Print these forms and complete them prior to your appointment because it will save you time. Remember to put them in the car, your backpack or your purse so that you won’t forget to bring them with you.
- IDSA Patient Questionnaire
- IDSA Patient Demographic and Insurance Information
- IDSA Agreement of Financial Responsibility
- IDSA Patient Authorization for Practice Release
What to Bring
- Forms that you have downloaded and completed in advance
- All medical records related to your condition, including X-rays, laboratory reports, and immunization records. Often your referring physician will forward this information to the specialist before your scheduled appointment.
- A list of all medications you take, including prescription medications, over-the-counter medications, vitamins, and nutritional supplements. Be sure to make note of the dosage of each medication.
- A list of any allergies you have
- Your calendar
- Proof of identification which includes a photo I.D. (Every visit)
- Insurance card (Every visit)
- Referral paperwork if required by your insurance (HMO)
- Co-payment, required at the time of the visit (Cash, check, Visa, MasterCard, American Express, and Discover accepted)
- NOTE: The ID specialist needs to know if you are taking birth control pills since some antibiotics may interfere with the effectiveness of oral contraceptives.
Preparing For Your Appointment
Please read the documents that are listed below because the information you find there will save you time and will improve the efficiency of your visit.
We are conveniently located on the campus of DeKalb Medical in the 2665 Professional Building.
2665 North Decatur Road
Decatur, GA 30033
Phone: 404-297-9755 X802 for directions
Parking: There is a surface lot on the west side of our building. Covered parking is available in the parking deck across from the building. Enter the deck from the side entrance on Rufus Evans Drive or from the entrance across from the Emergency Department.
We make every effort to stick to the schedule of appointments, but in medicine, unforeseen delays can occur. We hope you will understand that we strive to provide the highest quality of care to you and all of our patients.
To change your appointment for any reason, please call the office at 404-297-9755 as early as possible, but at least 24 hours in advance.
Insurance and Billing Policies
The physicians and staff of Infectious Disease Specialists of Atlanta, P.C. (IDSA) are committed to providing our patients with the best possible medical care. We also strive to minimize administrative and billing costs that would otherwise increase the cost of medical care to our patients. With these objectives in mind we developed insurance and billing policies that clearly outline the financial responsibilities of the medical provider and the patient. We ask you to review these policies before treatment so that there will be no misunderstandings later. The physicians and staff of IDSA firmly believe that a good physician-patient relationship is based upon clear communications and a mutual understanding of expectations.
We recognize that the process of filing medical insurance claims is complex, and we are ready and willing to help you with this process.
Insurance, Managed Care and Government Programs:
- The physicians of IDSA contract with numerous insurance plans and managed health care programs, and our business staff take pride in their ability to respond to the challenges of working with so many constantly changing plans. As a courtesy to our patients, our business office submits claims directly to insurance companies for services rendered for patients who are members of these plans. However, we cannot provide this service unless the patient completes all necessary insurance information, including special forms, before leaving the office.
- If referrals are required by an insurance company before treatment can be provided, it is the PATIENT’S responsibility to obtain the necessary referral PRIOR to being treated. If a required referral is not obtained by the patient in advance of treatment, the insurance carrier may not pay the physician for the treatment. Therefore, the appointment may have to be rescheduled, or the patient may have to pay IDSA in full for the treatment received at the time of service and seek direct reimbursement from the insurance provider.
- It is the patient’s responsibility to pay any deductible, co-insurance or any portion of the charges as specified by the plan at the time of the visit. Co-payment must be made before the patient sees the physician or practitioner. Any medical services not covered by an individual’s insurance plan are the patient’s responsibility, and payment in full is due at the time of service.
- Insurance companies require us to ask the patient to present a photo ID and current insurance membership card at each visit. The federal HIPAA Privacy Rule also requires us to verify identity at each visit to protect the privacy of each patient’s medical information.
- If IDSA is unable to verify the patient’s eligibility for benefits under an insurance plan, payment in full will be expected at the time of service.
- The receptionist or billing representative may require documentation that a deductible has been met so that insurance will cover the cost of a visit. A recent “explanation of billing” from the insurance company verifying the deductible met or deductible remaining for the patient will usually be satisfactory as documentation.
- It is the patient’s responsibility to provide us with current address and phone numbers as well as insurance information.
- It is the responsibility of IDSA business office representatives to answer patients’ questions regarding how an insurance claim was filed. We are also responsible for providing additional information that an insurance carrier may need to process a claim. However, we are not able to explain specific coverage details for individual patients. This information can only be supplied by the insurance company’s member services department. The telephone number for this department is listed on the insurance membership ID card.
- In an effort to save paper and our environment, a copy of your clinical summary will be saved in your electronic medical record. You will be provided with a printed copy upon request.
Forms of Payment
- Co-payments and private payment for professional services can be made with cash, check, Visa, MasterCard, American Express, and Discover.
- Patients who do not have insurance are expected to pay for treatment at the time of service unless prior arrangements have been made with us.
- In the event a patient is unable to pay the full amount due at the time of service, under certain circumstances IDSA will allow the patient/guarantor to complete a promissory note for payment. This note is a legal agreement to make payment within a maximum period of 12 months from the date of service. The minimum payment per month is $30.00. Failure to complete payment will be considered a breach of a legal agreement and will result in the account being turned over to a collection agency.