Updated: 03/2024

AIHW Office Policies for Patients

I. Introduction

A primary care provider (PCP) is a health care practitioner who provides and coordinates medical care for people that have common medical problems; a PCP may be a physician or a nurse practitioner.  Associates in Health & Wellness Corporation (AIHW) is an affiliate of Jenny Delaleu, Nurse Practitioner in Family Health, PLLC; two separate group entities.  Our office is comprised of nurse practitioners who are also primary care providers skilled at providing and coordinating quality health care.  We care for individuals ages 6 years and older.

What makes us unique as providers is our commitment to delivering individualized health care and tailored health education to our patients.  We are committed to improving the patient-provider relationship.  We pride ourselves in being highly accessible and communicate easily using most electronic formats, including email and text messaging.  Kindly take a moment to review our office policies to help streamline your partnership with our office.

II. Appointments

1. Booking an appointment:  There are various methods to self-book an appointment with one of our providers, nurses, or staff members. You have the option of choosing one of the following:  

1. Self-Booking: www.aihwCo.com

1. Book a Visit
2. Book an InstaCare Visit (Same-day Self-Pay Virtual Urgent Care)
3. Book a visit on your AthenaHealth portal

2. Call our office: 516.279.5484

2. Self-Booking Guidelines:

1. Within a reasonable timeframe, our office has the right to:

1. Notify you in advance and cancel inappropriate appointment bookings (e.g., Inappropriate, non-primary care visit bookings for our office include: newborn checks, request for dental work, colonoscopies, etc. Please see the services we offer.).
2. Notify you in advance and convert self bookings to a nurse or staff member such as a Medical Assistant or RN who can better handle your request if the provider is unavailable.
3. Remove your rights to self-booking and use of the portal for inappropriate use or abuse.

3. Balances, Copayments, & Coinsurance:

1. If you carry a balance, services at our office can not be rendered without a payment plan or until you have paid your copayment and/or coinsurance as part of the contractual agreement you have made with your health insurance for your upcoming visit.

1. We offer 3, 6, and 12 month payment plans.

2. We have the right to cancel appointments if we are unable to reach you within 24 hours or more if a form of payment cannot be clarified, balances are not paid in full (or a payment plan has not been set up).

4. Self Check-in:

1. The proprietary name of the patient portal, or patient health record (PHR) that we utilize is AthenaHealth.  If you are experiencing errors you must contact us immediately to resolve. Remember to take a screenshot or print the error(s) so that our team can open a case with Athena’s IT Department.
2. Most office forms such as consents and pre visit screenings are now electronic and can be completed through your mobile device or portal when you complete your Self Check-in.
3. If you cannot or do not complete your Self Check-in our system in Athena does NOT allow providers to access your chart to start your visit and send prescriptions or other orders.

5. No-shows:  

1. There is a $25.00 fee that will be billed to you for each no-call no-show appointment.
2. It is a mutual understanding that two (2) no-call no-shows including the inability of our office to reach the patient is an indication that the patient has decided not to continue obtaining medical services at our office and a discharge/termination from the practice will be mailed.

6. Cancellations:

1. There is a $25.00 fee that will be billed to you for same-day cancellations/rescheduling within two (2) hours of your appointment.  Waivers will only be made at the discretion of the Practice Manager if written documentation is provided for extenuating circumstances.

7. Phone Calls & Messages:

1. All non-urgent messages will be returned within five to seven (5-7) business days.
2. Urgent messages will be returned within two (2) hours. If you do not receive a call back by then, please call again or go to your nearest emergency department or urgent care.
3. Please present to your nearest emergency department or urgent care outside of normal business hours.
4. Emergent issues should be addressed by dialing 9-1-1 or going to your nearest emergency department.
5. Please do NOT send PHI (Protected Health Information) related messages via text (SMS) to our office line. Instead, we encourage you to use our patient portal through AthenaHealth to send private messages.

III. Prescriptions & Controlled Substances (Narcotics/Opioids)

1. Routine Prescriptions:

1. Prescription REFILLS are dispensed by the pharmacy. Prescription RENEWALS are made by the provider/office and sent to your pharmacy.
2. If you need a RENEWAL this is likely because your provider needs you to follow up in the office or virtually to be re-evaluated in order to check on medication tolerance, progress, etc.
3. Our providers can only RENEW prescriptions at the time of a booked appointment.
4. New Patients, Initial Visit: A maximum of 3 (three) prescriptions can be renewed (at the provider’s discretion) for a new patient’s initial visit. The remaining prescriptions will be renewed at follow up.
5. Please plan ahead; our office gets multiple requests, daily.

1. Please allow up to five to seven (5-7) business days to process your request.
2. If you have not been seen recently (e.g., within the last 3 mos or when sooner, as recommended by your provider), then our office may offer up to a 14 day temporary prescription RENEWAL until your next appointment. We will only allow this two times in succession, per year.

2. Controlled Substances (Narcotics/Opioids):

1. Medical providers are ONLY permitted to renew opioid and/or narcotic prescriptions at the time of a booked appointment.

1. Medical providers in our office can only renew opioid, habit-forming drugs, and/or narcotic prescriptions two (2) times before you are seen by a pain and/or behavioral health specialist.

1. EXCEPTIONS:

1. You have regularly books visits in our office under the Visit Type: “Behavioral Health (BH)” (i.e., psychiatrist or psychologist).
2.  <OR> Our office receives detailed, written recommendations by your BH specialist regarding medication renewals (i.e., medication name, strength, dose, quantity)  <AND> your BH visit notes are shared with our office on a regular basis.
3. <AND> Our medical providers agree with the dosing and strength of said prescription recommendations based on common practices in medicine and current guidelines.

2. Our policies on prescribing and monitoring the use of controlled substances are aligned with current New York State Laws and the CDC guidelines. Our practice aims to minimize opioid overutilization and provide referrals to pain specialists if clinically indicated.

1. Therefore, our office is required to utilize the NYS Prescription Monitoring Program’s (PMP) Registry using a Concurrent Drug Utilization Review (CDUR) (formerly known as I-STOP) while maintaining at all times the security and confidentiality of the information contained therein.
2. Please remember that all consumers, patients, and medical providers have the right to report illicit pharmaceutical abuse online with the US Department of Justice, Drug Enforcement Administration (DEA) through their website: RX Abuse Online Reporting: Report Incident

2. Opioid Patient-Prescriber Agreement (PPA): In order to set proper expectations for opioid utilization our office uses an opioid agreement or contract based on the FDA’s recommendations prior to prescribing controlled substances.  If applicable, carefully review the contents of the contract prior to signing.  Our office will answer any questions in regards to the contract that you may have.

III. Tests and Imaging Orders

1. If your provider requested or obtained a sample from you (blood, urine, etc.) then we ask that you book an appointment with our office in 7 to 10 business days to review these results.

1. If you are unable to make this appointment, we ask you to contact our office to review these results with you.  
2. Please note that you will be notified as soon as possible if grossly abnormal test results have been made available to our office.
3. Most laboratories will send you your lab results, but our office will also share your lab results with you on your patient portal: AthenaHealth.  
4. If you do not have access to the web or internet please notify us and we will mail a copy of your results to your mailing address, if requested.  

2. If your provider requested that you undergo an imaging study or diagnostic test, he or she has determined that there is a concern that requires a closer evaluation of your condition and or physical examination findings.

1. It is expected that you will be able to fulfill your part in arranging an appointment with the imaging center.
2. If you are having trouble contacting the imaging center(s), please call our office immediately for assistance.
3. If the results are abnormal, then our office will call you within 7 to 10 business days or sooner review these results with you.
4. Most imaging centers will send you your imaging results, but our office will also share your imaging results with you on your patient portal: AthenaHealth.  
5.  If you do not have access to the web or internet, we will mail a copy of your results to your mailing address, at your request.  Feel free to contact our office or your provider through your PHR with specific questions.

IV. Prior Authorizations

1. Prior Authorizations (PA) to perform certain tests and diagnostic studies are required by some insurance carriers.

1. Please note that these authorizations are primarily processed online and sometimes via telephone with your insurance carrier; this process is at times lengthy and can take up to 10-14 business days (for routine requests) depending on your insurance carrier.
2. Our office will notify you immediately once the PA is approved by your insurance carrier.

V. Patient Health Records & Medical Forms

1. Immediately prior to your first office visit, you will be invited by our office to view your medical records through the patient portal, or patient health record (PHR) that we utilize called AthenaHealth Portal.  If you did not receive this email, please check all spam folders, then call our office to make sure that we have the proper email address in our system.  The proprietary name of the PHR that we utilize is AthenaHealth Portal by AthenaHealth.
2. Patients and/or their patient-authorized representatives will be able to see structured data shared from the AthenaHealth EHR in their Athena Health Portal account if they are enrolled in AthenaHealth Portal. Structured data from the medical records include, lab results, diagnoses, medications, immunizations, allergies and certain fields of a chart note will be included.
3. Under HIPAA laws, we cannot utilize public email to correspond with our patients regarding personal health matters unless the message is sent via “confidential mode”.  Typically, we ask that you contact us via telephone or use the patient portal on AthenaHealth Portal to message our office staff.  You may also upload medical records directly into your Patient Health Record (PHR).
4. Medical Forms: All patients must have an appointment by our medical providers in order to complete medical forms (e.g, School physical, work physical, medical clearance, etc).

1. If you have been seen within 30 days then a medical visit may not be necessary.
2. Of note, insurance payors do not cover the work involved in competing school or work medical forms, therefore a $25.00 fee will be incurred for each required form, per entity (e.g., different employment forms, school forms, etc.).
3. Please allow for additional time for the provider to complete all medical forms, typically this takes between five (5) to seven (7) business days. We therefore ask you to please plan ahead accordingly.

5. If you happen to find any errors in your PHR please notify our office immediately.

VI. Specialists Referrals & Medical Clearance

1. For some individuals based on their insurance plan (e.g. HMOs), formal referrals are referrals that must be processed through your insurance company in order for you to be seen by a specialist.  These take up to five (5) to seven (7) business days for our office to process.
2. For some individuals based on their insurance plan (e.g., PPOs), formal referrals are not required.  Therefore, if needed an informal referral can be provided to you by our office prior to the end of your visit.
3. If your provider refers you to a specialist, he or she has determined that there is a concern for an in depth evaluation of your condition.  It is expected that you will be able to fulfill your part in arranging an appointment with the said specialist(s).  If you are having trouble contacting the specialist(s), please call our office immediately for assistance.

1. You must book an appointment to start the process of seeing a specialist and to obtain a referral.  You should not and depending on your insurance will not be able to “self-refer”, meaning you cannot make the determination to refer yourself to a specialist without first being seen by your provider.  

4. Medical Clearance:

1. Most insurance carriers require that you be seen and evaluated by your provider within 30 days of your procedure/surgery. Our office policies align with this recommendation.
2. We can only complete medical clearances for surgical procedures that will be performed in the state in which the medical provider is licensed.

VII. Communicating with our Office

1. Please remember that the provider cannot always reply to all AthenaHealth direct messages in a timely fashion as this inbox is not frequently monitored. Therefore, if you have an urgent matter please call our office or send messages directly to assigned staff. As always, if you have a medical emergency please dial 9-1-1.
2. When to call 911 for an emergency:

1. If you experience trouble breathing, passing out, unbearable pain, uncontrollable bleeding, slurred speech, weakness on one side of your body or face, sudden blindness in one or both eyes, chest pain, or fever greater than 102.3 deg F.
2. If you have been sent to an emergency room or have been hospitalized, please provide them with the name of your PCP and have them call our office or page the on-call provider.

3. When to call the office for urgent matters:

1. If you experience a worsening of symptoms, hives or rash with a new medication, or fever of 101.0 - 102.2 deg F.
2. Call our main telephone line and choose the option to speak to a live operator.  Someone from our office will return your call within 2 hours. If you do not hear from us by then <OR> your symptoms cannot wait, please report to the nearest UrgentCare (UC).

4. How to reach our office for non urgent matters:

1. Please note that SMS or text messages to our office are not frequently monitored outside of normal business hours; if you have an urgent matter please refer to the instructions above, VII, 3.
2. Call our main telephone line; if we are unavailable someone will return your call within two to three (2-3) business days.
3. Text our main telephone line, (generic messages only) and one of our staff members will respond typically within 24 hours.
4. Call our main telephone line and choose the option to page the on-call provider.  Someone from our office will contact you within 2 hours.
5. You can also message us via the patient portal, or patient health record (PHR) that we utilize: AthenaHealth Portal.

5. Grounds for Termination/Dismissal from the Medical Practice (i.e., the act of being discharged from the practice):  

1. The following sample behaviors that would constitutes a dismissal from our medical practice (this list is not exhaustive):

1. Inappropriate behavior:

1. Falsifying symptoms
2. Falsifying information
3. Feigning illness
4. Obtaining imaging/prescriptions/treatment/referrals without prior authorization from a medical provider
5. Threatening written or verbal tone
6. Excessive non urgent demands on staff resources and time
7. Demands on providers to prescribe medications and/or treatments that are not aligned with current guidelines
8. Contacting staff via social media
9. Forgery
10. Any other behavior that the provider and/or staff may determine is inappropriate, unethical, or illegal

2. Deliberately withholding any prior medical history or previous treatments.
3. Inability of our office to obtain records from you or your former medical providers after three (3) formal attempts. Unfortunately, we are unable to treat patients safely without a formal health history record.
4. Two (2) no shows for previously booked appointments.
5. Repeated failure to follow through with any mutually agreed upon lab work, imaging study, or consultation with a specialist (i.e., referral).

2. Once you are dismissed from our practice, our policy requires that our staff will then inactivate and archive your file.

1. Our staff will attempt to reach you to discuss the next steps in this process.
2. A formal letter via USPS will be mailed to you in that regard with detailed information on how to reach an alternate provider.

VIII. Privacy Policies, Terms & Conditions

1. Privacy Policies, Terms & Conditions

XI. Medical Records

1. HIPAA Authorized Medical Release Form:  This document, signed by you, allows you to list the names of family members, friends, clergy, health care providers, or other third (3rd) parties to whom you wish to have your medical information available. If anyone would ask for medical information regarding a specific patient and their name is not listed on the HIPAA form, they would not be privy, by law, to any of the patient’s information under any circumstances. The document also provides the ability for healthcare providers to share information with each other about your medical care. This document may be revoked and/or reassigned at the discretion of the patient at any time.

1. Our office requires a medical release form signed by you with the proper contact information, including fax number of the individual(s) or provider(s) that you need your records to be sent to. It takes approximately 5 to 7 business days and up to 30 days for our office to process your request for medical records."12
2. The Privacy Rule was issued by the U.S. Department of Health and Human Services (“HHS”) to implement the requirement of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).1 The Privacy Rule standards address the use and disclosure of individuals’ health information—called “protected health information” by organizations subject to the Privacy Rule — called “covered entities,” as well as standards for individuals' privacy rights to understand and control how their health information is used. Within HHS, the Office for Civil Rights (“OCR”) has responsibility for implementing and enforcing the Privacy Rule with respect to voluntary compliance activities and civil money penalties.  
3. A major goal of the Privacy Rule is to assure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public's health and well being. The Rule strikes a balance that permits important uses of information, while protecting the privacy of people who seek care and healing. Given that the healthcare marketplace is diverse, the Rule is designed to be flexible and comprehensive to cover the variety of uses and disclosures that need to be addressed.