For Patients

Making Appointments

Please call the Health West clinic closest to you for an appointment. You can find the location and phone number in the Locations section. Many appointments can be scheduled for the same day or next day or scheduled for your convenience. Our staff in Aberdeen, American Falls, and Pocatello are bilingual in English and Spanish and can deliver quality medical care using either language.

Your First Visit

Please arrive at least 30 minutes early for your first appointment so that you can complete the necessary paperwork. You will need to bring:

• Your current Medicaid, Medicare, or insurance card
• Proof of income (wage stub, unemployment stub, tax return)
• Names of dependent family members
• Minimum $15 office visit fee
• Child’s immunization/shot record, if appropriate
• List of current medicines (or medicine bottles)
• Medical records, if you have them You will need to complete some forms when you come in:
  • Patient demographic and consent form
  • Health history
  • Sliding Fee discount application

Fees and Insurance

If you do not have insurance, Health West fees are based upon a sliding fee schedule. The fee is based upon the size of your family, family income, and the services you receive. The fee will range from a minimum of $15 up to the full charge. Here is the sliding fee as of June 2007.

Family Size	Nominal fee $15.00	25% of charge	50% of charge	75% of charge	100% (full fee)
1	$10,210	$10,211-$15,315	$15,316-$17,868	$17,869-$20,420	$20,421
2	$13,690	$13,691-$20,535	$20,536-$23,958	$23,959-$27,380	$27,381
3	$17,170	$17,171-$25,755	$25,756-$30,048	$30,049-$34,340	$34,341
4	$20,650	$20,651-$30,975	$30,976-$36,138	$36,139-$41,300	$41,301
5	$24,130	$24,131-$36,195	$36,196-$42,228	$42,229-$48,260	$48,261
6	$27,610	$27,611-$41,415	$41,416-$48,318	$48,319-$55,220	$55,221
7	$31,090	$31,091-$46,635	$46,636-$54,408	$54,409-$62,180	$62,181
8	$34,570	$34,571-$51,855	$51,856-$60,498	$60,499-$69,140	$69,141

Your clinic receptionist will help you determine your cost of the visit.

Payment is due at the time of the visit. The minimum fees for service are:

• Office visit: $15
• X-ray: $10 per x-ray
• Lab: Up to $10 per test
• Supplies: 25% of charge

Payment options are:

• Cash
• Check
• Money Order
• Credit or Debit Card

Payment options and flexible payment plans are available. The receptionist or the Health West billing office (232-7862) can help with arrangements. Health West accepts most insurance plans including Medicaid, CHIP, Medicare, Blue Cross, Blue Shield, other commercial plans, and worker’s compensation. Please bring your insurance card with you to your appointment.

Requesting Copies of Your Records

With a few easy steps, we will copy and send your medical records to you or to an outside requester. We will ask you to sign a release of information for us to release the information. Records are released at no charge to other health care providers. There may be a fee if the records are released to attorney, private insurance companies, or for your personal use. Payment is required prior to copies being made. Records will be released when:

• A signed authorization is on file
• Payment is made (if fee applies)
• Records will be duplicated and mailed or be ready for you to pick up within 30 days of your signed request.

Patients Rights and Responsiblities

PATIENT RIGHTS

Health West, Inc. clinics have policies to assure:

• Right to Respect: You have the right to be treated with dignity and respect.
• Right to Privacy: And confidentiality regarding your health and health care.
• Right to Choose: You have the right to accept or refuse medical treatment at any time.
• Right to Choose: Your Provider.
• Right to Know: The identities and responsibilities of all individuals caring for you and what services they provide. Also the plans and facilities of the clinics.
• Right to Receive: The clinics services and accommodations your medical provider indicates are needed to the best of the clinics ability
• Right to Know: About your diagnosis, treatment and prognosis in terms you can understand.
• Right to Receive: Interpreter services and assistance if you do not speak or understand English or are hearing or visually impaired.
• Right to Expect: That your care is treated as confidential, secure and private.
• Right to Know: That continuous work on improving better communications with our patients is our goal.
• Right to Expect: That your care will be delivered in a safe environment.
• Right to Know: That you are involved and play a key role in your health care and treatment.
• Right to Know: That your personal values and beliefs are considered throughout the care process.
• Right to Know: That all health center locations provide reasonable access to care.
• Right to Know: That you have the right to complete a patient satisfaction survey form available in the waiting room.
• Right to Know: That opportunity exists for you to express any conflicts about your health care decisions to the management team.
• Right to Know: That education material is provided to explain the fee and payment policy.
• Right to Know: That you have the right to access your medical record.
• Right to Know: What if you become too ill to decide about your medical treatment? Before you become too ill to decide about your medical treatment, you can let your family and doctor know your wishes by writing a Living Will and Durable Power of Attorney of Health Care.

PATIENT RESPONSIBILITIES

As a patient, you have the responsibility:

• To keep the appointments you schedule.
• To provide accurate and complete information on your health and health history.
• To provide accurate and complete information on your demographic information, insurance, and financial status.
• To be an active partner in your health care, working with Health West staff on your health goals.
• To understand and follow treatment instructions and medications.
• To ask questions and be informed so that you know what you need to do to improve your health.

After Hours Emergencies

If you have a medical emergency that may be life threatening, call 911 or go to the closest hospital emergency room. If you are a patient at one of our clinics and need medical assistance after hours, call the clinic and you will be connected to our after hours service who will contact the on-call provider. If you need a prescription refill, the call must be made during regular clinic hours.

Prescription Refills

Health West knows that staying on your prescribed medicine is important and can help make sure you maintain your supply of medicine. Here are the steps to take to obtain prescription refills from Health West.

If you will be getting your prescription from a local pharmacy:

1. Call the clinic where you are receiving care at least 5 days prior to running out of your current medicine.
2. If you have a chronic disease such as diabetes or heart disease, you may need to schedule an appointment to be seen to monitor your health status.
3. You may need to come in and complete blood work.

If you will be getting your prescription through the patient assistance program (free or reduced cost medicine):

1. Call the clinic where you are receiving care at least 30 days prior to running out of your current medicine. It takes time to obtain the medicine from the drug companies.
2. You must be seen by a provider for an office visit every 3 months.
3. You may need to come in and complete blood work.
4. You need to have your account for clinic services paid in full or be making regular monthly payments on your bill.
5. You will need to bring a copy of your Medicaid denial letter. You will need to bring in the required financial documentation.