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KACHINA FAMILY PRACTICE NEW PATIENT INFORMATION



Welcome to Kachina Family Practice. It is our intent that your contacts and experiences with us will be positive in every aspect. Below, we have listed information that we hope will smooth your initial visit with us and provide you with important information about our practice. Please also see Frequently Asked Questions for more information that may benefit you in your interactions with us.

SCHEDULING:
To schedule an appointment with our office, please call 480-706-4100. Our office has an "Auto-Attendant" to assist with the high volume of calls received by our practice (go to How to Navigate the Phones). We ask that you listen to the phone menu and become familiar with the options. Choose option #2 to schedule an appointment.

REGISTRATION:
To register as a new patient with our practice, each patient will need to complete 3 forms: Registration Form, Financial Policy and Medical History Form. You may click on the appropriate form, download it and print it for completion prior to your first visit. We do not have the capability for fax or e-mail handling of these registration forms. We ask that on your first visit, you arrive 15-20 minutes early to allow enough time for the registration process. You should bring your insurance card and completed registration forms. If you have not received an insurance card, you will need to bring the ID number, Group number, Claim address and phone number for your insurance company or plan. If you are unable to provide the necessary information, we would ask that you be fee-for-service, or if you choose, you may reschedule your appointment. All minors must be accompanied by a parent on their first visit. Please bring the minor's immunization record to the first visit. Also bring any medication currently taken by the patient, in their original containers.

INSURANCE BILLING:
As a courtesy, we will file claims for those insurance plans with which we have an agreement. All co-pays and deductibles are due at the time of service. Please see our Financial Policy for further information about our billing guidelines. If we do not participate in your health plan or you have no health insurance plan, once again, fees for our services are due at the time of service.

REFERRALS:
Should your provider ever recommend that you consult with a specialist, we would appreciate you following our referral process: Schedule an appointment with your specialist at a time convenient for you. We would suggest that you then immediately call our office at 480-706-4100 and select option #5 to leave a message with your appointment time and date, and the name of your specialist with our Referral Coordinator. Please allow at least 1 week notice for our staff to complete the referral process. Please understand that your appointment with the specialist may be denied and you may have to reschedule your appointment if these guidelines are not followed.

PHARMACY MEDICATION REFILLS:
We request that any medication refills should be phoned in to your Pharmacy. The Pharmacy will then in turn contact the doctor for authorization if necessary. Please allow 48 hours for any refill authorization.

PHONE SYSTEM/CALL-BACKS:
It is the policy of Kachina Family Practice to return all patient phone calls the same day, however, calls left after 3pm may not be returned until the following work day. Our phone system is a digital system. It is necessary for us to have this type of system to handle the volume of calls coming in to our facility. It shows up as "unavailable" on any phone system with "Caller-ID". If you have "Caller-ID" of any kind, it will be necessary to unblock your phone in order to receive callbacks from our office. This would include callbacks from a physician, confirming appointments, talking with the on-call doctor. If you have a question or need to leave a message for your provider, we ask that you follow our "Auto-Attendant's" instructions. Please listen carefully to the prompts. The provider's voice mailboxes are checked frequently during the day and either a staff member or the provider will return your call the same day.



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16611 S 40th Street, Suite 120, Phoenix, Arizona 85048
All rights reserved.