practice policies

The nature of a one-person office limits some and expands other aspects of access. Please understand the following policies have each been created to address the needs of patients as well as the practice and its sustainability. Please review each of the points below and feel free to email me any questions that come up. I know it’s long, but bear with me!

Timeliness
This office is different from others in that there is no designated waiting area because there is usually no waiting. However, if you arrive earlier than your scheduled office visit, I may be finishing up with another appointment. Please wait outside if the weather is agreeable, or have a beverage at Javarama, just south of my building.

Scheduling Appointments
Please visit the Online Scheduling link under the Patient Area Menu for detailed information on scheduling your appointment electronically.  You will need to create an account AND establish contact with Dr. Ott, wait for your new account to be activated, and schedule away! As always, your feedback is welcome. 

Cancellation Policy
Your appointment time is reserved especially for you. If one forgets or otherwise fails to show up for their appointment in the absence of an unavoidable emergency, there will be a $75.00 fee. The same applies to appointments canceled with less than 24 hours’ notice. Please call if you are running especially late to prevent unnecessary worry; your appointment time will not be extended due to a late arrival. If missing appointments becomes a trend, you may be at risk for termination. (See below.)

Annual Fee
To support and sustain this model of practice (longer visits, more personalized care and direct physician access including email availability), there is a nominal annual fee.  For adults, the fee is $80.00 per year and for children, $40.00 per year.  The fee should be paid at your first visit and will be pro-rated. In subsequent years, it will be due In January.  For more information, or for individual consideration of sliding scale fees, please contact Dr. Chrissie directly. It is worth mentioning that most other practices that offer amenities like all-the-time access to your personal physician and include email access often charge four to six times this fee for that amenity.  In an effort to keep costs affordable, Dr. Chrissie has not chosen to follow suit and these remain the lowest annual fees around for this type of practice.  As such, annual fees are non-refundable.  They may be covered by your FSA or HSA as well.

Accepted Insurance Plans (See Blog for a PRIMER on Health Insurance terms and more!)
Nanopractice PDX is contracted with the insurance plans listed below. Please be sure to bring your insurance card with you and alert the practice of any changes in your insurance status. Dr. Ott will bill your insurance company as a courtesy, but co-pays and deductibles should be paid at the time of service and are accepted in cash, check, and now credit card!  You can also Paypal using the payment address drchrissie@nanopracticepdx.com.

Payment Policies
Outstanding balances such as deductibles and co-pays or co-insurances are the responsibility of the insured patient or guarantor and are to be paid in accordance with the signed agreement.  After a payment and/or EOB statement is received from your insurance company, a statement will be mailed at the beginning of the following month detailing your balance.  The remaining balance is due upon receipt and may be paid by check, credit card, or Paypal as above. If a balance remains outstanding with no payment arrangement for >2 months, a $20.00 late fee will be charged each month thereafter and if no arrangements are made, the account will eventually be sent to collections.

Alternative Financial Arrangements 

Self-pay patients are offered a 40% discount for payment at time of service.  This discount is often useful for people with high deductible plans or Health Savings Accounts as well.  I offer a larger self-pay discount than most, but to sustain it, it really must be for payment at time of service only.  Extended payment arrangements may be made on rare occasions.  Due to the constraints of various insurance contracts, I am not permitted to offer sliding scale fees.  I do occasionally elect to serve community members pro-bono, however, and am open to bartering some services.

Prescription Refill Policy
An important difference in a one-doctor office, is that there are no staff standing by to fax refills to pharmacies. This task can be more time-consuming than you might guess, so  most refills should be requested and handled during an office visit. This requires a bit of mindfulness on the part of patients who are on long term medication such as those for blood pressure, cholesterol, thyroid, et cetera. If you are aware of how many refills you have, you will be more able to plan appointments as needed. 

Services Offered
Dr. Ott provides basic primary care services for patients of all ages. Annual physicals including pelvic exams are available (though if a chaperone is desired, please arrange your own). Minor procedures such as wart removal, EKGs, nebulizer treatments, and skin biopsies are offered as well. Vaccinations are available (it is helpful if you confirm availability prior to appointment) as will a few simple lab tests such as urine pregnancy test, urine analysis, strep test, etc. Though hospital medicine is not the focus of this practice, Dr. Ott does have privileges at Legacy Emanuel and Providence St. Vincent's Medical Center.  If you are admitted, please ask your hospital team to alert me as soon as possible.

In the outpatient setting, Dr. Ott enjoys addressing health-affirming lifestyle changes, therapeutic nutrition, and she works closely with many practitioners in naturopathic medicine, chiropractic, acupuncture, body work, and more.

Narcotics Policy
Chronic use of habit-forming drugs such as narcotics and benzodiazepines is seldom in the best interest of patients or prescribers. For this reason, Dr. Ott will NOT prescribe long term narcotics or benzodiazepines with only the rarest of exceptions. A prescribing agreement with strict parameters will be signed in the unlikely event that long term narcotics or other drugs with abuse potential are required.  Having stipulated the above, a patient's pain or anxiety will be addressed and treated appropriately.

Dr. Chrissie’s Availability By Phone and Email
Due to the intention to maintain close relationships with a community of mindful patients, Dr. Chrissie strives to remain available and accessible at all times. Having said that, her personal time is also of great value. Please email or leave a message with the answering service for non-urgent matters.  Please have the answeting service page me if you have an urgent need.  The office phone is forwarded to the answering service most f the time, but they are able to page at any time. 

Email is usually checked multiple times daily, but in an effort to leave work at work, weekend emails may be answered on Monday and evening emails may be answered the following day. Urgent concerns can often be seen in the office outside regular working hours if needed.  Most importantly, emergency treatment should never be delayed when indicated.

When Dr. Chrissie is Away…
Should you need urgent matters addressed by phone or hospital care when Dr. Chrissie is out of town or unavailable, there will be an on-call physician responsible for these items whose phone number will be left on the office voicemail.  If you need hospitalization at a hospital where she does not have privileges, the hospitalist service at that institution will admit you and should alert Dr. Ott to your admission. There will be a phone recording that indicates when she is unavailable for returning phone calls and who is the physician to call. Never delay calling 9-1-1 if you feel you have a medical emergency.

Pharmaceutical Samples Policy
Dr. Ott believes her time should be spent with patients, not sales reps for pharmaceutical companies. Prescription samples are first and foremost marketing tools. These marketing tools are generally not available in this office. Instead, the best effective medication with the lowest cost  will be prescribed. For more information on the disturbing practices of the pharmaceutical industry in relation to datamining, prescription privacy, and more, please visit the National Physicians Alliance on-line at www.npalliance.org.

Grounds For Termination of Patient-Physician Relationship
A physician may terminate a relationship with a patient at any time by giving 30 days notice during which the physician is responsible only for responding to urgent medical matters. Dr. Chrissie will reserve this action for patients who demonstrate a lack of respect for themselves and the practice by missing appointments repeatedly, disregarding the practice’s stated policies, or acting in a way that is deceptive, disrespectful, or dishonest, or in cases where a therapeutic relationship cannot be formed. By definition this will be a small practice, so it is important that those who are seen here are invested in the relationship with their physician and act in a manner that demonstrates the same.