OFFICE POLICIES

Effective January 1, 2023

Thank you for choosing ANN HOFSTADTER, MD for your gynecologic care.

PAYMENT FOR SERVICES

Dr. Hofstadter does not accept insurance and is not a Medicare provider. Patients are required to pay at the time services are rendered. Dr. Hofstadter does not submit to your insurance company but will provide you with a copy of your charges should you decide to submit the charges for reimbursement. We are unable to predict whether your insurance plan will reimburse you for any portion of your bill.

Medicare patients will have to sign a form of understanding that Medicare will not reimburse for any services by Dr. Hofstadter. Medicare patients will not be able to submit for reimbursement to Medicare.

MISSED AND LATE APPOINTMENTS

If you are unable to keep an appointment, we ask that you kindly provide us with at least 24 hours’ notice. If 24 hours’ notice is not given, a $100 fee will be charged. If you do not show up for an appointment without calling or call after the appointment time, a $200 fee will be charged.  New patients who no-show or cancel less than 24 hours from their appointment time will be charged $250. No-shows will not be rescheduled until the no-show charge has been paid.

If you are late for your appointment, we will make an attempt to accommodate you but cannot guarantee that we will be able to see you. You may have to wait or your appointment may need to be rescheduled for another day. If you are more than 30 minutes late for your appointment, you will be charged as a no show.

MEDICAL RECORDS

If you should need copies of your records, California law allows us to charge a fee for these services. The law also allows us fifteen working days to process the request. Legally we may choose to provide a records summary as opposed to a copy of the complete medical record.

Medical records fees:

  • Initial fee: $10.00

  • First four pages: no charge

  • Each additional page: $0.25

 

 ADDITIONAL FEES

 We reserve the right to impose additional convenience charges which are not covered by insurance and which you will be advised upon in advance.

 Other Fees:

  • Accessing old medical records from storage

  • Completion of special reports or forms not usually part of an office visit (e.g., disability, school or work forms)

  • Communications with other agencies

  • Special requests for insurance authorizations for procedures unlikely to be covered

  • Supplies and/or medications provided for convenience typically obtained at the pharmacy

  • Obtaining prior authorizations

  • Phone consultations