PATIENT RESOURCES
Appointments
We will schedule all appointments according to the patient’s needs. Some insurance plans require a referral by the primary care physician before appointments are made. We will do our best to follow these requirements but it is the responsibility of the patient to know the requirements of their particular plan. A parent or legal guardian must accompany anyone under the age of 18 at the time of their appointment. Due to the nature of our specialty there may be emergency appointments that can lead to un scheduled delays. We will keep you informed of delays and reschedule appointments as necessary.
What To Bring To Your Appointment
- Current insurance information and cards
- Co-pay and deductibles payments
- Any insurance required referral number
- A list of medications you are currently taking
- Any recent medical records an/or x-rays from other physicians pertaining to your diagnosis
- Referral Form from Primary Care Physician if necessary
Prescriptions and Refills
Prescriptions and refills should be completed during a regular office visit. Refills can be handled over the telephone during regular office hours when the patient’s chart and information are available to the physicians and staff. Providing prescriptions and refills over the phone after hours is discouraged because medical records are not available, therefore these requests will only be honored under extreme circumstances.
Insurance Procedures
It is the responsibility of the patient to pay for medical treatment. We will file insurance claims as a courtesy and are a provider for Medicare, Medicaid and many HMO and PPO programs. We ask that you provide us with current and accurate information about your insurance coverage so that we may process your claims correctly.
We realize that medical care can be quite expensive and that patients are frequently out of work due to their illness. If you anticipate financial hardship, please discuss it with our billing department to make appropriate arrangements. When no payment is made on the account after 60 days, it is considered delinquent and special attempts to contact the responsible party will be made by telephone and mail. If no attempt is made by the patient or responsible party to settle the account after 90 days, the account will be given to our collection attorney.
Financial Hardship
Financial hardship involves a situation where a person is unable, reasonably, to meet their financial obligations to us. Financial hardship can take place over a limited timeframe or be long-term. Financial hardship can arise from causes such as illness, unemployment or some other unexpected change to income or expenditure expectations. Patients who claim they cannot financially pay any amounts owed will be evaluated for financial hardship upon completion of the Application for Financial Hardship Waiver. 
In the interest of making a financial hardship determination, a Financial Hardship Waiver Application is needed. The purpose of this application is to enable PKA to evaluate the level of assistance eligibility. The following documents must be submitted with the application:
Application is needed. The purpose of this application is to enable PKA to evaluate the level of assistance eligibility. The following documents must be submitted with the application:- W-2 Withholding Statements from Previous Year
- Pay stub for most recent pay period showing year-to-date.
- Any and all documents to support additional income as outlined on the hardship application.
Peninsula Kidney Associates would like to introduce our new hardship assistance program. Please select the patient resource tab for additional information.
Financial Hardship Program
