Insurance

Many insurance companies do not contract directly with medical providers, instead they contract through insurance networks. While our doctors are contracted with Medicare and work with most commercial insurance networks and insurance companies, the doctors at Southside Family Medical Group do not participate in all of the different plans offered by each. You are therefore encouraged to contact your insurance provider directly to confirm that Dr. Rhonda Goul and Dr. David Williams are contracted with them. Your Human Resource Department at work is also a good source of information in determining which physicians are considered in or out of network. They may be able to clarify insurance coverage. Your insurance policy is a contract between you and your insurance company.

Southside Family Medical Group physicians are contracted with the following Insurance Networks. Some of these Networks have reciprocal agreements with non-listed Networks and your visits may be covered under such arrangements. Check your insurance card to determine your insurance coverage.

The following insurance networks are accepted:

Aetna
Anthem / Blue Cross Blue Shield
Choice Care Network
Cigna (non-HMO)
Encore
First Health & CCN
Humana
Medicare
MultiPlan
One Health (Great West)
PHCS
Railroad Medicare
Sagamore
SIHO
TriCare
United Health Care

Please note that Southside Family Medical Group files claims to your primary insurance company as a courtesy to you. If your attending physician is not contracted with your insurance company, you are responsible for the balance due. The Southside Family Medical Group makes every attempt to provide complete and accurate insurance information, but it is your responsibility to verify that your doctor is in fact an ‘in network’ provider. It is your responsibility to contact your insurance directly to verify coverage.

Prescription Refill Request

This service is not to be used in a medical emergency situation. In the event of a medical emergency, please go to the ER or call 911. Please allow a minimum of 24 hours to receive a response.

How to Make an Appointment

Many people face anxiety when attempting to schedule a doctor’s appointment. Whether the appointment is for a chronic condition or a transient issue, the goal is to set an appointment time and date that is agreeable to your home and work schedule.

While many doctor’s offices are developing new ways of allowing clients to schedule appointments, telephone calls are still the way most complete way. Before you make a phone call to schedule your next office visit, take the time to prepare for the phone call.

Examine your schedule.

Take the time to look over your home and work calendars. Choose your most desired dates and times according to your schedule. Write them down to refer to while on the appointment scheduling phone call.

Gather your personal information.

The appointment scheduler may need information such as your name, social security number, address, date of birth, and insurance carrier. Depending on the appointment type, you may need to give other health information as well. Remember, you are the expert on your medical history.

Prepare and make the phone call in privacy.

You should make the appointment scheduling phone call during office operating hours. Our phones are turned on from 8-4 Monday thru Friday. Depending on the urgency of your health concerns, try to avoid calling during peak call times which include the minutes shortly after the office opening. Make sure you are calling from a room that is free from excess noise. You should also call during a time that you will be able to wait if needed. Our scheduling staff attempts to answer calls quickly and in a courteous manner. Wait time should be no longer than a few minutes.

Be sure to provide detailed information as to why you need to be seen. Please list all reasons. For example, if you have a sore throat, but also suffering from right knee pain, please advise the scheduler of this information. This way he or she can schedule you for the proper amount of time. It will make the office run more efficiently and help your doctor be on time.

If you are a new patient to the practice, please visit the Patient Forms page to print off and complete the required paperwork. You will save time on the date of your appointment by completing prior to arriving.

Have you recently moved? Has your either your home phone or cell phone changed? If you are an existing patient and your personal information has changed, please visit the Patient Forms page to print off and complete the patient change of information form.

If you have insurance and would like your visit billed to your insurance carrier, please be prepared to provide your card at EACH visit. Our office requires this information in order to file your insurance to the correct insurance carrier for each and every visit.

Call the Southside Family Medical Group at 317-452-8400 to schedule an appointment.

Office Policies

LAB AND TEST RESULTS: Our policy is to call all patients with their lab and/or test results regardless of outcome. However, you are ultimately responsible for your own healthcare. Unfortunately, we are not able to track when or if an individual patient has tests done. And, while the testing facilities make every effort to forward a copy of your test results to your doctor, we do not always receive them. Therefore, if you have had labs or tests done and do not receive a call from Southside Family Medical Group within one week of having lab/tests performed, you are responsible for contacting our office to determine your test results. The laboratory responsible for processing has advised it takes a minimum of 24 hours to process upon receiving the sample. Once results are obtained, it takes another minimum of 24 hours for the physician to review the results and make recommendation if needed. Please allow our office a minimum of 72 hours to obtain and review results.

FINANCIAL RESPONSIBILITY: You are responsible for the charges not directly paid by your insurance company. If you receive a bill from Southside Family Medical Group, your insurance has responded and not paid at least a portion of the charges. If you have questions regarding coverage, please call your insurance company first. Our billing department is also available to help, but has limited information.

INSURANCE: Insurance is a contract between you and your insurance company. We are NOT a party to this contract. We will bill your insurance companies as a courtesy to you. If your insurance company delays payment or refuses to pay, you are responsible for the FULL AMOUNT due. If/when your insurance company does pay, we will promptly refund any money owed to you.

We receive an EOB (Explanation of Benefits”) for each encounter. You will receive this same information directly from your insurance company. If you notice they have not paid and you do not understand why, please call them immediately. Your insurance company may delay or deny payment if they believe other insurance is in force or you have “pre-existing” conditions. Any balance not paid by your insurance company becomes the patients responsibility.

SECONDARY INSURANCE: Southside Family Medical Group bills secondary insurances. Please notify our front staff which insurance company is primary.

CO-PAY: Your insurance company requires co-payments to be paid at the time of service. This is an insurance requirement. If Southside Family Medical Group must bill you for the co-pay, a $15 fee will be applied. Payment may be in the form of cash, check, VISA, Mastercard, or Discover.

MONTHLY STATEMENT: If you have a balance on your account that is no longer pending with an insurance company, we will send you a Patient Statement. It will detail your balance due. Payment is expected within 15 days. IF YOU HAVE ANY QUESTIONS ABOUT YOUR BILL, PLEASE CALL THE OFFICE.

DIVORCE: In the case of divorce or separation, the party responsible for the account prior to the divorce or separation remains responsible for the account. After divorce or separation, the parent authorizing treatment for a child will be the parent responsible for those subsequent charges. If the divorce decree requires the other parent to pay all or part of the treatment costs, it is the authorizing parent’s responsibility to collect from the other parent.

PAST DUE ACCOUNTS: After we have made reasonable attempts to collect on a past due account, we may turn any uncollected balance over to a collection agency. You will be responsible for any collection costs which are incurred. In addition, if the collection agency decides to litigate, the fact that you received treatment in our office may become a matter of public record. Southside Family Medical Group is willing to set up payment arrangements with patients suffering from financial hardship. If a payment arrangement is made, you must comply strictly with the arrangements you have made with the billing department. Failure to do so will result in termination from the practice.

WORKERS COMPENSATION: We are not contracted for Workers Compensation Claims. You are responsible for payment in full at the time of service. We will provide you with the necessary receipts to turn in to your employer

MOTOR VEHICLE ACCIDENTS (MVAs): Because MVAs are not covered by Health Insurance, and because we are not a party to your auto insurance contract, you (the patient) are expected to pay for the mva related visit in full at the time of service. You can turn your receipt into your auto insurance agent for reimbursement.

SPECIAL FEES: We reserve the right to charge for the following services:

Disability, FMLA & Miscellaneous forms
MVA reports
Copying medical records
Rebilling Fee
Returned Checks
Missed Appointments

Patient Resources

Online Resources:

www.webmd.com
WebMD is a great resource regarding general health. This webpage keeps people up-to-date on what’s happening in medicine. It is a great resource for general health, drugs and supplements, healthy living, healthy eating and dieting, parenting and pregnancy, as well as mental health.

www.cdc.gov
The Center for Disease Control and Prevention website provides a vast array of credible information regarding health.

www.in.gov/core
The state of Indiana also provides a website dedicated to family and health matters. This website highlights subjects specifically addressing children, the elderly, those with disabilities, veterans, family, and general health.

Insurance Companies:

Many of our patients are enrolled in Anthem, Aetna, Cigna, United Healthcare, Tricare, Sagamore Health Networks, or Medicare. We have linked these company websites for your convenience.