About Your Visit
We welcome you to our practice and thank you for choosing us as your health care providers! In order to save you time and make your appointment efficient, we require all our patients to register for a secure patient portal account. Please plan on arriving 15 minutes early to provide some additional information and signatures. Please remember to bring your insurance card and your valid driver’s license or state ID to each appointment and let us know if there are any changes to your insurance coverage.
Routine Patient Delays
The health and safety of each patient is our main priority. At times, our patients may experience urgent, time-sensitive and emergent issues. Sometimes these are very wonderful events, such as the birth of a baby. Some are less wonderful, such as emergency surgery. At these times, our providers must prioritize the emergent case over routine appointments. In doing so, our staff will do their best to accommodate you, either by rescheduling or re-directing you to another provider in our office. The Women’s Group of Northwestern regret’s any inconvenience this may cause, but if you experience an urgent need, you will be happy to know our providers will make you the priority!
New and/or Existing Patients
A secure patient care portal is available to all of our patients. You can request an appointment, view your past & future appointments, request a prescription, update your demographic information, update your insurance information, view lab results and fill out your health information prior to your visit. Having an established and updated portal account will ensure a speedy check-in and check out process.
We are requiring all of our patients to register an account on the portal and complete the interactive “Health History Questionnaire” prior to being seen.
New Patients
Appointment Check list
2. Review the following Office policies:
- Financial Policy
- HIPPA
3. Complete the following forms:
- Patient information (enter your complete contact information, emergency contact, insurance and pharmacy information)
- Health History Questionnaire
4. Bring the following to your visit:
- Photo I.D. (Driver’s license or other state issued identification card)
- Insurance card
- Any relevant health records
- Collect information about your family’s history of major medical problems including: heart disease, cancer and genetic disorders (if OB).
- Credit card and/or check for your co-pay/deductible
Established Patients
Appointment Check list
2. Review the following Office policies:
- Financial Policy
- HIPPA
3. Update and/or complete the following forms:
- Patient information (update your contact information, emergency contact, insurance and pharmacy information)
- Health History Questionnaire
4. Bring the following to your visit:
- Photo I.D. (Driver’s license or other state issued identification card)
- Insurance card
- Any relevant health records
- Collect information about your family’s history of major medical problems including: heart disease, cancer and genetic disorders (if OB).
- Credit card and/or check for your co-pay/deductible
Medical Records Release forms
Records Release TO our office from another office:
Use this form to request another provider to release your records to The Women’s Group of Northwestern. Prior to your appointment, please follow up with us to make sure the records have arrived in our office before your appointment.
Records Release FROM our office to another office:
Are you moving? Is your insurance changing preferred providers for you? Does another specialty need your records? Please use the form below:
Appointment cancellation
Appointments not cancelled within a 24 hour notice will require a $75.00 cancellation fee. If you need to cancel an appointment after hours please call our office at 312.440.3810 and leave a voice message.
Pharmacy Policy
Routinely, prescriptions are filled at annual visits for one-year duration.
If you need your prescription refilled have your pharmacy contact us via escribe. You can also request your prescription refill through our Patient Portal by clicking on our Patient Link Tab below. You will need to have your prescription and your pharmacy information available to request prescription refills on line. Prescription refills outside of an annual visit will result in a $20 service fee. Medications may have side effects. Should you have a reaction to drugs prescribed for you, STOP the drug and contact our office. ROUTINE PRESCRIPTIONS ARE NOT CONSIDERED AN EMERGENCY.
Surgery Policy
Thank you for choosing us as your health provider. We are committed to providing you with the best possible medical care. (Please understand that payment of your bill is considered a part of your treatment.) Your clear understanding of our Financial Policy is important to our professional relationship. Please talk to our Business Office if you have any questions about our fees or Financial Policy.
We will verify your insurance coverage before surgery. You should also check with your insurance company about whether a second opinion is necessary and the number of hospital days approved with your admission.
We will submit an insurance claim form for any major gynecological or obstetrical procedures. You are responsible for any unmet deductibles or coinsurance payments to be paid in our office prior to the date of surgery. We require a credit card number to be on file with our Business Office prior to any surgery being performed. Our Business Office will contact you and outline payment arrangements prior to surgery. Any insurance overpayment will be promptly reimbursed to you. Thank you for your cooperation.
SURGERY CANCELLATION POLICY
When you ask us to schedule surgery for you, we must do several things, long before the day of your surgery:
- Reserve the operating room.
- Order and pay for any surgical supplies that are needed for your surgery.
- Secure the necessary specialized surgical nurses and surgical technicians that will be needed, and/or provide coverage to free them up from their other responsibilities.
- Arrange anesthesia coverage for your case.
- Prepare the required equipment and sterilize the necessary instruments.
- We must turn down every other patient who wants surgery on the day and time we have reserved for you.
Because of these financial and time commitments, we ask that you are certain about your desire for surgery and be sure that you can make the financial commitment to schedule your surgery.
The Following is our cancellation policy:
- If it becomes necessary for you to cancel your surgery within 7 days of surgery, a cancellation fee of $500.00 will be charged.
