What to Bring to Your Appointment
If you are a new patient, please arrive 30 minutes before your appointment time and bring with you the completed new patient paperwork that was mailed to your home or delivered though secure email or text message. If you are an existing patient, please arrive 15 minutes prior to your appointment to allow enough time to complete necessary registration procedures and/or update insurance information. Please bring photo identification such as a valid driver’s license or personal identification card, a form of payment (we accept cash, personal checks with valid identification, Visa, MasterCard, Discover, and American Express), your medical insurance card(s), and a list of your current medications.
We require 24-hour notice to cancel or reschedule an appointment. Appointments should be canceled only when it is absolutely necessary. If you cancel or reschedule with less than 24-hour notice of your scheduled appointment, it will be considered a “no show” appointment.
Additionally, patients who arrive more than 15 minutes late will be considered “no show” and may have to reschedule. Please remember that your care will be delayed when you miss a scheduled appointment.
Patients who repeatedly fail to fulfill scheduled appointments will be dismissed as a patient from the Therapy Institute.
Children Accompanying Parents
To ensure the safety of children, they will not be permitted to accompany you into the treatment area or be left unattended in the waiting area. Children must be supervised by another adult in the waiting area at all times. If your children are left unattended, your appointment will be canceled. Therefore, please make prior arrangements for appropriate childcare.
For the benefit of your understanding of the treatment provided, we encourage you to bring a translator with you to your appointment if you do not speak English. If you do not have a translator, please provide at least 24-hour notice so we can be prepared for translation services.
Please advise us in advance if you have a special need such as a hearing impairment or availability of a wheelchair.
Payment for Medical Services
Payment for office services, co-pays, and deductibles are due at the time of service. If you are unable to pay for your services on the date of your appointment, your appointment will be rescheduled. For your convenience, we accept cash, personal checks with valid identification, Visa, MasterCard, Discover, and American Express. There is an additional $30.00 charge for returned checks. Patients will not receive treatment until all fees and outstanding charges are paid in full.
If you have medical insurance, please bring your insurance information with you to your first appointment. This should include a valid insurance card, an address for submitting claims, and the name, date of birth, and social security number of the subscriber. We will file your insurance claim for you as a courtesy if you are covered by one of the plans with which our healthcare providers participate.
If our healthcare providers do not participate in your plan or you do not have insurance coverage, your payment in full for medical services will be due upon check-out from the clinic. It is ultimately the patients’ responsibility to review their insurance policies regarding any limitations, exclusions, alternative benefits, deductibles, co-payments, annual maximums, and pre-authorizations prior to treatment.
Referrals and Prior Authorizations
It is your responsibility as the patient to verify with your insurance whether you need a referral or prior authorization. If a referral or prior authorization is required by the insurance, you need to contact your Primary Care Provider’s office to obtain the referral or prior authorization and bring it to your appointment.
Financial Hardship Program
We are here to serve the community, and we offer a program to assist the public in times of financial hardship. Please contact the Assistant Manager of Patient Accounts at 623-537-6000 for information.
The Therapy Institute will attempt to make payment arrangements when necessary. However, if a payment plan has been established and no payment activity has occurred on the patient account, this may result in dismissal from the Therapy Institute and other Midwestern University Clinics and the account being sent to a collection agency.
Medical records are the property of the Therapy Institute. As the patient, you have a right to view them and have reasonable access. Copies of your records will be provided to you or forwarded to another provider upon your signed written request. There is a nominal fee charged for the duplication of records, which must be paid prior to the copies being released.
If you have any questions about your treatment or rights, you should first contact your healthcare provider. You should attempt to resolve non-financial patient problems and/or complaints with your healthcare provider while you are in the Therapy Institute. In the event that this effort is unsuccessful, you should consult the Medical Director.
Problems of a financial nature should be directed to the Patient Accounts Office.
Patient Bill of Rights
The Midwestern University Clinics are committed to providing quality care and service for our patients. As a health sciences university, we also provide training for future healthcare professionals who are supervised by our faculty. As a partner in this educational process, you have the right to:
- Impartial access to treatment without regard to race, national origin, religion, gender, sexual orientation, age, disability, marital status, or diagnosis.
- Receive care in a safe setting; be treated with dignity, respect, and consideration; and receive treatment that supports and respects the patient’s individuality, choices, strengths, and abilities.
- Receive privacy in treatment and care for personal needs, including the right to request to have another person present during certain parts of a physical examination, treatment, or procedure performed by a health professional of the opposite sex.
- Review, upon written request, the patient’s own medical record as set forth in A.R.S. §§ 12-2293, 12-2294, and 12-2294.01 and ask that your doctor amend your record if it is not accurate, relevant, or complete.
- Receive a referral to another healthcare institution if Midwestern University Clinics are not authorized or not able to provide the required physical or behavioral health services.
- Participate or have the patient’s representative participate in the development of or decisions concerning treatment, including an explanation of the prescribed treatment, treatment alternatives, the option to refuse or withdraw consent for treatment before treatment is initiated (except in an emergency), the risk of no treatment, expected outcomes of these treatments, and to be told, in language you can understand, the advantages and disadvantages of each.
- Participate or refuse to participate in research or experimental treatment.
- Receive assistance from a family member, the patient’s representative, or other individual in understanding, protecting, or exercising the patient’s rights.
- Receive accurate and easily understood information about your healthcare professionals and healthcare facilities.
- Ask for and receive an itemized bill and receive an explanation of your bills.
- Consent to photographs before a patient is photographed.
- Receive continuing care by your healthcare provider, under certain circumstances, when your health plan changes and your healthcare provider is not included in the new plan or your healthcare provider terminates his or her relationship with the healthcare plan.
- A prompt and reasonable response to any complaint you have against your healthcare provider. This includes complaints about waiting times, operation hours, the actions of healthcare personnel, and the adequacy of healthcare facilities.
Along with your rights, there are patient expectations and responsibilities.
- No patient will be denied treatment based on race, color, religion, national origin, gender, sexual orientation, age, marital status, disability, or public assistance status.
- The patient shall be treated in a courteous manner, with dignity and respect for the patient’s right to confidentiality.
- Patients scheduled during the posted operating times will be seen for services as quickly as possible, with assignment, initial treatment where indicated, and follow-up appointments scheduled as soon after the appointment as is practical.
- The patient shall have access to emergency, incremental, and comprehensive care as appropriate for the patient’s presenting condition(s).
- The patient or parent/legal guardian shall receive an explanation of the results of the examination, alternative treatment options, sequence, costs of service, and the option to pursue care elsewhere if dissatisfied with the planned treatment.
- The patient shall be advised of the risks of the treatment planned, including risks of individual procedures and the consequences of no treatment.
- The patient shall receive continuity of care and completion of treatment.
- The patient shall receive care at the Therapy Institute during posted clinic hours or shall receive emergency consultation by phone.
- Every patient will receive a copy of the Patient Bill of Rights at the time of service.
- The patient shall have access to a patient advocate should there be any questions or concerns related to the patient’s treatment.
- Patients whose treatment is discontinued will be notified in writing. Alternate treatment options may be suggested.
- At the time of admission as a patient, an individual patient record will be established. This record will contain diagnostic and therapeutic information related to the patient’s care and will be updated at every appointment according to the guidelines of the Midwestern University Therapy Institute Patient Record Protocol.
As a patient of Midwestern University Therapy Institute, I understand I have the responsibility to:
- Provide, to the best of my knowledge, accurate and complete information about current medical complaints, past illnesses, hospitalizations, medicines, and other issues relevant to my care.
- Inform my provider promptly if I do not understand information relating to my care and treatment or I receive instructions that I cannot comply with.
- Keep appointments, or call to cancel with a minimum 24-hournotice when I cannot keep a scheduled appointment.
- Observe Midwestern University’s no-smoking policy.
- Follow Midwestern University’s rules and regulations.
- Provide information regarding changes in my insurance, address, or phone number.
- Provide information about payment for services and meet all financial obligations.
- Accept responsibility for my actions if I refuse treatment or do not follow my provider’s instructions.
- Be considerate of other patients and Midwestern University’s property.
- Show courtesy and respect to Midwestern University’s personnel.
- Behave reasonably and appropriately, showing respect for the professional atmosphere of Midwestern University.
Patient Dismissal Procedure
It is the policy of Midwestern University to maintain a positive, trusting, and cooperative relationship with clinic patients. In the event a clinic chooses to dismiss a patient of record from the teaching program and/or clinical care, this policy outlines the University’s patient dismissal procedure.
Single Clinic Dismissal
A clinic may decide, independently of another clinic, to dismiss a patient. That patient may be dismissed from the teaching program or from the clinic for any of the following reasons:
- After three no-show appointments, during the preceding twelve calendar months, a patient may be dismissed from the teaching program or clinic. A no-show appointment is defined as the patient’s failure to provide a 24-hour notice of a cancelation and/or failure to show for scheduled appointments.
- A patient may be dismissed who is seeking only occasional treatment for relief of pain and not interested in comprehensive care.
- Failure to schedule appointments for completion of procedures.
- Failure to schedule health maintenance appointments.
- Refusal to provide complete and accurate information about current medical conditions and complaints, past illnesses, medications, and other issues relevant to care.
- Failure to adhere to the Midwestern University Clinics’ responsibilities as a patient or guardian of a patient, as outlined on the clinic website. https://www.mwuclinics.com/arizona/services/therapy/patient-information.
- Refusal of treatment and/or not following provider instructions.
- Failure to provide information about payment for services.
- Each clinic may individually make a decision to dismiss a patient. For example, a patient who fulfills criterion 4 may be dismissed from the Dental Institute, but might not be dismissed by the Eye Institute. Final decision for a patient dismissal is made by the Clinical Dean/Medical Director or his/her designee in each clinic.
A patient in the midst of a multi-step procedure may complete his/her treatment at the discretion of the Clinical Dean and be stable prior to dismissal. A dismissed patient will be allowed emergency care for 30 days from the date of dismissal and will be given a referral to another provider.
All Clinics Dismissal
- A patient who exhibits drug seeking behavior, sexual or other forms of prohibited harassment, and/or use of abusive or derogatory language will be dismissed from all clinics. In the instance where the dismissed patient has a pet being seen at the Companion Animal Clinic, that pet will be dismissed from that clinic.
- In the instance that the dismissed patient has a minor child and/or spouse being seen at a clinic, that minor child and/or spouse will be dismissed from the clinic.
- A patient may be dismissed for failure to meet all financial obligations.
Procedure for Notifying Clinic Staff of Patient Dismissal from One or More Clinics
- Patients who have failed to show for three appointments in the preceding twelve calendar months will be contacted by a staff member in patient services to assess if there are mitigating circumstances (i.e., hospitalization). At that time the patient will either be notified of the pending dismissal from the teaching program/clinic or be readmitted on a probationary basis.
- When the decision is made to dismiss a patient from one or all clinics, the following steps shall be taken:
- A clinic staff member generates the dismissal letter and uploads that document into the patient dismissal portal.
- Clinic leadership shall be notified and may be requested to approve the pending dismissal letter.
- A clinic staff member will enter a note into the EHR/Practice Management system(s) with the details of the dismissal. The note(s) shall include, but may not be limited to:
- The full name of the clinic initiating the dismissal
- The initiation date of the cross-clinic dismissal
- If a dismissed patient calls for an appointment at any one of the Midwestern University Clinics, the Patient Account Representative will explain that according to policy, he/she may not be accepted as a patient.
- When a Patient Account Representative experiences difficulty with a patient who was dismissed for financial reasons, that patient is referred to the Manager of Patient Accounts.
- When a Patient Account Representative experiences difficulty with a patient who was dismissed for behavioral reasons, that patient is referred to the Clinical Dean/Medical Director or the Dean of the College or his/her designee.
- When a patient is dismissed for behavioral or financial reason(s), a behavior dismissal notification alert is generated from the patient dismissal letter portal and sent to the President and Chief Executive Officer, Senior Vice President and Chief Financial Officer, Vice President and General Counsel, and the Vice President and Chief Academic Officer (CAO) to notify them of the intent to dismiss.Two business days after this notification, the dismissed patient will be sent a letter of dismissal with the reason(s) for the dismissal and stating that the clinic will provide 30 days of emergency care from the date of the letter.
- Patients may appeal their dismissal to the appropriate Clinical Dean/Medical Director or the Dean of the College or his/her designee for discussion and resolution. The Dean of the College will notify the CAO immediately of the patient’s appeal referral. If the dismissal is upheld, the patient is informed that he/she may appeal to the CAO of the respective college or clinic involved in the dismissal.