| Do
I have to have a primary care
physician? |
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We
recommend that you select one physician
as your primary provider. Your primary
care physician can easily direct you
to a medical and surgical specialist
when necessary. This gives you the benefit
of having one provider who knows you
and your medical history, and who can
coordinate all aspects of your healthcare
needs.
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| Why
must patients go through a referral
process to see a specialist? |
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| The
goal of the referral process is
to ensure patients are provided
an appropriate level of care and: |
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Authorized quality care is offered
in a timely manner. |
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Authorized
care matches the benefits defined
by the patient's health plan.
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Services
are medically necessary and are
delivered at appropriate levels
of care. |
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Guidelines and standards of medical
practice criteria set by governmental
and other regulatory agencies
are adhered to as appropriate.
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You
will be referred to a physician specialist
or other healthcare provider when you
need care that your primary care physician
cannot provide.
If you are a HMO patient, many referrals
to a specialist can be authorized directly
by your primary care physician during
your office visit.
If you are a PPO patient, contact your
insurance plan to verify that services
such as referral to a specialist, a
surgical procedure or diagnostic testing
are covered by your benefit plan. Inquire
which primary care physicians, specialists
and places of service are considered
preferred providers to reduce your out-of-pocket
expense.
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| How
do you choose the specialists
to whom you refer? |
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The
specialists to whom we refer are carefully
chosen and work closely with your physician
to provide the best care you need.
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If
you are interested in a particular specialist,
please discuss this with your physician.
There are many factors involved in the
decision of which specialist you will
be referred to, including the specialist's
hospital admitting privileges, area
of expertise, schedule, and patient
preference.
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| What
if I need access to medical care
after the office has closed? |
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If
you are experiencing a life-threatening
emergency, call 911 or go to the nearest
emergency room and have the hospital
notify our office or Dr. Madappallil.
Also, for a condition needing prompt
attention, you can call our 24 hr answering
service at 630.941.5294. The doctor
will be paged for emergencies.
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You
should seek emergency care at the closest
hospital emergency room if you experience
an injury or condition that could permanently
endanger your health if not immediately
treated. If you need emergency care,
contact your primary care physician
first to determine what treatment is
required. If a delay could seriously
jeopardize your health, get treatment
at the nearest emergency department
first and then notify your primary care
physician as soon as possible.
Remember, if your
injury or condition is life-threatening,
call 911.
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We
admit patients to Elmhurst Memorial
Hospital, Elmhurst, and Good Samaritan
Hospital, Downers Grove Your primary
care physician will direct your care,
including arranging specialty care consultations,
ordering diagnostic tests.
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Routine
prescription refills are available by
telephone during regular office hours,
or you may bring your medications with
you to your appointment. Please allow
up to 24 hours for the refill to be
called into your pharmacy
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| What
if I need medical attention while
I'm away from home? |
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Most
health plans have provisions for illness
and injuries that occur away from home.
Contact a representative from your health
plan for more information.
Once you return home, be sure to contact
your primary care physician to let her
know what happened. She can help you
determine if follow-up care is necessary.
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A
personal medical record of all medical
care received at the MGM Medical Associates
is maintained for each patient. It provides
a history of treatment, medication and
diagnostic information that will enable
your physician to make comprehensive
ongoing evaluations of your health.
Your physician may ask you for information
about previous medical care to supplement
your medical records. Your medical record
is confidential. Information will not
be disclosed without your written consent.
Although the medical record is the property
of MGM Medical Associates, you may request
a copy. There is a charge for the cost
of duplication. You will be required
to sign a release form and can expect
the copies to be ready within five working
days. Emergency situations are expedited.
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If
you have a complaint about the care
provided or a service rendered, please
talk to your physician. It is important
that we hear from you so that we can
work to resolve the problem.
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| MGM
Medical Associates is committed
to partnering with you in maintaining
good health. As a patient, you
have the right to: |
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Be treated with professionalism,
respect, courtesy and dignity. |
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Have all
matters considered private and
confidential within the limitations
of the law. |
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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.
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Refuse any procedure or treatment
if you so desire and be told what
effect this may have on your health. |
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Receive medical services regardless
of age, sex, race, color, religion,
ancestry, national origin, disability
or sexual orientation. |
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| As
a patient, what are my responsibilities?
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| MGM
Medical Associates is committed
to partnering with you in maintaining
your good health. As a patient,
you have a responsibility to: |
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Provide your healthcare provider
with complete and accurate information. |
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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. |
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Know the
benefits, limitations and exclusions
of your insurance coverage. |
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Pay for services rendered, including
co-payments and deductibles. |
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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. |
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Contact your primary care physician
or available provider for healthcare
questions or care needed after
hours. |
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Know how to access healthcare
services in routine, urgent and
emergency situations. An emergency
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. |
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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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If
you have questions about billing, please
call our patient billing department
Monday through Friday, between 9:30
am and 2:00 pm, at 630.368.3909
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