Medical Records Release And Confidentiality:

Your medical information is kept in strict confidence. Before your records are released to your insurance company or any other medical provider involved in your care, you will need to sign a medical release authorization. This can be found on the Insurance Information form in Patient Registration Forms.

Insurance And Disability Forms:

Please bring any forms that you need completed for medical leave to our office. There is a $25 cash fee charge for filling out “medical leave / disability” forms that will be collected at the time the papers are presented. Please allow 72 hrs for these forms to be completed.

Emergency Care:

Dr. Mailapur tries to be available to his patients at all times. We can be reached through our office during normal business hours. If you call our office after hours, our answering service will pick-up and contact us. If you feel you have a life-threatening emergency, please call 911 or go to the nearest emergency room.

Patient Registration:

For your convenience, you can print the forms you will be asked to fill out at your initial visit. Forms are available under patient resources menu. Please complete them and bring them with you to your appointment along with your driver’s license and insurance cards. Also, please bring any reports of tests completed related to your problem. If you need assistance on how to obtain your studies please call us. Please bring all medications or a list of medications you are currently taking.

Billing And Insurance:

As a courtesy to our patients, we will file all office and procedure charges with your insurance carrier. Please bring your most recent insurance card to every appointment. Some insurance plans require a referral from your primary care provider before you see us. You must obtain this referral prior to your scheduled office visit. If your insurance plan requires a co-payment or if you have a deductible, these fees are due at the time of your visit, this is due before you see the doctor. We accept cash, check and credit cards. If you are covered by a health insurance plan, please be aware that your policy may not cover 100% of the physician’s charges due to deductibles and co-insurance amounts. You will be responsible for any deductible and co-insurance amounts. If you do not carry health insurance coverage you will need to make arrangements with our office manager for payment of your bill.

Payments form more than 250 dollars cannot be a personal check or a credit card. They need to be a certified check, money order or cash.

Appointment Request:

Patients are seen by appointment only, however we try to allow time in our schedules to accommodate patients with urgent problems.

Refill Request:

Our policy is to only refill medications Monday-Friday during regular office hours. We will not refill prescriptions for narcotics (pain pills) or any controlled substance after hours or on weekends. If you call the office for a medication refill, please have the name of the medication and your pharmacy number ready.

Checks

  • We do not take post dated checks.
  • We do not accept checks written and signed by someone else.
  • Checks need to be signed by the person whose name is on the check and given in person.
  • Bounced checks for whatever reason is headed over to the worthless check division at the District Attorney’s office after giving a 10 day notice to you by certified letter. If the check is bounced, there will be a minimum fee of $40.00
  • If the check amount is more than 250 dollars, we need a certified check or a money order.

Credit Card Payment

  • We accept Visa, Master Card, Discover card and American Express cards only.
  • We do no credit card payments over the phone.
  • We do not accept credit card payments for amounts greater than $250.00
  • We do not split credit card payments between several cards.

Flex spending cards

Flex spending cards are accepted for amounts over $250.00 only.

Financial Fees

  • A late fee of $10.00 will be due if the co-payment is not paid at the time of the office visit.
  • A fee of $25.00 per form for completion of any forms, except work excuse or school excuse. This needs to be paid in cash only.