Patient Financial Policy
Credit Card on File Policy
Coastal Credit Card On File Policy
Prevention is always the best medicine! We don’t want to see you just when you are sick, so schedule your well visit or regular check-up today!
When you are sick, call the office by 2 p.m. and we will do our best to get you an appointment with your doctor that same day. We believe that giving our patients the best and most appropriate care possible means being accessible for in-person diagnosis and discussion. Please understand that we are only able to supply a new prescription or antibiotics to people we have seen in the office that day – after we agree together that a new prescription is best for you.
Please have your insurance ID card with you at each appointment. If we are unable to verify your coverage, you will be asked to pre-pay $50 at check-in. Your balance will be collected after your appointment. If your claim is denied because we do not have accurate insurance information on file the day of your visit, you are personally responsible for full payment of our charges.
Payment of all copays and deductibles is due at the time of service. Please arrive for your appointment with any co-payment, co-insurance, or deductible that your insurance requires. If you are unable to pay for these items or for any balance due for previous services, your appointment may be cancelled and may be subject to a cancellation fee.
If you cannot keep a scheduled appointment, please give us 24 hours notice. Otherwise, a $30 or $50 Missed Appointment Fee may be added to your balance.
Return of Phone Calls
If you need to talk to your doctor, call the office in the morning and we will do our best to get you an appointment within a few hours. Because it is almost impossible to recognize and treat illness over the telephone, we give our first and best attention to those making an appointment to see the doctor. We work hard to be accessible for in-person diagnosis and discussion. Please understand that we can only supply a new prescription or antibiotics after we've seen you in the office and agree together that a new prescription is what is best for you.
If you decline an appointment and ask for a callback, your doctor will generally return your call within two business days. If you must speak to your doctor sooner, please make an appointment.
Answering Service/On call
IN A LIFE-THREATENING EMERGENCY – CALL 911
Life-threatening emergencies include, but are not limited to:
- Anything involving shortness of breath;
- Chest, arm, or shoulder pain;
- Uncontrolled bleeding;
- Unconsciousness or unresponsiveness;
- Threats of suicide or harm to others.
Our Answering Service
(for urgent after-hours calls from established patients) (401) 793-2661
If you are an established patient, a Hillside doctor is available by phone for urgent but not life-threatening medical issues 24 hours a day, 7 days a week. To reach a Hillside doctor after-hours, call our Answering Service at (401) 793-2661 and ask the operator to page the doctor on call. A Hillside doctor should return your call within a few minutes so that you can decide together the best course of action. Please understand that our answering service cannot schedule an appointment, refill your prescriptions, or give any medical advice.
Our Answering Service and pagers are not infallible. If you did not receive a return call within 20 minutes, please call the Answering Service again. Please know that the doctor on call after-hours is responsible for all of our patients in four hospitals and for the emergency needs of about 20,000 people. Therefore, it may take a little extra time to return your call on busy weekends and holiday mornings. Thank you in advance for working with us so that we can be available when you need us most!
Use our On-line Refill Request Form. Refill requests are usually processed within two business days. Your doctor may need to see you in order to refill your prescription. Also, please understand that we can only supply a new prescription or antibiotics after we’ve seen you in the office and agree together that a new prescription is what is best for you.
A referral is a request from your Primary Care Provider (PCP) for consultation with another physician. Referral decisions come from discussions between you and your PCP. If you are insured through RIte Care or an HMO that requires a referral in order to pay for visits to a consultant physician, you will need to get an authorized referral from your PCP. Please understand that we can only authorize referrals after evaluating the patient for the medical condition in question and agreeing together that a consultation with another physician is what is best for you.
On-line Referral Request Form: Referral requests are usually processed within five business days.
Consultant Physician Select List: For a list of specialty physicians that we recommend.
Lab and Diagnostic Test Results
We are unable to provide test results via telephone. Please do not call the office to obtain routine test results. Also, please understand that our Medical Assistants are not authorized to release any test results over the telephone without the doctor’s permission.
If test results suggest that urgent medical attention is needed, we will try to reach you by telephone immediately. If your test results are abnormal, but not urgent, we will send you a letter with instructions on what to do next. We will NOT contact you if your test results are normal.
Confidentiality of records: We value the trust that you have placed in us, and are committed to the responsible management, use, and protection of your personal information. We only provide your medical records to nonaffiliated third parties with a signed Records Release Request Form from the patient or legal guardian. However, there are some circumstances in which we may provide your records, or access to them, to third parties without your specific consent. These circumstances generally include:
- Submission of claims information to our billing company.
- When we consult, or are contacted by, another health care provider participating in your care.
- When your health plan requires access to your records for quality assurance or claims adjudication purposes.
- When we provide access to your records in other situations as required by law.
Release of Information form: If you need a copy of your records, you may print a Records Release Request Form This form cannot be submitted electronically because an original signature is required. Also, please understand that we generally need ten business days to process these medical records requests.
Fees: Rhode Island State Law (R5-37.11.) and HIPAA federal law regulates what we can charge a fee for copying medical records. See our fees section for more information.
If your medical records are subpoenaed: We will attempt to notify you via telephone. This will provide an opportunity for you to discuss the situation with your attorney before your medical records are released.
To download a copy of the Release of Information, please click here. (Requires Adobe Acrobat)
Billing & payment
Health insurance today is very complicated. It is important to know how your health plan works, what services it covers, and what it requires of you. If you have any questions about your coverage, call your health plan for information.
If your insurer denies payment for services you receive at Hillside for any reason, you (or the legal guardian) are personally responsible for our charges. This is why it is very important for you to understand how your health plan works, what services are covered, and what it requires of you.
The most common reasons for claim denials are:
- Incorrect or outdated insurance information in our system. (It is a good idea to carry your insurance ID card with you at all times.)
- Your Primary Care Physician (PCP) is not a Hillside doctor. (If you are insured through an HMO or RIte Care, call your health plan to make sure that your PCP is a Hillside doctor.)
- Having two physical “annual” exams within a 12-month period. (Most health plans will only pay for one in any 12-month period.)
- Medicare does not pay for preventive physical exams.
Click here if you do not have health insurance.
All fees outlined below are NOT covered by insurance and are the personal responsibility of the patient or legal guardian.
Missed Appointment Fee - $30 - $50
For missing an appointment without providing 24 hours notice. This fee is not covered by insurance.
Returned Check Fee - $25
This fee is added to your balance for checks returned unpaid. After a second submission to your bank, returned checks are turned over to the police.
After Hours/Holiday Fee
At Hillside we work hard to make appointments available after 5pm and on most holidays. There is a nationally recognized and allowed procedure code for this service that is covered by most insurance companies.
If for some reason your insurance company does not cover this fee or applies this fee to your deductible, coinsurance or other out of pocket expense, the fee of $15 will be billed to the patient. Access Alliance members are responsible for the $15 fee.
Medical Records Fee
Patient fees and access to records: You can request a copy of your medical record for a processing fee. Rhode Island State Law (R5-37.11.) and HIPAA federal law regulates what we can charge the following fees for copying medical records: 25 cents per page for the first one hundred pages and 10 cents per page for every page thereafter. This fee is used to help offset our cost to copy and process you records.
Fees for organizations on the patient's behalf: If you would like an expedited response, we offer a flat rate of $50.00 for copies requested by attorneys and insurance companies, understanding that you may be over or undercharged a few dollars. By going this route, you accept the extra or reduced cost and agree to pay it, despite the fact that it may not conform to fees allowed by state or federal law. If you would like a price based on page count, please indicate this on the Release of Information form. We will then provide you with a precise page count in the form of a bill. Records will be made available within ten business days after receipt of your check.
To download a copy of the Release of Information, please click here. (Requires Adobe Acrobat)
Form Fee - $5 per form
For forms that need to be filled out and signed by the doctor such as: school, sports, or camp forms. There is no charge if the forms are brought in at the time of a scheduled exam. We do not charge to prepare WIC, handicap-parking renewals, or housing or utilities assistance forms. We generally require five business days to process these forms.
Lost Prescription/Lab Order Fee - $10
For the doctor to duplicate paperwork that was misplaced by the patient.
Notice of Privacy Practices
Click here for a copy of our Notice of Privacy Practices.