Elk Grove Internal Medicine Associates
Quality Personal Healthcare
Michael Goodman MD
Richard Cash MD
5th floor, Eberle Building
Alexian Brothers Medical Center Campus
800 Biesterfield Road, Suite 505
Elk Grove Village, IL, 60007
(847) 437-5843     FAX: (847) 437-5859

Your Responsibilities

We will try and contact you with your test results.  Unfortunately, test results can be lost or misplaced.  You are our fail-safe.  If you have not heard from us within a week, it is your responsibility to contact us. You need to get your results, and don't assume that "no news is good news."

You have to keep your office appointments.  If you cannot, please let our office know as early as you can.  Another person can use your appointment time.  We do not want to charge you a $25.00 "No Show" fee.

Financial Responsibility

Your financial responsibility depends on a variety of factors. For a complete understanding of your specific plan's benefits you should contact the customer service department for your insurance carrier. That number should be listed on your insurance card(s).

Your balance will also be reflected on the Explanation of Benefits or Medicare Summary Notice you receive from your insurance carrier after your visit has been processed by their offices.

Billing and Collection Policies

Please understand that a mutual financial understanding is also part of our relationship.  We expect you to pay your co-pay at the time of service.
We accept payments by cash, check, Master Card, Visa or Discover. All balances are due within 30 days of your patient billing date.

Other Policies

We have posted our 'support fees' in our waiting room area for your review. Please make yourself aware of our charges for postage, faxing, medical forms, etc.
We also charge for cancellation of an appointment with less than 24 hours notice.
Our office has instituted these policies in an attempt to maintain an efficient environment for our patients and staff.

Your Rights

Our physicians are committed to partnering with you in maintaining good health. As a patient, you have the right to:

  1. Be treated with professionalism, respect, courtesy and dignity.
  2. Have all matters considered private and confidential within the limitations of the law.
  3. Participate in decisions about your healthcare and treatment, as well as receive adequate information about your diagnosis and proposed treatment plan from your healthcare provider in order to give informed consent.
  4. Refuse any procedure or treatment if you so desire and be told what effect this may have on your health.
  5. Have 24-hour access to a primary care provider.
  6. Receive complete information about our fees.
  7. Be informed of the procedure we have for grievances, complaints or other conflicts, as we take these very seriously. We recognize listening improves your best care and helps us to improve our services.
  8. Receive medical services regardless of age, sex, race, color, religion, ancestry, national origin, disability or sexual orientation.

As a patient, what are my responsibilities?

Our physicians are committed to partnering with you in maintaining your good health. As a patient, you have a responsibility to:

  1. Provide your healthcare provider with complete and accurate information.
  2. Follow the treatment plan agreed upon by you and your physicians, with the understanding that your primary care physician should provide the care he or she is trained to provide prior to any referral to a specialist.
  3. Know the benefits, limitations and exclusions of your insurance coverage.
  4. Pay for services rendered, including co-payments and deductibles.
  5. Understand that before any specialty care may be obtained, you must receive a referral from your primary care physician, if required by your insurance company.
  6. Know how to access healthcare services in routine, urgent and emergency situations. An emergency, which requires a call to 911, is a serious condition requiring immediate intervention. An urgent condition could either lead to a potentially harmful outcome if not treated or require immediate attention (within 24 hours) due to the severity of the symptoms. A non-urgent condition includes a limited physical exam for follow up of acute or chronic medical or surgical conditions.
  7. Regard healthcare providers and staff with courtesy, attend scheduled appointments or thoughtfully cancel an appointment with as much notice as possible so that other patients can utilize that time.
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