PRACTICE GUIDELINES

MOGA follows a number of guidelines in our day-to-day practice which dictate how we address the needs of our patients. These include the following: ◾You are responsible for knowing which hospital your insurance carrier allows us to utilize for your procedures, tests, and admissions. ◾Routine medication refills are called in only during office hours. We do not refill prescriptions after hours or on weekends. When calling for a prescription, please have the phone number to your pharmacy.

• Requests for narcotic prescriptions will not be granted after hours or on weekends.
• If you have a question for the nurse or physician, we will return your call as soon as possible, giving priority to emergencies and scheduled patients in the office. At the time of your call, please let us know if you will be unavailable at a certain time.
• Physician excuses for days missed from employment or school are written only for the day you are seen in our office and additional days needed for recovery. We are unable to write excuses for illnesses not evaluated in our office.
• Please allow us one week to contact you regarding lab/test results.
• MOGA requires a 24-hour cancellation notice for any scheduled medical appointment or surgery/procedure.
• No shows and cancellations without a 24-hour notice may receive a $20.00 charge for missed office visits and a $150.00 charge for missed surgeries or procedures. This charge will be the patient’s responsibility and will not be billed to or reimbursed by your insurance.
• There is a minimum fee of $20.00 for the release of medical records which is the responsibility of the patient to pay prior to receiving the records. For records that exceed twenty (20) pages, there may be an additional charge of $0.50 per page for all pages exceeding the first twenty (20) pages. A $20.00 fee will be charged to complete up to two (2) forms for FMLA and standard disability. An additional fee of $25.00 will be charged for submitting subsequent forms.
• MOGA does not participate with TennCare or with any TennCare Managed Care Organization (MCO) and will not submit claims to these plans.
• It is the policy of MOGA to collect all patient balances, co-pays, and deposits due from patients at the time of service.