HELPFUL TELEPHONE NUMBERS

WEBSITE/EMAIL ADDRESSES

• Website for Hillcrest HealthCare Medical Center - www.hillcrest.com
• Email Address for UPC Patient Billing Questions - upcbill@hillcrest.com

WELCOME

Thank you for choosing Utica Park Clinic!

We warmly welcome you and your family.

We look forward to serving you and working with you toward better health.

Our goal at Utica Park Clinic is to provide you with medical care of the highest quality in an ethical manner and at a reasonable cost. We are committed to giving friendly and efficient care in a comfortable environment. We hope this handbook will provide you with useful information about our clinics.

MEDICAL GROUP PHILOSOPHY

Utica Park Clinic (UPC) is a part of the Oklahoma Physicians Group (OPG), which is a service of Hillcrest HealthCare System (HHS). HHS is a network of hospitals, primary care and specialty clinics, long-term care facilities, and physician services that are available in 39 Oklahoma counties.

We are pleased to serve as your health care provider. As your medical care needs change, we will work with you to understand and address your physical and psychological needs. Some needs are found to be common for all patients. Our philosophy is to understand and solve your special needs as well as integrate those needs into your medical care.

One of our primary goals is to establish a close working relationship with you. We will always try to accommodate you in scheduling an appointment with your doctor. If you become ill and your doctor is not in the office or the available appointment time is not convenient for you, an appointment with another UPC provider will always be arranged. You may be offered an appointment with a Certified Physician Assistant or a Registered Nurse Practitioner. These providers are fully trained and legally authorized to provide care under the supervision of a licensed physician and thus fulfill a broad range of medical services that might otherwise be provided by a physician.

We believe that a multi-specialty group practice is the most efficient way to meet your health care needs. A group of doctors from UPC is available at all times. In a group practice you may receive the benefit of evaluation and input from more than one doctor in evaluating or treating your medical problems.

If your Primary Care Provider determines that the services of a specialist are necessary, we have a wide range of qualified professionals from which to choose (your choices may be limited depending upon the requirements of the insurance plan you have chosen).

It is against our policy to discriminate against any person on the basis of sex, race, religion, lifestyle preferences, diagnosis, or ability to pay. We always try to treat our patients appropriately and with due respect. We do, however, reserve the right to dismiss any patient from our practice who refuses to actively and appropriately participate in their own medical care, abuses our staff, or disrupts our office functions. These are merely examples of behaviors that warrant dismissal from our group and each situation is evaluated on an individual basis.

OFFICE HOURS

Our UPC Clinics offer a wide range of expanded hours for your convenience.

• Routine clinic / office hours are normally from 8:00 A.M. to 5:00 P.M. on Monday through Friday. Our last routine appointment is generally scheduled by 4:00 P.M. Each physician, depending on location, may offer slightly earlier or later hours. Please check for specific information with the physician and office you selected.

• Some clinics offer extended hours.

APPOINTMENT SCHEDULING

Patients may always choose to schedule an appointment for a future date. However, we do have "same day or next day" appointments available for the convenience of our patients. We try to make your "same day" appointment with your Primary Care Provider. If this is not possible, we will arrange for you to be seen by another health care provider on that day in the metro area or as soon as possible in the region so that your health care needs can be addressed promptly.

It is important to bring ALL MEDICATIONS you are currently taking to your appointment.

If you are unable to keep your appointment or find you will be late, please call the office so we can adjust the schedule. However, if you are significantly late for an appointment, we may have to reschedule it for you. We request that you notify us at least 24 hours before your scheduled appointment if you must miss an appointment. You may be charged a fee if prior notice is not received. If appointments are consistently missed (with or without prior notice) we may choose to decline to make further appointments for you.

Walk-in patients are discouraged out of courtesy to our scheduled patients. Ill or injured patients should call the office first to ensure that a doctor and appointment is available. In most cases we will be able to offer an appointment on the same day. Major emergencies will, of course, be addressed appropriately as the need arises.

EMERGENCY AND URGENT CARE

Although it will not always be your Primary Care Provider, there is a UPC doctor on call and available to you for emergencies 24 hours a day and seven days a week. To reach us after office hours, please call your doctor's office at the usual phone number. A UPC physician will then be contacted for you.

We request that calls after office hours be limited to emergencies and other problems that cannot wait until the following day. If you need to be seen immediately, we can arrange a visit to the UPC After Hours Clinic or the emergency department.

Call 911 for life or limb threatening emergencies that require immediate treatment and/or transport to the nearest emergency department. The emergency room staff will contact your UPC physician.

OFFICE LOCATIONS

UPC Physicians include doctors of Pediatrics, Family Practice, Internal Medicine, and a variety of specialties. In the metro area these specialties include Dermatology, Neurology, Obstetrics and Gynecology, Pain Management, Pediatric Neurology, Pediatric Development & Rehabilitation and Neurosurgery. Specialties offered in the region are General Surgery, Orthopedic Surgery, Obstetrics & Gynecology and Urology. Our physicians are fully licensed and are required to maintain malpractice insurance. We require that each physician undergo a rigorous screening process to verify his/her credentials prior to offering medical services through UPC.

REFERRALS / CONSULTATIONS

The process and time necessary for obtaining a referral for testing or a consultation by a specialist will vary according to the requirements of your insurance plan. Laboratory, X-ray, and other testing or treatment services are often available in the clinic. However, you may have to be seen at a different specified location based on availability of services as well as the requirements of your insurance plan.

CHANGING PHYSICIANS

Any patient may choose a different Primary Care Provider (PCP) or specialist. However, limitations regarding timing of provider changes or specific provider availability may exist depending on the requirements of your insurance plan or the patient load of the provider you have chosen. We will always try to accommodate your request as quickly as possible.

PRESCRIPTION REFILLS

It is very important that you follow your doctor's orders regarding the medications prescribed.

If you need a medication refilled, please call your PHARMACIST DIRECTLY.

Your pharmacist will contact the clinic during routine office hours to obtain authorization for your refill. We will address requests for medication refills within 24 hours after we receive the call during the workweek. Please plan ahead so that you do not run out of medication since it can take time to respond to your request and allow your pharmacist to actually prepare your medication refill. Therefore, it is very important that you remember to call your pharmacist for refills AT LEAST TWO DAYS PRIOR to taking your last dose of medication. Refills will not routinely be addressed at night or during weekend / holidays.

Narcotics may ONLY be prescribed during the workweek and ONLY at the discretion of your physician.

Your physician may occasionally have access to non-narcotic "samples" of medications. Samples may be provided based on need, availability, or at the discretion of the physician. Receipt of sample medications is not a patient right and is provided only as an additional effort toward customer service.

TELEPHONE ADVICE

Many minor medical problems can be dealt with by advice over the telephone and do not necessarily require an office visit with a physician. During office hours a Medical Assistant (MA) or Nurse is designated by your doctor to be available to help you with your questions. Your call will be referred to your doctor as needed.

Depending on your medical history, your doctor may also have made arrangements for you to receive more intensive monitoring or health education services. If so, a member of the nursing staff may contact you periodically to assist you in maintaining or improving your health status.

If you are a managed care (HMO) health plan member, there may be additional assistance and information phone lines available through your health plan which you may find useful. Call your insurance company directly to determine availability.

MEDICAL RECORDS

A specific UPC record release form, signed by you or your legal designee, is generally required for your medical records to be transferred outside of UPC. There are many federal laws that govern how we are allowed to release medical information and records.

Detailed information regarding the HIPAA laws (Notice of Privacy Practices) can be obtained at any of our clinics. In general your personally identifiable records are not accessible to anyone without your permission unless required by law (such as requirements to notify the Health Department for communicable diseases) or when needed for situations involving your medical care, payment for services, or administrative functions.

Additionally, although you may have previously arranged to provide us with records from outside sources, our normal policy is not to reproduce these records. If you require records that were generated by a non-UPC source, we respectfully request that you directly contact the source from which you need copies.

In order to have your requested records ready for you, please call at least 24 hours (variable based on copying service) in advance. We will be happy to provide our form for your signature as well as mail the records for you (or you may pick them up at the clinic). There is a charge for this service that is regulated by Oklahoma law.

LIVING WILL - ADVANCE DIRECTIVE

We strongly recommend that you complete a living will to be added to your medical record and discuss your wishes with your physician and family members. The forms are available in each office or by clicking here. Your family members, friends, or attorney can assist you in completing this if you so desire.

FEES

Increasing costs are a growing problem for everyone, including medical offices. Today we find ourselves confronted with ever increasing costs for almost every supply and service we use to provide professional care to you. In order to keep costs for all patients as low as possible, you are expected to pay for services rendered at the time of your visit. If you are a member of a managed care plan (HMO), we are required to collect your co-payment from you at the time of each appointment or service provided.

As a courtesy, we will file your insurance for you. Your medical insurance represents a contract between you and your insurance company. Depending on your individual health insurance plan and benefits, costs of services provided may or may not be covered. Remember that you are a customer of your insurance company and you or your employer pays the premiums for your insurance. Your insurance company must be responsible to you and answer all of your questions about your health insurance coverage and benefits. Please do not hesitate to contact them when necessary.

Additional fees of varying amounts may be charged to you for missing appointments without proper notification or for completion of forms at your request, such as those for school physicals or disability determinations.

If you have questions concerning specific charges or your UPC account, please contact the Business Office at (918) 560-3838 or via their email address at upcbill@hillcrest.com. We value you as a customer and will strive to provide you with the best service that we possibly can. Frequently asked questions and answers can be found here.

PAYMENT POLICIES

Payment in full for all services provided, or co-payments for managed care plans is expected at the time of the service. Depending on the situation, you may be asked to discuss payment arrangements with a billing representative or be required to make payment on a past due account before another appointment will be scheduled. Questions or problems regarding your bill should be directed to our Business Office.

SAFETY

We strive at all times to maintain an environment that is pleasant and safe for our patients, visitors, and staff. If you happen to notice a situation that you believe to be unsafe, please notify one of our staff members so we can immediately take action to begin correction.

CHAPERONES / TRANSLATORS

We are very concerned with maintaining your privacy and dignity. Therefore, we always have a staff member available who can act as your advocate and chaperone during an exam. If you prefer to have a family member or friend act in this capacity for you, please notify our staff and arrangements will be made to accommodate your request whenever possible.

Although we will certainly attempt to meet any of your requests regarding availability of a translator, this may often be cumbersome for both the patient and the provider. If you prefer to bring a translator with you, we will make every effort for them to remain with you at all times, according to your wishes.

MEDICAL RESEARCH

We often have opportunities available for our patients to participate in medical research studies. Often these studies include free medical examinations, testing, and medications for the patients who participate. It is always your right to decline to participate in these studies and you will never be involved in a research study that would change your medical care without your specific authorization. For additional information, contact (918) 579-3931.

PATIENT SATISFACTION

One of our primary goals is to do everything in our power to insure the satisfaction of our patients. In fact, we monitor and address these issues constantly. Occasionally, we may request your assistance in identifying issues of satisfaction or concern by giving or mailing you a brief "Patient Satisfaction Survey."  We greatly appreciate any feedback you choose to provide and respectfully request that you complete and return the survey so we may take action on your suggestions.

PATIENT RIGHTS

As a patient receiving medical services from UPC, you have the right to expect to be treated with consideration, respect and dignity. To ensure that you gain maximum benefit from our care, you have certain responsibilities that contribute to the partnership between you and UPC.

AS A PATIENT OF UTICA PARK CLINIC (UPC) YOU HAVE THE RIGHT TO:

• Fair and truthful marketing regarding the competency and capability of UPC.
• Refuse treatment to the extent permitted by law, and to be informed of the medical consequences of your action or decision.
• Be informed in advance about the care and treatment you will receive, including but not limited to, your diagnosis, prognosis, risks, benefits, and alternatives available in terms you can reasonably expect to understand. This right includes any treatment classified as "experimental."
• Receive necessary information from your physician prior to changing any care or treatment provided or any medical procedure to be performed. Informed consent or refusal is your right and you may reverse your decision at any time without fear of reprisal, discrimination, or unreasonable interruption in services.
• Expect any information regarding your case or contained in your medical record will remain confidential and will not be shared with others unless permitted or required by law.
• Know the names and qualifications of physicians, consulting physicians and UPC staff members who are providing your care and treatment.
• Access to your medical record with reasonable guidance from your physician in order to protect your health and mental well-being.
• Access to any bill or charges with an explanation of the information present.
• Request and, in most circumstances, be allowed to have your family or designated representative participate with you in decision making regarding your medical care.
• Have your family or guardian exercise your medical rights if you are incapacitated and are unable to make your own health care decisions.
• Expect that reasonable effort will be made to respond to your request for services with information provided to explain decisions that were made.
• Expect reasonable continuity of care and to change PCP or specialists if other qualified physicians are not available.
• Information regarding processes available to address or resolve concerns or issues.
• Expect that your wishes regarding your rights on advance directives and heroic measures in your health care, when communicated to your provider, will be carried out whenever possible.
• Know what your responsibilities are as a patient in the care of UPC.

PATIENT RESPONSIBILITIES

AS A PATIENT OF UTICA PARK CLINIC (UPC) YOU HAVE THE RESPONSIBILITY TO:

• Provide, to the best of your ability, accurate and complete information regarding your past and current health status and to provide previous medical records whenever possible to your UPC provider.
• Act as a responsible partner in your own health care, setting your health care goals, and to clarify any information provided to you which is not completely understood by you.
• Follow the treatment plan recommended by your provider when agreed to by you.
• Be considerate of other patients and staff members. Conduct yourself in a reasonable manner while observing the rules and regulations of Hillcrest HealthCare. This responsibility is yours as well as any family or visitors you might have and also applies to any property or equipment owned or maintained by Hillcrest HealthCare.
• Keep all appointments at their scheduled time or provide reasonable notice of inability to keep a particular appointment.
• Provide necessary and accurate information for medical care reimbursement in a timely manner.
• Be aware of benefits or services which are not, or may not be, covered by your health plan and to assist your provider with your healthcare. (See your health plan member handbook.)
• Continue your treatment plan until changed or stopped by your provider with your agreement.
• Use Hillcrest HealthCare facilities and services whenever possible. (This does not apply to potentially life-threatening emergency situations).
• Be aware of, and follow, proper procedures to address concerns or issues.
• Call your primary care provider when you have:
  • 1. An unplanned visit to an emergency room;
  • 2. Been admitted to a hospital;
  • 3. Any problems or questions with your treatment plan.
• Call your health plan with any questions or concerns regarding benefits or services available to you.

FOR MEMBERS OF MANAGED CARE (HMO) HEALTH PLANS

As the medical group you have selected, UPC would like to welcome you. We hope your affiliation with us is a happy and healthy one. It is important to us that you receive full value from your health plan. In order to do this, we would like to request that you take just a few minutes to read the following information:

HMO COORDINATED CARE

The Primary Care Provider (PCP) you choose will be your partner in your healthcare. Selecting a personal physician and establishing a good relationship is key to maintaining your health. Your doctor will get to know you and your medical history. Coordination of your medical care will be a team approach drawing from the expertise of the clinic's experienced medical staff. Our staff, or your HMO Member Services Department, can assist you in selecting your Primary Care Provider.

HMO EMERGENCY

There are many conditions that are not life threatening but may need medical attention that day. For these acute problems, you must call your Primary Care Provider for direction. As a member of a managed healthcare plan, there may be a "nurse phone line" available through your plan for you to utilize. This applies during and after office hours. Many problems can be addressed in your doctor's office or even managed by phone until the office opens but, if your physician deems necessary, you may be directed to seek assistance at an emergency room or in the After Hours Clinic. It is important to always call your doctor whenever you have a medical need or concern.

Call 911 for life or limb-threatening emergencies for transport to the nearest emergency room. The emergency room staff will notify your UPC physician. In order to avoid becoming personally responsible for medical charges and payments, life or limb-threatening emergency is the only circumstance under which you should go to an emergency room without notifying your doctor. You should always notify your doctor's office within 48 hours after any emergency room visit to avoid possible payment responsibility. Whenever possible you should utilize the Hillcrest Medical Center emergency department.

HMO REFERRALS

Your Primary Care Provider is responsible for your medical care and coordination of any necessary specialty services. Your Primary Care Provider will arrange a referral for you to receive specialty services if he or she believes that it is medically necessary. In most cases your doctor can even approve the referral without further review. However, there are some limited situations that require your health plan to approve the referral. In those cases you will be notified in writing of their decision.

To avoid being financially responsible for a bill, do not schedule an appointment until you have approval. You could be solely responsible for a bill if services are provided to you without pre-authorization. Please contact your health plan's customer service department to determine the status of your referral. Please DO NOT call your primary care provider for the status of your referrals because your primary care provider's office does not have access to this information and will not be able to help speed up the approval process.

Please be aware that only the services specifically listed on the approval will be paid. Any additional services must also be pre-authorized.

HMO CO-PAYMENT

If your health plan requires a co-payment for office visits or procedures, you will be expected to pay prior to the service being received. Your co-payment is listed on your membership card. If you have any questions regarding your prepaid health plan, please call your health plan's customer service department directly.

PROBLEMS OR CONCERNS

We are constantly striving to make our practice better to serve the needs of our patients. However, if you do have comments or concerns please contact us at:

Call our Action Line
(918) 579-2968
1-888-603-3222

or

Write directly to:
Utica Park Clinic
Kevin Gross
Interim Chief Executive Officer
1145 S Utica, Suite # 110
Tulsa, OK 74104

THANK YOU AGAIN FOR CHOOSING UTICA PARK CLINIC!