Patient Rights Policy
Your Information. Your Rights. Our Responsibilities.
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Patient No-Show & Late Policy
We understand that unplanned issues can come up and you may need to cancel an appointment. If that happens, we respectfully ask for scheduled appointments to be cancelled at least 24 hours in advance.
Our providers and staff want to be available for your needs and for the needs of all our patients. When a patient does not show up for a scheduled appointment, another patient loses an opportunity to be seen.
Circumstances have caused us to enforce our 2019 policy. The policy is as follows:
- A fee of $60.00 assessed if we do not receive a call to cancel an appointment within 24 hours of your appointment.
- You will be given one (1) warning before fees are assessed.
- If you are more than 15 minutes late to an appointment, it will need to be rescheduled to a different date/time.
- After a warning and four (4) missed visits, you will be discharged from this clinic.
Thank you for being a valued patient and for your understanding and cooperation as we institute this policy. This policy will enable us to open otherwise unused appointments to better serve the needs of all patients.
Sliding Fee Discount Program
This program is designed to provide free or discounted care to those who have no means, or limited means, to pay for their medical services (Uninsured or Underinsured). The program is based on the eligibility of a person’s ability to pay and will not discriminate on the basis of individual’s race, color, sex, natural origin, disability, religion, age, sexual orientation, or gender identity. The Federal Poverty Guidelines are used in creating and annually updating the sliding fee schedule (SFS) to determine eligibility.
Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, healthcare providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your healthcare provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule the item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure the save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.
Bowling Green Medical Group is a Certified Rural Health Clinic and was awarded the Exemplary Provider Award in 2020 for demonstrating Outstanding Healthcare Delivery Practices and Compliance to Safety-Honesty-Caring Accreditation Quality Standards.