IRPC RULES FOR PATIENTS
IRPC RULES FOR PATIENTS TO
FOLLOW
Failure to keep appointments or rescheduling appointments more than 3 times will result in dismissal from the clinic. After 3 consecutive no shows, A NO SHOW fee MUST be paid prior to being seen again. Fees for 3 consecutive no show follow up appointments or procedures are $40/$100 respectively. New patients who no show 3 times will need to wait 6 months before they will be scheduled again
Will not undergo any pain management procedures or injections elsewhere without the consent of my IRPC pain management doctor. I understand I am free to transfer my pain management care at any time. If I choose to transfer care, I understand the new physician will assume all responsibility for my prescribed pain medications
IRPC will not make any exceptions for the following
- No narcotics for any pregnant women
- No narcotics to anyone under 21 years of age
-
No early replacement prescriptions for
lost or stolen medicine - No early refills
-
No narcotics to anyone with a history of
buying or selling illegal drugs
IRPC PAIN MANAGEMENT AGREEMENT
Please click the attached pain management agreement for schedule drugs and narcotics policies and make sure to read and understand completely before signing it. Any intentional hiding or false statement can result in immediate termination
IRPC NEW PATIENT
PACKAGE
Please click the attached new patient package and make sure to fill it completely before signing it at the end. Please bring it with you at the time of initial visit.
PATIENT INFORMATION:
Due to high volume of patients needing appointments at our clinics, we have a wait time of about two-three weeks for appointments. With this in mind, it’s important for our patients to provide us with notice if they need to cancel their appointments so we can provide care to others who are waiting to be seen.
In order to provide the highest quality care for each of our patients, we’re asking for all patients of IRPC to keep their appointments unless it’s absolutely necessary to cancel.
Payment Options
All co-pays and deductibles are due at the time of service. For your convenience we gladly accept cash and credit cards. You must have your insurance card at time of check-in.
Insurance Coverage
IRPC accepts all major insurance carriers (including Medicare, Medicaid and most other insurances). We also will pre-certify any insurance requirements as a courtesy for our patients. Please have all insurance cards, photo ID and copays ready at each and every visit. If we are unable to verify your insurance information then you will be expected to pay full cash price for services rendered.
Our Cancellation Policy
IRPC is proud to provide a flexible cancellation policy for our patients. If you need to cancel your appointment at one of our clinics, please provide at least 24 hours’ notice. Feel free to reschedule your appointment for a date that works for you.
YEARLY UPDATE PATIENT’S INFO
Please click the attached form to update your data on yearly basis.