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Avera Aberdeen Family Physicians

Avera St. Luke's State Street Medical Square
105 S. State Street, Ste. 113
Aberdeen, SD 57401
605-225-0378

For Patients

Patients & Visitors

Appointments

To schedule an appointment:

Call: (605) 225-0378
Fax: (605) 225-7919
Email: avera.afp@avera.org

Hours

8 a.m. to 5 p.m. Monday - Friday

Patients are seen by appointment, so please call in advance so that we may schedule a time for you. Because we must leave time in each physicians schedule to allow for sick visits and emergency care needs, routine health care appointments are limited. Health maintenance appointments such as well child exams and many types of surgical procedures should be scheduled at least 3-6 weeks in advance. Appointments for complete physicals should be made 4-6 months in advance. Should a situation arise where immediate treatment is necessary, every effort will be made to work the patient in at the earliest possible time.

Nurse visits are scheduled for children and adult injections, blood pressure checks, follow-up EKG's, ear irrigations, weight checks, etc. Appointments are required; otherwise there is no guarantee that a nurse will be able to see you. Visits are scheduled from 9 to 11:30 a.m. and 1:30 to 4:30 p.m. weekdays.

As a clinic we are very sensitive to the fact that long waits are unwanted and uncomfortable, and we make every effort to avoid delays. If it seems that your wait has been too long, please inform the receptionist and they will inquire as to the reason for the delay. Unfortunately situations do arise where the physicians must leave the clinic temporarily. Should this happen, clinic staff will notify the patient of the situation and the anticipated delay.

Cancellations

If you cannot keep an appointment, reasonable notice (24-hours) should be given to our office to cancel the appointment. This courtesy on your part makes it possible to give an appointment to another patient thus enabling us to serve all of our patients better.

Telephone Calls

Incoming calls are generally answered by a switchboard operator and directed to the proper staff personnel or department Please be specific of where you would like your call directed and have all pertinent information available to provide to the operator to speed your call along.

Our staff has been trained to answer most questions and inquiries. In the case that a staff member was unable to answer your question or help you, you will be directed to someone who is able to assist you better or a qualified staff member will return your call. Because of time restraints, only calls of "an emergency nature" will be forwarded directly to a physician's nurse. For all non-emergency calls, your name and phone numbers of where you can be reached will be provided to the nurse or physician for a return call. Our staff will make every effort to return calls within a reasonable time, so please do not make repeat calls as this will only delay the call process.

Please note that calls to fill prescriptions are only taken Monday through Friday.

Billing & Insurance

Billing & Insurance

In keeping with our mission statement, it is our goal at Aberdeen Family Physicians to make every visit with us a positive experience and to provide your family with complete care and services. We provide a full-service business office to assist in processing insurance, Medicare and Medicaid billing to expedite and maximize your benefits and payments. Please read more about our financial policies in the information below. If you have a question for the business office, they can be reached at (605) 225-5856 Monday – Friday, 8 a.m. to 4:30 p.m.

Financial Arrangements

We are committed to providing you with the best possible care and are anxious to help you receive the maximum allowance of benefits from your medical insurance. In order to achieve these goals, we need your assistance and your understanding of our payment policy.

Payment for services is due at the time services are rendered unless payment arrangements have been approved in advance by our staff. Co-payments are expected at the time of service. We accept cash, checks and credit card payments. As a service to you the patient, we process your insurance and send all necessary forms to your primary insurance company. You may have these forms sent to you so you can deal directly with your insurance company.

We are always willing to discuss any questions you have about your account, charges, insurance, Medicare, or Medicaid. As a general rule, please remember that.

  • Your insurance is a contract between you, and/or your employer and the insurance company. Avera Aberdeen Family Physicians is not a party to the contract.
  • Not all services are covered benefits in all contracts. Some insurance companies arbitrarily select services they will not cover.
  • If a credit balance should occur because of duplicate payments, please contact us for a refund.
  • Medicaid recipients must advise us when benefits begin and when they discontinue.

As a Medicaid recipient you are required to:

  • Present your Medicaid card when you check in at the front desk as mandated by the Department of Social Services. If you do not present your card you may be requested for same-day cash payment, asked to reschedule your appointment or denied services.
  • The co-pay must be paid the same day as services are rendered.

We must emphasize that as health care providers, our relationship is with you, not your insurance company. While the filing of insurance claims, which is done weekly, is a courtesy that we extend to our patients, keep in mind that all charges are your responsibility from the date the services are rendered.

It is important to keep your account current and in good standing, as balances older than 60 days will be subject to an interest charge of 1.5% per month. Balances older than 90 days are subject to collection. If an account is referred to collection, cash payment will be required in advance for all future services, or medical care will be denied. This requirement would be enforced until your account is in good standing.

We realize that financial situations may arise that may affect payment of your account. Should this be the case, we encourage you to contact the business office for assistance in the management of you account.

Medicare

Avera Aberdeen Family Physicians accepts Medicare assignments and routine services not covered by Medicare. Medicare will send their payment directly to us. You will be billed for the yearly deductible and co-insurance, and routine services. The difference between the charge and the Medicare allowance will be written off.

Cash Only Policy

All patients who have outstanding accounts with excessive balances of more than 120 days (unless there is insurance pending) that have been sent to collections or have declared bankruptcy will be put on a CASH ONLY status.

A patient will remain on CASH ONLY status until he or she has paid in full their outstanding balance to Avera Aberdeen Family Physicians or other arrangements have been approved by the Business Office or Clinic Administrator.

Business Office hours:
8 a.m. to 4:30 p.m. Monday - Friday

For questions regarding billing or insurance, call: (605) 225-5856.

Privacy

Privacy

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.

Protection of patient privacy is of paramount importance to this organization. We take pride in treating our patients with dignity and respect. The following privacy policy is adopted to ensure that Avera Aberdeen Family Physicians complies fully with all federal and state privacy protection laws and regulations. If you have any questions, please contact our Privacy Office at the address or phone number listed at the end of this notice.

The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a federal program that requires that all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, are kept properly confidential This act gives you, the patient, significant new rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse personal health information. As required by "HIPAA", we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information.

We may use and disclose your medical records only for each of the following purposes. treatment, payment and health care operations.

  • Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. An example of this would be sending medical information to a specialist as part of a referral. 
  • Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be sending a bill for your visit to your insurance company or Medicare for payment.
  • Health care operations include the business aspects of running our practice, such as coordinating quality assessment and improvement activities, auditing functions, cost management analysis, and customer service. An example would be comparing patient data to improve treatment methods.

We may use or disclose medical information about you without your prior authorization for several other reasons. Subject to certain requirements, we may give out medical information about you without prior authorization for public health purposes, abuse or neglect reporting, health oversight audits or inspections, research studies, funeral arrangements and organ donation, military, national security, worker's compensation purposes, and emergencies. We also disclose medical information when required by law, such as in response to a request from law enforcement in specific circumstances, or in response to valid judicial or administrative orders.

We also may contact you for appointment reminders, or to tell you about or recommend possible treatment options, alternatives, health-related benefits or services that may be of interest to you, or to support fundraising efforts.

We may disclose medical information about you to a friend or family member who is involved in your medical care unless you object or to disaster relief authorities so that your family can be notified of your location and condition.

We may also create and distribute de-identified health information by removing all references to individually identifiable information.

Any other uses and disclosures not covered by this notice will be made only with your written authorization You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

You have the following rights with respect to your protected health information, which you can exercise by presenting a written request to the Privacy Officer:

  • The right to inspect and copy your protected health information that we use to make decisions about your care, when you submit a written request. If you request copies, we may charge a fee for the cost of copying, mailing or other related supplies. If we deny your request to review or obtain a copy, you may submit a written request for a review of that decision.
  • The right to amend your protected health information if you believe that information in your record is incorrect or if important information is missing submitting a request in to writing that provides your reason for requesting the amendment. We could deny your request amend a record if the information was not created by us; if it is not part of the medical information maintained by us; or if we determine that record is accurate. You may appeal, in writing, a decision by us not to amend a record. It is the policy of Aberdeen amily Physicians that all requests for amendment of incorrect protected health information maintained by this organization will be considered in a timely fashion. If such requests demonstrate that the information is actually incorrect, this organization will allow amending language to be added to the appropriate document It is also the policy of this organization that notice of such corrections will be given to any organization with which the incorrect information has been shared. 
  • The right to receive an accounting of disclosures of protected health information of those instances where we have disclosed medical information about you, other than for treatment, payment, healthcare operations or where you specifically authorized a disclosure, when you submit a written request The request must state the time period desired for the accounting, which must be less than a 6-year period and starting after April 14, 2003. You may receive the list in paper or electronic form. The first disclosure list request in a 12-month period is free; other requests will be charged according to our cost of producing the list. We will inform you of the cost before you incur any cost.
  • The right to obtain a paper copy of this notice from us upon request.
  • The right to request restrictions on certain uses and disclosures of protected health information, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it.
  • The right to reasonable requests to receive confidential communications of protected health information from us by alternative means or at alternative locations, such as sending mail to an address other than your home, by notifying us in writing of the specific way or location for us to use to communicate with you.

We are required by law to maintain the privacy of your protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information.

This notice is effective as of April 14, 2003, and we are required to abide by the terms of the Notice of Privacy Practices currently in effect. For a more comprehensive copy of our Notice of Privacy Practices, please see the Privacy Officer or ask a Receptionist for a copy. We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all protected health information that we maintain. We will post and you may request a written copy of a revised Notice of Privacy Practices form this office.

You have recourse if you feel that your privacy protections have been violated. You have the right to file a written complaint with our office, or with the Department of Health & Human Services, Office of Civil Rights, about violations of the provisions of this notice or the policies and procedures of our office. We will not retaliate against you for filing a complaint.

For more information about HIPAA or to file a complaint, please contact either:

Privacy Officer
Michael W. Opp
Clinic Administrator
Avera Aberdeen Family Physicians
(605) 725-6800

The U.S. Department of Health & Human Services Office of Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
(202) 619-0257
Toll Free: 1-877-696-6775