Below is a sampling of questions often asked by our patients, along with the kind of response you can anticipate. You’ll want to take time to develop your own list of questions, or concerns, to review with the doctor on your first visit.
"This place is my second home , they treat all my family with love. The staff is amazing very concerned about the health of the patient. I will recommend this place to everyone."
WMC Patient Basics
What is expected of me as a WMC patient?
At Windermere Medical Center, we practice patient-centered, preventative care. This means we do regular check-ups, counseling and screenings to prevent illness and disease progression. We also manage diseases or conditions with routine visits including labs and imaging if needed. As a Windermere Medical Center patient, you will be expected to be involved in your healthcare and adhere to preventative care and disease management policies. This includes regular visits and routine to manage your disease. In addition, you will also be expected to follow age specific screening recommendations such as cervical cancer screening (PAP), colon cancer screening (colonoscopy), breast cancer screening (mammogram) as well as an annual physical in order to maintain active status as a patient. If you do not believe in preventative care or are looking to manage your medical conditions by only coming once a year, Windermere Medical Center is not the practice for you.
Why did my medication refill get rejected?
If your pharmacy sent a refill request or you called for a refill and it was rejected, it is likely because you missed your previously scheduled follow-up visit. It also may indicate that they are due for bloodwork if you have any chronic conditions that need routine blood monitoring. We always outline the expectations for follow up appointments when the medication was prescribed. Please see below for some examples of condition follow up:
- Controlled substances – every 3 months, labs every 6 months
- Blood pressure/cholesterol/depression meds/Thyroid/diabetes – a visit every 3-6 months with labs. The frequency of your visits is determined by your provider.
- Testosterone/PrEP – visit and lab every 3 months
You can get a short term medication refill (7-30 days) on the walk in side but you will be expected to make your regular follow up visit and labs that day may be required of you.
Why do I have to pay for a prior authorization?
How is WMC Walk-in different from another urgent care?
Why is the wait so long on walk-in side?
Why do you need vaccination records? Why don’t you see unvaccinated children?
Why haven’t I been called with imaging/labs as discussed in the visit?
Do you offer dermatology services?
Why can’t I schedule a physical for my first visit?
Does my walk-in visit count as an establishment visit?
What is a physical?
Why do I have to wait so long to be seen as an appointment with a provider?
Established patients: Why do I have to follow up after a hospital visit?
Non-established patients: Why can’t I be seen after a hospital visit?
Why do I have to have an appointment to get (lab/imaging) results?
Not all labs and imaging require a follow up, it is condition dependent and is on a case by case basis. We strive to review labs and imaging in a timely manner in order to avoid unnecessary visits. However, if you have abnormal labs or imaging, we have a responsibility as your care provider to educate you on your condition and discuss the plan. Additionally, if the labs were from a physical (preventative visit), you will still be subject to your regular office fee for follow up as lab reviews are not considered “preventative”
Why do I need a referral to a specialist?
How long does it take to get a referral?
Why is my appointment being rescheduled?
What steps do I need to take for surgical clearance?
Why do I need a surgical clearance appointment?
Why do you stop seeing patients 30-60 minutes before you close?
Insurance and Billing
What does my insurance cover?
It is the patient’s responsibility to learn about their coverage when they choose a plan. This includes co-pays, deductibles, services covered, lab fees, imaging costs, medications covered etc. We take many insurances and their coverage changes on a regular basis. As a result, we are unable to keep up with those changes. We only order labs or tests that are necessary for screening or disease management, but we cannot guarantee their coverage. You can decline testing but depending on your condition, some labs may be non-negotiable to maintain patient status.
Why did I get a lab bill?
Although physicals are considered preventative and covered 100% by insurance. The screening labs are not always covered at 100%, therefore if you have a deductible or had a test that insurance does not cover, you will be billed for the amount not covered. It is your responsibility to find out what your insurance will and will not cover. We cannot provide that information as the plans change on a regular basis and it would not be possible to give an accurate estimate.
Alternative: If you have a high deductible plan, consider opting for self-pay labs instead of going through your insurance. The fee schedule can be provided for you.
Why did I get a bill for imaging?
Alternative: If you have a high deductible plan, consider opting for self-pay imaging instead of going through your insurance. The fee schedule can be provided for you.
Why is there a $15 lab draw fee?
What is a HMO?
What is a PPO?
What does Co-Pay mean?
- For example: Your insurance card states $20 co-pay for PCP, you pay $20 at the office visit.
What does Deductible mean?
- For example: If you have a $1000 deductible, you will pay out of pocket for your health care expenses until you reach $1000, after that you will only pay a co-pay, co-insurance or nothing depending on your plan.
What does Co-Insurance mean?
- For example: If you’ve already paid your deductible and you have a 20% Co-Insurance, your insurance is billed $100, you will be responsible for $20 of the bill.
What does Out-of-pocket maximum/limit mean?
The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits.