1. What if I am sick or have an emergency, can I be seen quickly?
2. What if I am running late, can I still come to my appointment?
3. What if the physician is running behind, how am I treated and can I reschedule?
4. I understand there may be a penalty if I fail to show for my appointment, can you explain this?
5. Do you give us copies of our labs if we ask?
6. I need to have my medical records how can I get them copied and is there a fee?
7. What if I am hospitalized, who will care for me and how are you kept informed?
8. How do I get my prescriptions refilled?
9. What is a “90 day supply” for prescriptions and how do I get one?
10. What if I am on medication I cannot afford?
11. I was told I am in the “Doughnut hole”, how can I get my medication cheaper?
12. Is there a physician on call and do you see patients after hours?
13. What can I expect from my first visit to the practice as a new patient?
We are there for all your health needs and feel it is very important you have access to your physician in an emergency or when you become ill. We make it a point daily to set aside visits on our calendar for sick patients whom may be calling the same day they need to be seen. We have added a physician assistant who is more than capable of seeing you as well when you are ill or having an acute problem. Please call the office as early in the day as possible so we can make our best effort to fit you into our schedule at a time that is convenient for you. At RARE times we may have some patients who need to use urgent care facilities, these are usually after hours or weekend visits; but we make a strong commitment to you that the majority of the time we will make time to see you when you have an emergency. Back to top
We understand that arriving for your appointment late is sometimes out of your control. We will honor your appointment if you arrive within 15 minutes of your scheduled time. If you are later than 15 minutes after your appointment you may need to be rescheduled. We say “may” need to be rescheduled because if we can at all accommodate you we will try our best to see you but cannot guarantee this. We have this policy as we do not overbook our schedule and have time set aside for you, so being late eats into another patient's appointment time and delays the physician having a snowball effect for the rest of the day. To help us all stay on time please arrive 5 minutes before your appointment for an established patient and 20 minutes for a new patient. Back to top
There are days when the physicians / PA are running behind schedule and we try hard to avoid this. Several factors go into creating this problem that are often beyond our control. Patients are late for their appointments, emergent visits are fit in, or patients come in with problems that are more complicated than anticipated and may require more emergent time with the physician. We understand this seems like a “double standard” since the doctor can be late but we discourage you from being late for your appointment. Unfortunately when we deal with illness and patients who are in emergent need we hope that you understand that when you need more time with your emergent problem we will give it to you, scheduled or not. We value your time and make a practice of not double booking patients so that each patient gets our full attention and does not feel rushed. When we are more than 45 minutes behind schedule, which happens very rarely, we understand you may need to reschedule and our staff will keep you informed of our status and reschedule you if absolutely necessary. All of our providers try very hard to stay on time and keep patients from having long waits. Back to top
If you fail to cancel your appointment with 24 hour notice to the office or fail to show for your appointment then you most likely will be charged a service fee. This is not to make revenue for the practice, we would much rather see you and tend to your needs; but this is a fee to deter discourteous patient behavior which causes holes in our schedule where other ill patients could have been seen but were turned away. Our practice strongly believes in your time and focusing on your needs when you are here so we do NOT overbook our time slots like many practices or other industries who anticipate a no show rate. To that end if a patient does not show up we have wasted time on our schedule in a busy practice that could have used this time for patients in need. In order to protect other sick patient’s access, which may be you one day, we have this “service fee” to discourage improper cancellation or failure to show for appointments. Back to top
We do give copies of your labs if you request them. We always call personally with lab results so we do not mail them to your home. As costs are a concern in health care we will generate a copy at no charge only if you request it when you are in the office. If you need copies of other labs and it requires chart retrieval and/or review there may be a very small copying charge. Back to top
We believe in access to your records and at times other physicians may need to see our records to assist in caring for you. There are two ways your medical records are copied. First, if CIMA is referring you to another physician or specialist for an illness to assist in your care then your records that pertain to the issue will be copied and sent for you to that physician’s office free of charge. The second way your records are duplicated is for your requested personal use or transferring out of the practice (i.e. moving to another state). We will copy all or part of your medical record (depending on what you ask us to prepare) that has been generated since your establishment with our practice. We cannot forward other physicians records (historical records) that were sent to our office PRIOR to your joining CIMA as this must come from their office. We do copy your records generated from your time with our practice upon your request for a fee that follows the Commonwealth of Virginia’s law pertaining to this service. We charge the nominal fees for the cost of the staff preparation time, paper, copying, and mailing of records for personal use. Please allow 2 weeks after we receive your signed written records request for processing of all medical records for personal use. Back to top
The physicians of CIMA currently utilizilize the services of “hospitalists” who are Internal Medicine physicians that only specialize in hospital medicine. They have the same training as our physicians but due to the structure of today’s health care environment do not have outpatient offices and can better facilitate your efficient care in the hospital. They do not replace your primary doctor but in fact work in concert with us as they can discuss the case with your primary medical doctor if questions arise that need their input. Discharge summaries are sent to your primary physician at CIMA upon your release from the hospital to coordinate your follow up care from the hospital if we were not directly involved in your care at that facility. CIMA physicians also have direct computer accessfrom our office to your records at Mary Washington Hospital and Stafford Hospital. We currently maintain referral privileges at Mary Washington Hospital and are in the process of applying for these privileges at the new HCA Hospital in Spotsylvania as well. These privileges allow us to order outpatient infusions/transfusions and procedures at these facilities. Back to top
We want to make refilling common long term prescriptions hassle free for you. If you are refilling a prescription that has run out of refills (look on your bottle and it will tell you if none are remaining) just contact your pharmacist and ask they fax a request to our office. Many pharmacies use “auto-fax” for your refills which cuts down on phone time and potential medical error when patients list their medication and dosage on a voice mail. We pull and review your chart every time you call for a refill to review your case for accuracy. If there are questions or problems with your refill then staff will contact you directly or you may be given a one month refill and asked to make an appointment to see your doctor. Please give the staff 72 hours (3 days) notice for refill needs as it takes time to pull and review your records to generate the refill and doctors seeing patients won’t be interrupted to refill a prescription. Back to top
A “90 day supply” refers to a prescription that has 3 months worth in one bottle filled for you every 3 months and usually has 3 refills giving you 12 months of a prescription. Many patients, especially seniors, are encouraged by their insurance to get a 90 day supply of medication as they are often sent to drug clearing houses and in bulk can be cheaper for patients than just going monthly to the local drug store. How you go about a 90 day supply differs based on your insurance so call your carrier and ask which agency they use. Some insurers will allow you to go to your local drug store and get a bulk rate savings on a 90 day supply but you will need to check with them. If they do not allow this and you take a 90 day supply prescription to your local pharmacy they will charge you 3 co-pays instead of one. This all controlled by insurance and your individual costs will vary based on what company you are contracted with. When filling 90 day supply prescriptions please allow 72 hours notice for CIMA to authorize the refill request. Many drug clearing houses need 2 weeks to receive and process your prescriptions in the mail. It can be a great savings but requires advanced planning on your part so know your insurance plans’ program and regulations before you file. Back to top
As medication cost rise some of our patients may encounter difficulty affording the pharmacy co-payment. Your physician has nothing to do with the cost of medication and receives no payment for any medication or treatment you receive so we are absolutely unbiased as to what medication is prescribed for you. CIMA physicians strive to select generic medication that cost the lease and work the same as “brand name” drugs which can be costly in the form of higher drug co-pays. There are many drugs that have no generic because they are still on patent and insurance may charge you higher copayment to help cover the drug cost and/or act as a deterrent persuading you from taking that medication. If this is the best drug for you than discuss the cost issue with your CIMA physician who may be able to refer you to the “community pharmacy” that uses grant money to assist patients with affording their medications when finances are tight. Back to top
The “doughnut hole” is a Medicare term that refers to a senior having to pay the full cost of their medication until they spend a certain dollar amount than at which time the government will resume paying the full cost of the patient’s medication. Many of you want to change medication to generic drugs during the “doughnut hole” period and go back on brand name medication when you are out of the hole. We understand this cost concern but CIMA physicians discourage patients from frequently switching their medication as generic and brand name medication do essentially the same thing but are not really the exact same drug at its chemical level. Sometimes insurance plans will tell a Medicare patient that a drug has a generic and to ask your doctor to change your medication. They are being a bit misleading in that the drug you are on has no available generic but a similar drug to the one you are taking has a generic (so it’s really the generic to a drug similar to your drug but not your drug’s generic). Because we understand you want to get the best and most cost effective treatment we will be happy to have you make an appointment and discuss you medication and doughnut hole concerns. We will not do it over the phone, however, as this issue is complex and individual specific; changes to your medication may require monitoring so a face to face appointment with your physician is needed to safely change your medication if you and your CIMA physician deem appropriate. Back to top
CIMA always has a physician on call 24 hours a day 365 days a year without exception. This physician is available for emergency calls only and will not be able to refill routine prescriptions, call in antibiotics or give lab results. Should you be recommended by the on call physician to be evaluated by a physician emergently then they may suggest you utilize a local urgent care facility or emergency room in the area and if needed follow up with your regular doctor during standard office hours. We are always available to help you select the most appropriate next step in assessing your current health condition, but prefer to be called for emergent situations only after hours. Back to top
Your initial visit will be about 35 minutes long. The physician/PA will review your current problems as well as an extensive history review and detailed physical exam. When you leave after your appointment we feel confident we know you well enough to have a good foundation to start off from as your new primary health care provider. We also feel confident you will have enough time to address your issues and discuss your individualized treatment plan so that you feel comfortable in your decision to establish care with one of our providers. Please bring a detailed list of your medications or all your pill bottles with you to your initial appointment. Any pertinent medical records are also appreciated so that we may get to know you and your health background and so that you feel comfortable in establishing your new medical home. Back to top
Colonial Internal Medicine Associates is to set the local standard for treating illness in an empathetic and supportive environment. CIMA goes beyond the basic needs of patients in guiding them through complex medical problems as the patient's main health care professional, focus on the whole person with an emphasis on disease prevention, and take ownership of a patient's total medical care by serving as their chief advocate.