Further information

FOLLOW UP APPOINTMENTS:
Time intervals for follow up visits are determined by the acuity and complexity of the patient’s medical problems. Patients who are unstable or who have unresolved or undiagnosed issues are seen more frequently. Patients who are stable and doing well are sometimes seen at one-year intervals. Legal and insurance mandates require that we see any patient receiving a prescription medication from this office on a regular basis. Prior to each follow up visit, you will usually be requested to do laboratory work about one week before the visit is scheduled.

INITIAL VISIT:
You initial visit will require more time to ensure completion of all office forms. The health care team will also review and clarify your health history and perform a physical examination. All of your problems will be entered onto a master problem list. Additional time is also required to order and refill medications, order and explain laboratory tests and imaging procedures, and review instructional information regarding your illness as well as the benefits and possible adverse reactions to any new medications. After obtaining your medical history, the physical examination will often be performed by the nurse practitioner who will formulate a problem list, order diagnostic tests, prescribe medications, and schedule your follow-up visit after consultation with Dr. Gardner. At the initial visit, Dr. Gardner will also meet you and discuss the salient aspects of your case.

INSURANCE:
This clinic has contracts with most major insurance carriers including Aetna, Blue Cross / Blue Shield, Cigna, Humana, and United Healthcare. We also welcome Medicare patients and many secondary Medicare health plans. If you are uncertain about your insurance coverage, Mrs. Debbie Conway, our billing and insurance specialist, will almost always be able to help answer your questions.

LABORATORY TESTING AND OTHER DIAGNOSTIC PROCEDURES:
Patients are requested to do their laboratory work one week prior to each return visit. This allows time for the results to reach our office and to be reviewed by our personnel for critical laboratory values prior to placement in your chart. Having the laboratory results when you return makes the follow up visit more productive.

We encourage patients to use any certified laboratory of their choice, such as LabCorp, Quest, and Memorial Hermann. Memorial Hermann Laboratory has a drawing station on the third floor of our professional building. Some insurance companies require their customers to use a specific laboratory. Fortunately, the large national laboratories such as Quest or LabCorp have drawing stations located all over the city and one is probably located near your home or office. Each testing facility will submit its own claim to your insurance company. This office does not profit from tests or procedures done at outside facilities.

Patients are requested to save a paper copy of each laboratory requisition, even though the requisitions are also submitted electronically to the laboratories. Presenting the paper copy to the laboratory drawing station ensures that the proper tests will always be done.

Sometimes, laboratory tests are ordered and done at the time of your visit or between visits. If the results are normal or felt to be acceptable, a brief form letter with the results attached will be mailed to you, indicating that the results are acceptable to the professional staff. If one of your laboratory values is felt to be too far out of range, you will be called and the abnormal result will be discussed by telephone. Sometimes, you may be asked to return for a follow up visit to discuss an abnormal laboratory or other test result with the physician or nurse practitioner. If the laboratory or other test results are received by this office within one month of your next appointment date, the results will usually be discussed with you in person during your follow up visit.

With certain exceptions, requests for results of tests or an analysis of test results by our providers by telephone are discouraged. Information presented in this way is prone to misinterpretation, and the review, analysis, and discussion of numerous laboratory and other tests are best done in person in the office.

You will receive instructions indicating whether the test needs to be done while you are fasting, in which case you should not eat or drink anything (except water which is fine) after 10:00 p.m. on the evening prior to the test. You should take all of your medicines the prior evening and on the morning of the blood draw, with the exception of some diabetes medications (such as insulin or glipizide) which should not be taken prior to the test but should be deferred until breakfast time after the blood has been drawn. If you have a question about these matters, please ask our office personnel.

MEDICATION REFILLS:
The best way to obtain a refill for one of the medications prescribed through this office is to call or contact your pharmacy or prescription service directly. They will then fax or email us a requisition if a new prescription is needed. After verification of the medication dose and quantity, we reorder the medication, often via the Internet or by return fax. This process usually requires 72 hours (three days). The modern electronic filling of prescriptions does provide an extra measure of security, helping to ensure that all of the prescribing data are correct. To prevent delays or missed medications, it is important to call or contact your pharmacy at least one week before your medication supply is exhausted. Many emergencies have been caused by unnecessary delays in obtaining prescription refills.

MEDICATIONS:
Side effects or “adverse reactions” are possible with almost any medication. We strive to carefully review with you the most important possible side effects of any new medication which we prescribe. Patients are also given printouts which review new medications in detail. These should be read carefully prior to use of the new drug. If you do experience possible side effects from a medication, call us immediately to determine the proper course of action.

PAYMENT AND BILLING POLICIES
Payment of your co-pay, deductable and co-insurance is requested at the time of service. Patients are also responsible for any adjusted charges not paid by the insurance carrier(s). You will be notified on a timely basis of residual unpaid balances due on your account.

It is the responsibility of the patient to disclose any preexisting illnesses not covered by insurance prior to service in this office. Adjusted charges declined by insurance carriers because of preexisting illnesses are the responsibility of the patient.

Payment plans will be offered to any person who has difficulty paying for medical services through this office.

PRIMARY CARE:
In the past, this clinic has helped with the primary care needs of many of our patients. Comprehensive primary care is labor intensive (periodic physical examinations, vaccinations, mammography, treatment of acute illnesses, etc.) and we no longer provide these services. Limiting our practice to endocrinology helps us to stay current with new advances to provide better care for the endocrine needs of our patients. We advise all patients to maintain a regular relationship with a primary care physician to address their other health issues.

PRIVACY:
Memorial City Endocrine Consultants is compliant with national and state regulations regarding the privacy of your personal health information and any other sensitive personal data. Your privacy is important to us, and we strive to follow all current guidelines regarding the handling of such information. Please review our “Notice of Privacy Practices”, also located on this website, and sign the “Acknowledgment”.

TELEPHONE ACCESS:
Office personnel are available to answer your telephone calls during regular office hours from 8:00 a.m. until 12:00 noon, and from 1:30 p.m. until 5:00 p.m. daily except for Wednesday, when the office is closed. Your calls are important, and during these hours one of our staff is always available to answer to your call. Your questions or requests may be forwarded to a specialist, such as our billing manager or one of the nurse assistants. If that individual is occupied or away from the desk, you will be requested to leave a voice message. Voice messages are checked at least twice daily. You will often receive a response to your call the same day. Some questions require review by the physician or nurse practitioner, in which case your call will be answered during the evening that day, after regular office hours, or the following day.

If you feel you have a medical emergency, you should call 911 immediately, rather than trying to contact one of our health providers through the office or the answering service. Your physician or nurse practitioner could be talking with another patient or physician, or helping with a critically ill patient at the hospital at the time of your call. In such situations, there may be some delay in returning your call. If you feel your call is urgent, alert the person receiving your message. Our office personnel or our answering service will direct your call to the appropriate person. If for some reason you do not receive a return call from our office promptly, call the office or answering service again. Explain that your call is urgent and you require a rapid response.

Before and after regular office hours, your call will be handled by our answering service. Routine calls regarding prescription refills, appointments, and test requirements and results should be made during regular office hours. If you have run out of an important medication such as insulin or a blood pressure medicine, you should contact us immediately, however, because missing such drugs for even one day can be dangerous. Dr. Gardner, or a respected colleague who is covering in his absence, is available by telephone for emergencies at night, weekends, and holidays.

COMPLAINTS
The staff and personnel of this clinic strive to please you and to provide the best possible medical care. The quality, cost, and convenience of your care as well as your opinions about our attitudes and performance are very important to us. If you have a suggestion for our improvement, or a complaint about our performance, voice it to the appropriate staff member. Usually complaints are best resolved by talking to our Office Manager, Mrs. Shernika Paige. If you feel your complaints were not properly addressed or given adequate attention, you should also discuss your concerns directly with Dr. Gardner. Many of the improvements in the performance of the office have occurred in response to complaints or thoughtful suggestions from our patients. If you remain concerned and feel the remedies listed above have been unhelpful, we are required by law to provide you with contact information for the Texas Medical Board or the Department of Health and Human Services in Washington, where you may further express your complaints or concerns.