PATIENT AGREEMENT

Updated March 25, 2018

Dear Patient:

I am thrilled to have you board this ship with me, with the common goal of being part of the solution.  I hope to provide you with some of the best care you have ever received (the “TLC experience”), in addition to accomplishing the three-fold Mission of TLC Family Health.  The purpose of this agreement is to outline some guidelines that will help us accomplish these goals together.

*Hours may change – see Online Scheduling Page.  Lunch is taken from 12:00 – 1:00 every day.

Scheduling, Paying for, and Attending Appointments

It is most efficient to schedule all appointments online (see link above).  However, if you are techno-challenged or otherwise prefer, you may also call us or send a request through the Elation Passport Patient Portal

REMEMBER:  WHEN SCHEDULING YOUR APPOINTMENT, SKIP THE PAYMENT PAGE!

Appointments are billed around the time they are booked, with any necessary adjustments made as needed afterwards, through the same third-party payment system (Hint Health) used when you signed up.

For in-office, telephone or video visits, we’ve developed a new, unique scheduling system that drastically reduces wait times.  Instead of simply specifying a start time, blocks of time are reserved, just like a lesson or class.  For example, if you schedule a 20-30-minute appointment, your appointment must conclude by the time the 30-minute block is over – if more time is needed, another appointment will need to be scheduled or a follow-up phone call can be made (usual charges apply – see next paragraph).  This will ensure that subsequent patients can be seen on time. 

As such (for in-office visits), please arrive with plenty of lead time to be able to be checked in and begin your visit at the appointed time.  We recommend arriving 10-15 minutes early if you are an established patient, and 25-30 minutes early if you are a new patient.  If you arrive late, you may still see the provider up until the end of the block (also see our Late Policy below).  In emergencies, visits that go longer than scheduled will be charged in 5-minute increments ($2.50 for members, $25 for à la carte).  Phone calls may need to be made later to wrap up unfinished business, and they will be charged in the same way.  

Remember that the practice of medicine (especially Family Medicine, which deals with the whole body, mind and soul) can be very unpredictable, and not all problems are equal (e.g., the evaluation of chest pain takes a lot longer than that of a skin lesion); therefore, there can be no guarantees as to how much will be accomplished in a particular visit.  How much time you wish to reserve should be based on your past experience or the level of complication of the problem(s) needing to be addressed.  See the Pricing page, under PHYSICIAN AND PA SERVICES, for examples that will help you estimate how much time you may desire to reserve.

Late and No-Show Policy

If you are running late, you may still come in, but your visit must end at the appointed time (see Scheduling section above).  If you know in advance that you cannot make it, or otherwise prefer, you may convert your visit to a telephone or video visit (established patients only) – call the office (972-914-9421) to let us know.  If you must reschedule, try to do so >2 hours prior to your appointment start time; otherwise, our late cancellation policy below applies.

Telephone, Video, and Portal Visits

When you reserve a telephone appointment, I will do my very best to call you at the appointed time.

When you reserve a video appointment, go to www.doxy.me/drcluff shortly before the appointment time and check in.  I will do my very best to join you at the appointed time.

When you wish to address concerns via the Patient Portal, you may send us a message at any time.  Portal messages must not be used for urgent matters, as response time is based on availability; most responses will occur within 24 business hours (if the problem becomes urgent while waiting, contact us as below).  Portal visits are billed after the fact, according to the amount of time spent addressing them, including research time (for every 5-minute increment, $2.50 for members/$25.00 for à la carte).

How to Reach Us

  1. For clinical/patient issues:  Through the Elation Passport Patient Portal
  2. For non-clinical issues:  E-mail us at info@tlcfamilyhealth.com.  Do not include Private Health Information (PHI) as it is not a secure e-mail.
  3. Office phone:  972-914-9421.

For Emergencies

  1. If you have a life-threatening emergency, call 911.
  2. If you require an urgent care visit during office hours, go online to schedule an appointment (we reserve a few slots each day for urgent care).  If no slots are available, call our office, and we will try to accommodate you.  If you still can’t get through, follow steps 3(1) or 3(2) below.
  3. If you require attention after hours (or even during the day if no appointments are available and you cannot reach us via the office phone), remember that one of my major goals is to save you money by preventing a visit to an urgent/emergent care center:
    1. If it is urgent and you need to contact me immediately (i.e., you need me to stop whatever I am doing and call ASAP), text "Call (first name) NOWto my personal cell phone (provided in the New Patient Orientation PowerPoint presentation attached to your Welcome e-mail – if you cannot find it, send me a message through the Portal).  If you do not hear from me within an acceptable time frame, call me.
    2. If it is urgent but can wait up to a couple of hours, send me a message through the Elation Passport Patient Portal, then text “Please check portal.”  If I don’t respond in the time frame needed, revert to #1 above.

Notes:  1)  The above communications will be billed according to our Pricing policy, i.e., according to total time spent.  2)  In the rare case I do not respond, there is likely a very good reason (e.g., I’m zip-lining, in surgery, in the shower, or on a plane; or my cell phone died; or I’m in a service that requires cell phones to be off), and you still need to seek whatever care you feel is necessary (e.g., at an urgent or emergency care center).

Use of My Cell Phone

Please use my cell phone only for emergencies as outlined above.  If you call me, since I do not store patient information in my phone, I will likely send you to voicemail, since I receive calls from a lot of telemarketers.  If you text me for non-urgent issues, I will kindly ask you to send me a message through the Patient Portal to facilitate proper documentation in the chart.

When I’m out of Town or Sick

There may be times that I leave town or become ill.  Whenever I do, I am usually still reachable via the Patient Portal or the office phone (972-914-9421) – or you may text me as above if it is an emergency.  Depending on the circumstances, I may even be able to schedule a telephone or video visit.  If I am unavailable or unreachable and you need urgent care, go to an urgent or emergency care center.

Medication Refills

I usually put enough refills on a medicine to last until I need to see you again.  So, if you are on your last refill, please schedule an appointment.  If you do not feel you need an appointment, send me a request through the Patient Portal.

Controlled Substances

Patients who require ongoing Schedule II-V controlled substances must be seen every 3 months until stable for 6 months, then every 6 months thereafter.  These medicines will not be prescribed without signing and abiding by our Controlled Substances Contract.  Narcotics (such as hydrocodone and Tylenol III with codeine) and benzodiazepines (such as Valium and Xanax) are not prescribed for regular, long-term use.  You will be referred to a pain management doctor or psychiatrist if that is desired or needed.

Using Your Health Savings Account (HSA) Card or Submitting Expenses to Your Insurance for Reimbursement

Monthly membership fees are not considered to be a qualified medical expense by the IRS, but all other expenses can be applied to your HSA or submitted to insurance if desired (reimbursement will likely be at out-of-network rates).  If you would like other expenses to be billed to an HSA card, simply call us (972-914-9421) and we will add it to your file.  Regular TLC Family Health members consider most expenses (outside the monthly membership fees) too small to go through the trouble of submitting them to insurance; however, If you are an insured à la carte patient, you may ask for a superbill for office visits so those expenses can be submitted.  Unfortunately, because I have opted out of Medicare, Medicare patients cannot submit bills for reimbursement.  If you have Medicare, you must agree to this stipulation (by signing a Medicare Private Contract, available for download from our Forms page).

TLC (Therapeutic Lifestyle Changes)

One of our primary goals is to improve your health through “TLC.”  By joining this practice, you agree that you will try hard to work with us in this way to improve your health!

Please follow us on Facebook and Instagram for helpful tips and to keep up with goings-on!  I look forward to embarking on this journey with you!  I plan on making changes to my practice model if I feel it will help me accomplish my Mission, so please give me feedback on how I am doing, what I can do better, or any other ideas you would like to share.

Dr. Cluff (and staff)