INFORMATION FOR NEW PATIENTS
Welcome to Rainier Foot & Ankle Associates!
If you have scheduled an appointment for the first time—or are considering calling us for an appointment—then you are in the right place.
Here you can find information on our policies, as well as patient forms that you can print out and complete before your visit, should you wish to do so. Coming in with paperwork already prepared can reduce your time in the waiting room and get you in for your examination much faster.
(We like getting to that part just as much as you do!)
We provide an overview of each document accessible on this page below; however, these overviews do not provide the full information of the document. We highly encourage you to read each document fully.
If you have any further questions or seek clarification on anything you read, please do not hesitate to reach our office at (360) 761-1285 or by filling out our online contact form.
Click the Button to get started
Click the button below to be taken to our patient portal, and be sure to read below what each section of the form covers and what they mean.
New Patient Information
This section is required to be filled out by every new patient to our practice, and is added to our electronic records. Having this form filled out prior to arriving for your first appointment can be a significant time-saver in the waiting room.
Current Medications and Allergies
All treatments we provide must be best suited to a patient’s needs, and that includes not providing anything that may negatively interact with allergies or other medications. We require that all patients list current medications they are taking, as well as their reasons for taking them. We also ask that you provide all known allergies you have to medications, latex, iodine, food, or metals. If you have questions or concerns regarding any potential allergies or medications, please do not hesitate to ask us.
Narcotic Pain Medication Policy
In certain cases, we may prescribe narcotic medications for pain relief. These medications are dispensed only under specific conditions and stipulations, as stated in this section of the form. This section must be read, understood, and signed before proceeding with any treatment involving narcotic medications.
HIPAA Privacy Notice Consent
The privacy of your medical information is held in the highest regard-both legally and as an ethical imperative. When you fill out this section, you define who exactly can be allowed to receive access to certain types of medical information, and what specific types of information that would be. You can also define how you wish to be contacted by our office as well as how and whether we can leave messages with you.
No Show Policy
Our goal is to provide quality care in a timely manner. Rainier Foot & Ankle Associates schedule appointments in order to provide each patient with the individual attention you deserve.
Financial Policy
This section further details our policies on missed appointments, insurance billing, required payments, release of records, and other important items.
Payment for services is due at your scheduled appointments. Self-pay patients must pay in full.
Insurance: Co-payments, co-insurance and deductibles, where applicable, will be collected at the time of service. As a courtesy, Rainier Foot and Ankle will bill your insurance company for services provided. If you have a secondary insurance, we will bill them one time. If the secondary does not pay the balance within 45 days, the balance will be billed to you and due at that time. If for any reason the required payment cannot be made at the time of service, Rainier Foot and Ankle Associates reserves the right to refuse treatment.
Balances/Collection Fees: A statement will be sent to the mailing address you provide notifying you of any outstanding balances. If balances are not paid within 30 days of receipt, a $10 re-billing fee will be added each month. If you are unable to pay the balance in full, it is your responsibility to contact our billing department to discuss a possible payment plan. If you then fail to make payments, your account may be referred to a professional collection agency and/or attorney and will be subject to a 35% fee.
Non-Covered Charges: Under some circumstances, there may be some charges for our services which your insurance company considers non-covered and may be excluded from your policy. In these cases, you the patient, will be responsible for these charges.
Durable Medical Equipment: When necessary our office will assist in authorizing coverage for Durable Medical Equipment. All services, procedures, treatments and care will be billed to you and your insurance. There is no guarantee of payment by your insurance company and any item not covered will be patient responsibility.
Cancellation/No Show Policy: A 24-hour notice is required for all cancellations of appointments. If you fail to give 24-hours’ notice or no show to a scheduled appointment, you will be charged a $50 no show fee. We will do our best to accommodate you in rescheduling your appointment as soon as possible.
Forms: There is a $30 charge for form completion. Please allow up to 7 business days for completion of forms.
Payment Methods: We accept all major credit cards, (Visa, Mastercard, American Express, Discover) as well as personal checks, money order, cash and Care Credit on purchases/services over $200.