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VHC Physician Group Policies

Prescription Policy

All Virginia Hospital Center (VHC) Physician Group providers (physician, nurse practitioner or physician assistant) participate in electronic prescribing directly to your local and mail order pharmacies. Our goal is to assist patients with prescription requests in an efficient manner. In order to process your request as quickly as possible, please see the details of our prescription policy.

  • Prescription refills require close monitoring by your physician, nurse practitioner, or physician assistant to ensure the safe continuation of the appropriate dose, frequency and term of that medication. Your provider will prescribe the appropriate number of prescription refills to last you until your next scheduled appointment.
  • It is the patient’s responsibility to schedule your next appointment in advance and with adequate time to receive a prescription refill.
  • As prescriptions are prescribed with the amount of refills needed until the next appointment, almost all requests for prescription refills between regularly scheduled appointments will require a appointment in the office prior to authorization. The clinician will review the request from the pharmacy, as well as the patient’s medical record, to determine appointment needs. The patient will be contacted by the staff to schedule such appointment, if necessary.
  • In the event that you require an emergency refill, prescriptions refill requests should be electronically submitted from the pharmacy directly to the office. If approved by your provider, an appropriate refill will be submitted to your local pharmacy. If your prescription refill is not approved, please contact your provider’s office to schedule an appointment.
  • Patients requesting new prescriptions or antibiotics must be seen for an appointment by a clinician. They are not prescribed over the phone.
  • Urgent Care will not refill prescriptions.
  • Maintaining current pharmacy information is the responsibility of the patient. Please confirm with our practice that your correct local pharmacy address and phone number or mail order pharmacy information is on file. Prescription refill requests will be submitted electronically to your pharmacy. Your local pharmacy will contact you when your prescription is ready.
  • Our practice will always order generic prescriptions whenever available unless brand is medically necessary. Each insurance plan outlines a detailed classification for medications which could impact which medication, generic or brand, is prescribed and the cost to you. Contact your insurance plan for details.
  • Prescriptions classified as controlled substances are not processed after hours or on the weekends.
  • Our providers participate in the Virginia Prescription Monitoring program, and prior to prescribing controlled substances, our office will access the VPM database.
  • Please allow 48–72 hours to process prescription requests. Medications requiring pre-authorization may require additional time to process. Please plan ahead for refills during holidays and when traveling.

Referral Policy

The Virginia Hospital Center (VHC) Physician Group must adhere to guidelines as outlined by the contracts we have with your insurance company. As a patient, you have a responsibility to understand and follow the requirements of your plan. In order to best accommodate your needs please be mindful of the following policy:

  • Requests for referral(s) must be authorized by your primary care provider and may require an appointment.
  • A minimum of 72-hours is needed to process non-emergency referral requests. Emergency referrals will be handled as quickly as possible.
  • It is your responsibility to make sure that you have complied with the referral policy guidelines of VHC Physician Group and have met the requirements of your health plan. You must have an approved and completed referral form or authorization number in hand prior to testing or an examination by a specialist. Referrals may be picked up at your primary care provider’s office or mailed to your home if time allows. Referrals will not be emailed nor faxed.
  • No retroactive referrals will be issued. If you are seen by a specialist or facility without the proper referral, your insurance carrier will likely deny coverage and you will be responsible for charges incurred. If you receive treatment in a hospital emergency room or urgent care facility during a weekend, a holiday, or after hours, you must report this to our office on the first business day following the date of service, so we can provide proper authorization to that facility.
  • If a referral to another VHC Physician Group provider was given to you at the time of your visit, the VHC Physician Group’s specialist’s office will reach out to you within 48-hours. If a referral to a specialist outside the VHC Physician Group is given to you at the time of your visit, it is your responsibility to contact the specialist to schedule an appointment. You will need to bring your referral to your appointment.

Instructions for Obtaining a Referral

  1. Your primary care provider or a designated staff member will give you the name of a specialist or group to whom you are being referred. Call the specialist’s office. Verify that the specialist accepts your insurance plan. If so, make an appointment. Please be sure you give yourself at least 72-hours prior to the appointment so you can obtain a referral.
  2. Once the appointment is made, immediately call your primary care office and provide the following information (in some offices a voice mail option is available):
  • Your name and date of birth (please spell your last name).
  • A phone number where you can be reached or where a message can be left.
  • Name and phone number of the specialist you will be seeing (please give the address if you have it available including the zip code).
  • The reason for your visit to the specialist, the date and time of your appointment.
  • Please state whether you will be picking up the referral from the front desk or if you prefer it mailed to your home.

Patient Financial Responsibility for Services

The providers and staff of the Virginia Hospital Center (VHC) Physician Group and Virginia Hospital Center Urgent Care are committed to providing you with the best possible care and to help you receive your maximum allowable insurance benefits. We are here to help and are happy to answer any questions you may have about billing for our services. While the filing of insurance claims for contracted insurance carriers is our obligation, all fees are ultimately your responsibility. We recommend that you be completely familiar with your individual coverage, benefits, limitations, and exclusions. All questions in this regard should be addressed to your insurance carrier directly.

Please be aware of the following important financial responsibilities:

  • It is your responsibility to keep all insurance and demographic information up to date.
  • You must make all co-payments and outstanding balances at the time of your visit, as well as payments for any deductibles, co-insurance, or non-covered services.
  • If referral is required for your visit, it is your sole responsibility to arrive for your appointment with your required referral. If you do not have the required referral at the time of your appointment, you will be required to pay the full appointment fee at the time of service.
  • It is your responsibility to notify the office of any appointments to be rescheduled or canceled, and must be addressed no less than 48 hours prior to the scheduled appointment time. Patients with greater than 3 late cancellations and/or no shows per calendar year will be notified in writing of the absences. Patients with continued occurrences following written notice may be subject to the Virginia Hospital Center Physician Group Patient Dismissal from Care Policy (R-001).
  • If you do not have insurance or receive treatment for a non-covered service, you must pay for services in full at the time of the visit. In most cases, we are able to give you a discount for payment given in full at the time of service. There is a separate fee schedule for cash services.
  • You may pay in the form of cash, money order, check and credit card in most cases. We will assess a fee of $30.00 for returned checks.
  • If your account becomes delinquent, we will submit the account to our attorneys, at which time you will be responsible for all collection costs including attorney fees, court costs, and all civil penalties as provided by the Code of Virginia.

Effective Date: November 2016

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