YOUR FIRST VISIT
With the implementation of electronic medical records, information that once was not required is now mandatory for all physicians to obtain from their patients. During the first visit we need to obtain your entire medical history, including a list of any and all medications that you may be taking and any allergies that you may have. Even information that you feel is not pertinent to the care of your feet is necessary to comply with HIPPA regulations.
At your first visit you will need to fill out a patient information form. This form is used to obtain the patient’s date of birth, address, phone number, employer information, pharmacy, primary care physician information, as well as insurance information. This information is required to properly enter the patient into our system. Along with this form, a medical history form is also required to enter the patient into our system. Both of these forms may be downloaded and printed from our website. We also offer the forms in Portuguese and Spanish for our patients that cannot read English. There are also a few waivers and authorization forms that we ask you to fill out or sign when you present to the office for the first time.
We are required to update patient information yearly, even if nothing has changed. If your information changes within the year please let the staff know. If you are a patient but have not been seen in over 3 years you are considered a new patient by insurance standards. You will need to fill out all new paperwork.
We understand that paperwork is sometimes overwhelming but we make every effort to make this process as easy as possible. Your first visit to Family Footcare establishes a vital foundation for our relationship with you.
- If you are a new patient, we ask that you arrive for your appointment 15 minutes early to complete the registration process. Please bring the following with you to your visit:
- Completed patient information form (PDF FORMS on the right of this page)
- Completed medical history form (PDF FORMS on the right of this page)
- Insurance card
- Driver’s license or photo ID
- Referral from your primary care physician (if required by your insurance plan)
- Medication list
- Copy of medical records (if you are coming in for a second opinion)
Our practice participates with most major insurance plans including but not limited to: Medicare, Medicare HMOs, Blue Cross & Blue Shield Health Plans, Cigna, Aetna, United Healthcare, Oxford, Medicaid, Husky and many more. Please contact our office to inquire about your specific insurance plan.
Please make sure you have your current insurance information when you come to the office for your appointment. If you have more than one insurance please provide us with the information for all your plans. Failure to provide all insurance information may cause claims to be submitted past the filing limit. Many insurances have a filing limit and if they do not receive the claim prior to the filing limit they will not pay the claim and you will be responsible for the charges. Some carriers require you to obtain a referral from your primary care doctor to see a specialist in order for your visit to be covered. It is your responsibility to know if your plan requires a referral and it is also your responsibility to contact your PCP and obtain the referral prior to your visit. Co-pays are due at time of service.
The Patient Portal provides an easy-to-use, secure, web-based method for patients to access portions of their medical records on-line. This is available from any computer (desktop, laptop or tablet) with Internet access. When you log into the Patient Portal, you will be able to view information, including your medical conditions, medications, vital signs, lab results, allergies, and insurance policies. You will also be able to view upcoming appointments and appointment history, view your account balance and make any necessary changes to your personal information.
If you would like to create an account to access your medical records please fill-out the Patient Portal Registration Form. Once the form has been completed it can be faxed to our office at 203-723-2946 or emailed to email@example.com. You may also deliver this form in person to any of our office locations. If you need assistance filling out the form please call 203-723-7884 and someone will assist you.
Once you have registered for the Patient Portal, you will receive an email from our office with instructions on how to complete your Patient Portal registration.