Making it Easy for You: Our Policies and Procedures - Our Business Functions
Emergencies
If you have a medical emergency visit Urgent Care or the Emergency Room at St. Peter's Hospital.
Urgent Care
27 Neill Avenue
443-4354
Emergency at St Peter's Hospital
2475 Broadway
444-2150
If you think you are having a heart attack take an aspirin and go directly to the ER. Urgent Care will insist on transport to the ER with urgent cardiac symptoms.
Conventional medicine is the best at providing care in traumatic and emergent situations. The Natural Medicine Clinic has good relationships with both Urgent Care and with the Emergency Room at St. Peter's Hospital. Never hesitate to tell the caregivers that your primary care physician is Dr. Aagenes. Ask to sign a release form that will automatically send to the Natural Medicine Clinic records of your care. It happens rarely, but if for any reason you feel another caregiver is less than professional about naturopathic care, please let us know. We help educate that person in the kindest and most useful way.
Telephone Policies
- Dr. Aagenes answers the phone herself between 8 and 9 am on Monday and Tuesday; between 8:30 and 9:30 on Friday. This is one of the best practices at the Clinic. You can call her with anytime, but this saves the phone tag calling back and forth. It gives you easy access to just ask a question or give her some information.
- Call us any time. We work hard at returning calls promptly.
- Always let us know if the call is urgent. Staff will alert the doctor if you need a call back quickly.
Clinic Hours
We are open from 9 am to 5 pm on Monday, Tuesday, Thursday and Friday.
These are the hours we take appointments and have staff available for Clinic business and pharmacy sales. Dr. Aagenes comes in earlier to answer the phone on Monday, Tuesday and Friday.
On Wednesdays always leave us a message and we will respond first thing on Thursday morning. If your need is urgent you can call Dr. Aagenes at home on Wednesdays and weekends. If you cannot reach her and have an immediate and compelling need visit Urgent Care.
We have long debated opening on Wednesdays. Occasionally you will find one of us at the Clinic doing catch-up work and we are always willing to help you if we are there. We are small and cannot offer the employee benefits of larger businesses. As a benefit we can offer, employees of the Clinic love having a day off in the middle of the week. It engenders their loyalty and enthusiasm in their work for you. It enables us to keep exemplary and high quality staff at the Clinic.
Return appointments can often be made the day you call. New patients can usually get in within a week. The rumor that new patients wait weeks for an appointment is not true and it hurts our business.
Your Annual Appointment
If we are responsible for your primary care, that is if we are who you call first for any health care need, Dr. Aagenes wants to do an hour visit with you every year. This visit is your best chance to stay well and to prevent illness. Dr. Aagenes often talks about compressing the time of illness and disability to the shortest possible time before death. Your annual exam helps make that possible.
For women receiving gynecological care, this visit includes the annual pelvic and breast exams, pap smears, etc. For older patients a chemistry screen, CBC and urine analysis will probably be done every other year. We use this time to review changes in weight and habits. We look at your plan with supplements and medications and, if it is appropriate we, renew prescriptions for the coming year.
Payment Policies
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We generally expect payment at the time of your visit . At the Natural Medicine Clinic our financial relationship is directly between you and us.
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We do not accept insurance assignment and the patient is responsible for payment. We provide all forms necessary for you to file with your insurance, but we do not file for you. We will work with your insurance company to safeguard your maximum legitimate reimbursement.
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We expect payment for pharmacy and lab orders-the things that cost us money-at the time the cost is incurred.
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We extend credit generously for physician fees. We never turn you away because you can't pay us that day. In fact, we encourage you to get care whenever you need it. When we extend credit we ask you to tell us how and when payment will occur.
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Fees are discounted by 10% for patients 65 years and older.
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The Clinic's excellent staff has full authority to make any payment arrangement with you. You are always welcome to discuss these things with your doctor.
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Obviously we cannot give reduced fees to many patients and stay in business. Dr. Aagenes does consider discounted fees to young women on limited incomes who are raising children alone.
Why do we do it this way?
Early in my own practice I would have loved to have the paychecks that beginning doctors at St. Peter's Hospital earn. After 15 years in practice I still do not take home that amount. What I know now is that Helena doctors are often frustrated by the demands of their employers and the third party payers. At the Natural Medicine Clinic we do not have to think about that. Our independence-yours and the clinic's-is precious in clean decisions your health care to be. Our only considerations are good patient care and a fair return for our services.
The best medical care is possible when doctors and patients are responsible to each other in all aspects of the relationship. Financially this clean relationship is rare in the health care system. Fee for service is the old fashioned way, "the way it was when I was kid in Wolf Point," said Dr. Aagenes. In the current health care world if this responsibility were retained between doctors and their patients the crisis in care and cost would be eased. Across the country many conventional practices are returning to this concept.
Third party payers-principally insurance companies and the government-involve themselves in health care decisions that might best be left to patients and their doctors. Further, there are administrative costs, if not actual profit, when a third party is involved. Blue Cross/Blue Shield, for example, is a non-profit corporation but their administrative cost is estimated between 15 and 20% of the transaction.
Less transparent and even more hidden in health care financing is the fact that most doctors are now employees of a hospital or a clinic. They receive a salary rather than take payment directly from patients. As an employee, decisions filter the bottom line for responsibility to the employer. "This doesn't have to be a negative thing, but it does affect how decisions are made," said Dr. Aagenes. Many doctors simply do not want to be responsible for running a small business.
"Over the years, I have become increasingly committed to my patients to maintain between us control of the financial transaction. This independence means that you and I are the only ones involved in decisions about your care. I don't want to let a third party come between us," said Dr. Aagenes. Cash based practice is still common for Montana naturopathic doctors and their patients.
Screening and Diagnostic Test Results
We are responsible to you for reporting to you lab results of any kind. And you are responsible for letting us know if we don't! We routinely give you copies of any test results with useful information. If you have not received a copy of a test result that you want, please let us know.
Our policy at the Clinic is that these results become a part of your official record when the doctor has reviewed them with you and reported them to you. Staff will not release lab work that a doctor has not previously discussed with you. If it is simple that will be done by a telephone call, noted as the report becomes a part of your chart. If more complex information is involved, we may ask for a visit to discuss the results.
A chemistry screen is the most basic panel of blood tests. Patients over 50 might want a chem screen every two years. In younger patients we do them on an as needed basis. The tests alert us to potential disease states, but also have information that will help us make decisions for optimum health. The chem screen we use at the Clinic tells us about blood sugar as a screen for diabetes, kidney function, protein nutrition, liver function, electrolyte balance, cholesterol and other lipids (fats). There is also a sedimentation rate, a gross measure used to detect any inflammatory process in the body.
The complete blood count (CBC) measures the function of red and white blood cells. This is sometimes ordered separately and is also a part of our basic chem screen.
Our standard thyroid function blood work includes thyroid stimulating hormone (TSH) and a free T4 levels. For patients on thyroid medication we generally require these every year.
A blood test for hemoglobin A1C measures how much glucose (sugar) is built into red blood cells. This test is commonly used to confirm a diagnosis of diabetes and to check for good glucose control.
Pap smears are used for early detection of cervical cancer or the much more rare vaginal or vulvar cancer. After years of sending them out of state, we are pleased to have these read locally by Elkhorn Cytology. They also give us information on inflammation, bacterial overgrowths and some sexually transmitted diseases. We are especially happy with their fast turn around time.
Mammograms and bone density tests are ordered for you from St. Peter's Hospital's Maria Dean medical specialists or in your own community if you are not from Helena. Tests ordered by a specialist for our patients should be routinely reported us. If you are ever waiting for a lab result from a physician to whom we referred you, call us and we will get it.
Any test or procedure done at St. Peter's Hospital requires special attention from you and from us. When you have any diagnostic procedure or other interaction with St. Peter's hospital ask to sign a release at the hospital saying you want us included with any other doctors receiving the results. Also call the Clinic and let us know when a test or procedure was done. For example, even if we are the ones who ordered your mammogram, let us know immediately it when you had it done. We want to insure prompt reports from St. Peter's. We will continue to work with them to assure this. Your care is at stake. Help us help them. |
