Education

Office Policies

Office Hours

Our office is open from 8:00am to 4:30pm. The first patient to see Dr. Spurlock is scheduled for 9:00am. Patients who come to see the Medical Assistant may be scheduled as early as 8:00am. Patients are not scheduled from 12:00pm through 1:00pm for lunch. However, our phones remain open for messages. We are closed in observance of major holidays. We see patients by appointment only.

After Hours

If you need to contact the office after hours we have an answering service available for messages. If you are experiencing a medical emergency please call 9-1-1- or proceed to your nearest emergency room.

Courtesy

We strive to provide the best medical care for our patients. While we make every effort to provide prompt on-time service, the healthcare needs of each individual do not necessarily lend themselves to an exact schedule. We therefore appreciate your understanding and patience. If you have any suggestion or complaint for our office, please let us know. Angry or foul language directed to our staff regardless of the issues involved will absolutely not be tolerated and will be grounds for immediate dismissal from the practice.

New Patients

Please arrive early so that we can finish completing your initial paperwork. Please bring your patient information form and your signed No Show/Cancellation Policy to your scheduled appointment. In addition, please bring the following: Patient's insurance card, a list of current prescriptions and/or over-the-counter medication, including dose and frequency and any drug allergies, and information about patient's medical and surgical history.

If the patient requires legal or physical assistance at the time of the appointment please make sure that those arrangements are made prior to the scheduled visit.

Changes in Address, Billing, or Contact Information

Please notify our office in wiriting if any changes of address, telephone, billing or contact information. It is imperative that we have the most current information on file.

Supervision of Children & Minors Present Without Parent or Legal Guardian

For safety reasons, we depend on parents to properly supervise their child(ren) at all times. Our staff cannot watch your children. Under no circumstances should a child under the age of 10 be left unattended. We also require a consent form signed by a parent or legal guardian to legally provide medical care to minors 16 and 17 years of age when the parent or legal guardian cannot be present. Minors 15 years of age or younger must be accompanied by a parent or legal guardian.

No Show and Cancellation Policy

We may every effort to provide prompt medical care to all our patients. We understand that situations arise in which you will not be able to keep your scheduled appointment. If you are unable to keep your appointment. we request that you call our office at least 24 hours prior to the scheduled appointment to cancel. This will enable another patient waiting for an appointment to be scheduled in the vacant slot. Patients may be subject to a late cancellation fee of $50.00. Patients who do not show up for an appointment and do not call to cancel will be considered NO SHOWS. No shows may be responsible for a $50.00 fee.

The Cancellation and No Show fees are the sole responsibility of the patient and must be paid in full before the patient's next appointment.

We know that sometimes special unavoidable circumstances will arise that do not allow for you to provide us with 24 hour cancellation notice. Fees in this instance may be waived, but only with management approval.

Our practice firmly believes that a good physician/patient relationship is based upon understanding and good communication. Questions about cancellation and no show fees should be directed to the Office Manager at 610-868-5780.

Telephone Messages

We will try our best to respond to your messages as soon as possible. However, please be aware that messages may take up to 24 HOURS to process and respond. More often than not, if your questions require extensive attention your providers may elect to have you make an appointment and come for further evaluation for quality assurance purposes. If you have a medical emergeny NEVER leave a message, but call 9-1-1 or go to the nearest emergency room.

Insurance and Billing

AS you are well aware, the business of providing insurance-based healthcare is increasingly complex and challenging. For our office to operate effectively and provide teh best service to you and your family, we need your cooperation with the following policies. Your clear understanding of these policies is very important. Please let us know if you have any questions or concerns.

Our office will submit claims for insurnance carriers with which we participate. At the Continence Management Institute of the Lehigh Valley, we are dedicated to offer QUALITY and, often times. beyond the standard medical care to our patients. To this end, it is YOUR RESPONSIBILITY to know your particular insurance plan benefits. Comprehensive physicals, immunizations, certain laboratory tests. procedures, and prescribed medications including nutrition and herbal supplements may not be covered. Prior Authorizations may be completed at the discretion of our providers. We therefore cannot guarantee that all services and therapies we provide are covered by your insurance. We also cannot just change CODES in order to modify insurance coverage as it is illegal and fraudulent. We stongly encourage you to contact your insurnance carrier ahead of time and verify appropriate coverage.

We obtain APPROVAL for services rendered prior to the patient's scheduled appointment as a courtesy. The quotation of benefits and eligibility is not a guarantee of payment or coverage and is subject to each patient's specific policy upon submission of the claim for a particular date-of -service. IF you have any questions regarding your coverage or a service please contact your insurance comapny. We work hard to obtain the necessary information to share with you when you arrive for your scheduled appointment.

Our staff also works to obtain Prior Authorizations for certain services, such as outpatient and inpatient procedues, prior to the scheduled appointment or procedure date. Please plan accordingly as this process may take several weeks to complete. As with approvals, the prior authorization is not a guarantee or payment or coverage for the date-of-service.

We also require proof of current insurnance at check-in for every visit. It is essential that you provide all the necessary information about your insurance, both primary and secondary. Since changes in insurance coverage are frequent, is is our policy to obtain a copy of your card(s) for applicable insurance. Please be prepared to present your card(s) at each visit. In case of a new policy, a copy of the enrollment form specifying insurance company name and phone number, insured employee's name, date of birth and social security number will be required.

We do our best to be as clear and thorough as possible when communicating with each insurance provider, but it remains the responsibility of the patient to be informed about his/her plan. The co-pay cannot be waived by our practice, as it is a requirement placed on you by your insurance carrier. We strive to be as accurate as possible in calculating your payment responsibility, but with so many variations in policies and fee schedules, we are not always exact.

If you receive a bill from us it is because we believe the balance is your responsibility. Please contact your insurance company FIRST if you think there is a problem. If you have any questions about your bill, please call our billing department immediately. If you cannot pay your entire balance at once please call to make payment arrangements.

If a REFERRAL is required by your insurance provider to see a specialist it is the patient's responsibility to obtain one from his/her primary care physician and either bring it to your appointment or have the primary care provider fax it to our office prior to your scheduled appointment. If we see you without a valid referral for the date-of-service you may be responsible for the entire fee for that visit. It is also the patient's responsibility to determine if the specialist participates with his/her insurance plan.

We are currently contracted with these major insurance carriers

AARP
Aetna
Amerihealth Administrators
Capital Blue Cross
Cigna
Geisinger
Highmark Blue Shield
Horizon BC/BS of NJ
First Priority Life
Freedom Blue
Independence Blue Cross
Keystone
Medicare
Multiplan
Oxford Health Plan
Tricare for Life
United Healthcare

If you are unsure if we participate with your plan, please call your insurance provider and ask as they will be able to tell you if we are in-network with your particular plan.

WE DO NOT ACCEPT ANY MEDICAID PRODUCT including, but not limited to: Medicaid/Access, Aetna Better Health, Amerihealth Caritas, Amerihealth Connect, Amerihealth Mercy, Amerihealth Northeast, Coventry Cares, Gateway, Geisinger Health Plan Family Medicaid HMO, Horizon of NJ Health, and United Healthcare Community Plan.

Self-pay patients (with no insurance) should expect to pay for your visit in full at time of service.

Payment Methods

At the Continence Management Institute of the Lehigh Valley we accept cash, check, cashier's check, money order, and credit and debit payments. We accept Visa, Discover, Mastercard and American Express.

We do accept credit and debit payments over the phone.

The Continence Management Institute of the Lehigh Valley understands the difficulty some patients may have in paying for medical services due to financial hardship and we therefore provide the option of establishing a PAYMENT AGREEMENT with the office. This can be set up, with management approval, in person or over the phone.

There is a returned check fee of $40.00. This fee will be added to your balance and be required to be paid in full prior to your next appointment by method other than personal check.

Collections

Accounts that are not paid within 30 days begin our in house collection process. We will do our best to resolve the issue outside of the legal system, but if your balance becomes more than 60 days past due, you may be subject to settling the matter through the legal system. We make every attempt to avoid these decisions by allowing for payment agreements. We value open communication with our patients regarding their financial situations, however, it remains the patient's responsibility to pay any balance not covered by insurance regardless of financial hardship.

Medical Records & Forms

All requests for medical records must be on a HIPPA approved form, which must be properly and completely filled out and signed by the patient or legal guardian. Improperly filled out forms may delay your request. Please allow at least 5 BUSINESS DAYS for processing.

Medical records released to a new provider, specialist or school: For continuity of care and as a courtesy to the patient, our office will forward records requests at not charge if we are provided with a signed medical records request.

Medical records released to the patient, some insurance companies, law firm or miscellaneous requests: Records are subject to copying fees. If the patient is signed up for our Patient Portal through the office website we can forward the requested medical records electronically through the Portal at no charge.

FMLA & Disabilities Forms

In general, we DO NOT complete or perform Long-Term Disability Forms & Evaluations as bladder issues are rarely, if ever, a cause of long-term disability. We DO REQUIRE that FMLA Forms & Short-Term Disability Forms be given at least 5 business days to complete. We prefer to complete these forms during a scheduled visit, but at times we will complete them during regular business hours at the doctor's discretion. Please plan accordingly with our timeline when requesting to have your paperwork completed. In general, we DO NOT submit FMLA or Short-Term Disability forms for the patient.

There is a $25.00 fee for the completion of medical forms such as FMLA or disability. For more extensive paperwork, such as surgical paperwork, an office visit will be scheduled for the doctor to review and complete the paperwork with the patient.

If you have any questions regarding our medical forms policy please ask Katie Rymon, the office manager.

Prescriptions

The best time to get your prescription refill is at your appointment. If you need to call for refills don't wait until you run out as it may take up to 48 hours to process a refill request as many requests require the doctor's approval. Please make sure the receptionist has the most up-to-date pharmacy listed in your chart. We are required to send all prescriptions electronically for Medicare patients. If we have not seen you in at least 6 months, you will need to schedule an appointment for a medicine follow-up before the doctor refills the prescription. Under 6 months since you last visit we can refill it without scheduling an appointment.

We will not call in a prescription for antibiotics after hours and without an appointment as many chronic bladder conditions (such as Interstitial Cystitis) mimic bladder infections. There is no way for the doctor to determine the cause of your bladder pain over the phone.

Samples: We sometimes offer you samples to help you try out a new medication before you purchase it. Remember that samples are not a long term way to fill your prescription. We do not always have samples of your medications. Please do not rely on samples for medications you take long term.

Narcotics: We do not prescribe narcotics for chronic use. We do not call in narcotics after hours. If you require use of narcotics, our doctor will refer you to a pain management specialist. We are unable to call in narcotics prescriptions over the phone. Many times a handwritten prescription is required to be presented at the pharmacy. We will not issue written prescriptions after hours.

Mail Order Pharmacies: Many insurance plans offer financial incentives for using mail order pharmacies. We are glad to print our prescriptions for your mail order pharmacy needs. With management approval we will fax mail order prescriptions, but please do not assume the office is responsible for sending/calling in mail order prescriptions. If you would like us to fax it, please ask at the front desk.

Prior Authorizations: Insurance companies frequently deny payment for certain non-formulary prescriptions. Our staff will make every effort to conduct a "prior authorization" on your behalf so you receive your medication. This process may take a few weeks. You are invited to inquire about the status of your "prior authorization" with us if the pharmacy is refusing to dispense your medication. An office visit may be required to discuss "prior authorization" concerns.

Surgery Scheduling

Dr. Spurlock performs surgeries at St. Luke's Hospital in Bethlehem, Pa and Palmerton Hospital in Palmerton, Pa. A separate appointment may be required to compete surgery paperwork and discuss the procedure. The office staff will then work with the OR schedulers at the hospitals to schedule your procedure. Please be advised that the average wait time for an elective procedure is 6 WEEKS from the time the paperwork is signed to the date of the surgery and to plan accordingly. Any short-term disability and FMLA paperwork may require an additional visit to be completed.