance plan requires that you have a primary care physician (PCP), please call or e-mail your insurance company and select Dr. Kaim as your PCP. If your plan allows you to see any physician in the network or out of network without a PCP selection, you can simply call the office and make an appointment with Dr. Kaim.
Q: I had blood tests done in Dr. Kaim's office but in several weeks I received a bill from a laboratory. What am I supposed to do?
A: Blood drawing, processing and handling of blood tests are provided as a courtesy and a convenience to the patient. Blood tests are then sent to an appropriate laboratory that participates with your insurance plan. If you received a bill from the laboratory, it is quite possible that the laboratory was denied payment by your insurance due to incorrect or insufficient data available in the laboratory about your personal information or your insurance. Please call the laboratory or fill in an appropriate form you have received, make a copy of your insurance card (both sides), and mail them back to the laboratory. If you receive a second bill, please call your insurance company to clarify the problem. If the billing problem is not resolved and you keep receiving bills from the laboratory, please call Dr. Kaim's office.
Q: I would like to see a specialist. Do I have to get a referral from Dr. Kaim's office?
A: If your insurance plan allows you to visit a specialist without a referral, you don't need to obtain it from Dr. Kaim's office. If your insurance requires that you have a formal referral from your primary care physician (PCP) in order to see a specialist, you have to initially visit Dr. Kaim, who will then issue a referral form, if necessary. The referral form can be a prescription blank, paper referral, or electronic print-out form. However, if the reason for your consultation with a specialist is obvious or you just need a follow-up visit, you don't have to see Dr. Kaim first. Please call the office with your request in advance and pick up your referral when it is ready, or provide a fax number where the referral form can be sent to.
Q: For personal reasons I would like to reschedule my appointment with Dr. Kaim. Do I have to cancel the appointment?
A: Yes. You have to call in advance and reschedule your appointment because other patients, perhaps, would like to see Dr. Kaim at your scheduled time, but the office keeps the time for you.
Repeatedly missed appointments without a timely cancellation may result in your being charged a nominal fee of $75.
Q: I have heard about a HIPAA privacy rule. What is it all about?
A: In general, the HIPAA privacy rule gives individuals the right to request a restriction on uses and disclosures of their protected health information (PHI). The individual is also provided the right to request confidential communications or that a communication of PHI be made by alternative means, such as sending correspondence to the individual's office instead of the individual's home.
The Privacy Rule generally requires health care providers to take reasonable steps to limit the use or disclosure of, and requests for PHI to the minimum necessary to accomplish the intended purpose. These provisions do not apply to uses or disclosures make pursuant to an authorization requested by the individual.
However, in an emergency, uses and disclosures for treatment, payment information, or healthcare operations (TPO) may be permitted without prior consent.