We accept patients 13 years of age and older. A patient of minor age (under 18 years) requires a parent or legal guardian’s written permission. These forms must be signed at the time of the appointment. Consent to Examine a Minor Form (DOC). A special note to patients under 18 – as per Illinois state law you may be seen confidentially without parental consent for services including contraception, std screening, and pregnancy testing. Billing and the insurance claims process may compromise confidentiality and if this is a concern cash payment would be expected. As with all of our patients, any information in your chart is kept strictly confidential - according to your HIPAA designation. See Patient Consent for Use and Disclosure of Protected Health Information (DOC)
Prescription refills will be processed for Established Patients Only who have been seen within the past 13 months. If you need to refill a prescription, please call during our regular office hours when we have access to your medical record You will need to provide your name, date of birth, pharmacy name, phone number, and the name of the medication you want to be refilled as well as a phone number where you could be reached. You can also have your pharmacy call or FAX the refill request to us. Prescription refill requests will be honored within 24hours of receipt or on the next business day. If your doctor feels that an office visit is necessary before a refill can be given, you will be notified.
Prescription refills are not considered emergencies and will not be handled during non-business hours when your medical record is unavailable.
We welcome you to call the office or email us through the Patient Portal if you have a general question or problem. Please DO NOT send emails regarding your personal medical history or condition. Our telephone lines are open throughout our normal business hours. Our professional office staff will be able to answer many of your questions and if you need to speak with a clinician, our medical assistants or a physician will answer your call. In the event that you have to leave a message, your call will be returned as quickly as possible. All non-urgent calls will be answered within 24hours of receipt. DO NOT leave urgent messages on our answering machine or email address, instead insist on speaking to one of our medical personal.
IF AT ANY TIME YOU FEEL THAT YOU ARE HAVING A MEDICAL EMERGENCY, CALL 911, OR GO TO THE NEAREST EMERGENCY ROOM.
Non-urgent messages that require a physician to call you back are typically returned after patient care hours. Please leave appropriate call-back phone numbers.
After office hours, our phones are answered by our answering service. Please limit your after-hours calls to medically urgent calls only. The doctor on call will be paged when appropriate and your call should be returned within 30 minutes. Please call the service again in the rare event that the page did not go through if you do not hear back within 30 minutes. If you have call blocking on your telephone, please UNBLOCK your phone. We are unable to call blocked lines.
Your medical records are strictly confidential. Information cannot be shared with your spouse or family members unless specific authorization is obtained to do so. We will release your records, or a part of them, only when you provide us with written authorization. Be advised that there usually is a fee for copying records which complies with the State of Illinois fee schedule. Also, please allow 7-10 days to process your copy request.
If you need to reschedule your appointment, please provide us with a minimum of 24 hours notice. This enables us to accommodate another patient who will be able to use your appointment time.
As a courtesy, please call our office if you are unable to make your appointment. Our office does attempt to contact patients who do not show for their appointments and who do not call us in advance. Please be advised that occasionally we find it necessary to dismiss a patient from the practice who fails to keep her appointments because we are unable to provide quality health care in this situation.
As a courtesy to our patients we accept assignment of insurance benefits. We cannot bill your insurance company unless you provide us with all required insurance information including a copy of your insurance card. Full payment will be expected at the time that services are rendered if a valid insurance card is not available. Payment options include: cash, check, Visa, Mastercard and Discover. Returned checks will incur a $25 service fee. A second returned check will result in a $50 service fee and the patient will be on a cash or credit card payment method only status.
It is your responsibility to determine what benefits are covered by your insurance plan. The balance of your account is your responsibility regardless of whether your insurance company pays. If your insurance company has not paid your claim in 60 days, the balance will be transferred to you.
ObGyne Associates of Libertyville
801 S Milwaukee Ave Ste 100 Libertyville, IL 60048
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