Etheridge Family Medicine, LLC. - Office Policy
Etheridge Family Medicine, LLC. -
 In order to conform to the insurance regulations and keep our costs competitive, we kindly request you to comply with the following office policies.
In  Emergencies
For life threatening conditions call 911 or go to the nearest emergency room.
  • Please bring a valid photo ID and your insurance card to each visit.
  • In order to minimize your wait time, please be on time for your appointments. 
  • 24 hour advance notice is needed for rescheduling of appointments or cancellations.  Failure to do so will result in additional charges.
  •  As a courtesy, our office places reminder phone calls up to 2 days prior to scheduled appointment. However, it is the patient’s responsibility to remember their appointment and be on time.
  • Referrals will be processed after the patient is seen by the physician and if it is deemed necessary.

  • There is a charge for completing medical forms-including but not limited to school physicals, disability forms, CDL licensing forms, etc.  Please contact our office for more details

  • Insurance/ Referrals:
  •    In the event that your insurance plan requires you to have a referral: ¨ It is up to the physician to decide whether or not the referral is necessary.  Referrals may take up to 7 business days to complete.  Certain tests require precertification from the insurance company which is out of our hands and there is no guarantee that your request will be approved.  Referrals cannot be back dated under any circumstances.  It is the responsibility of the patient to check with the specialist a few days prior to their visit to ensure that they have visits remaining on their referrals.  This office will not be responsible for any inconvenience or expenses incurred if the insurance company denies or delays such referrals.  You will be notified once your referrals are ready for pickup.  They will not be mailed. 
  •     It is your responsibility to be fully familiar with your insurance coverage and benefits. Due to varying insurance company requirements, we cannot be responsible for referring you to a facility not covered by your insurance company (For Example: for blood work, x-ray, specialist or other paramedical specialty). Prior to visiting any facility or doctor for further work up or treatment, please confirm with your insurance carrier or related facility.
  • All related medical forms take 7-10 business day to complete and there is an additional charge, unless it is an emergency. Please note-it is not an emergency if you are in a specialist's office and forgot to ask for the referral
  • Prescription medication will be given during regular follow-up office visits.  In order to avoid confusion, please bring a detailed medication list including all prescription, over the counter and vitamin supplements to each visit, including those given by specialists so that we may continue to provide accurate, quality medical care.
  • No Refills of medications will be called into the pharmacy after office hours or over the weekend.  Please be sure to monitor the amount of medication and refills that are clearly written on your prescription bottles.  Please do not wait until the weekend or when the office is closed.  In cases of emergencies, a 3 day supply of meds may be called into the pharmacy for vital medications only (ie hypertension or diabetic meds) until the office is open for the patient to be physically seen.  Patient may go to an urgent care facility if needs evaluation in times when the office is not open.  Under no circumstances will prescriptions for narcotics or controlled substances be given without being physically seen and examined.
  • For your safety, please do not ask us to diagnose illnesses or prescribe medication over the telephone- it is not in the best interest of the physician or patient to make such diagnoses without examining the patient. 
Financial Policy:
1. We are committed to providing the best treatment for our patients and charge what is usual and customary in our area. We take our responsibility with utmost seriousness and would appreciate prompt payment for our services.
2. We will provide you with a receipt for services at the time of your visit. Kindly keep this receipt in safe custody as we may not be able to provide you with another receipt or copies of statements at a later date
3. Regarding Managed Care Insurance in which we participate: Please supply our office staff with your primary and secondary insurance identification card(s) at the time of your appointment. If your insurance requires co-pay or deductible, kindly pay it, at the time of the appointment.
4. A charge of $30.00 will be collected for any bank return check, along with the previous balance.
  • At this time we only accept cash or checks/ money orders
Information Change
Please let us know if you address or insurance information has changed