New UCH Patient Welcome - University of Colorado Health

advertisement
Welcome to The Center for Integrative Medicine at the University of Colorado Hospital. We are committed to
serving you and your health care needs. Our team of health care professionals knows trust and confidence are
earned, not assumed. We value your selection of us and look forward to earning your trust.
Appointments
Call 720-848-1090 and press 3 to speak to a clinic representative who
will schedule, adjust, or cancel your appointment.
Cancellations
We ask you to call 24 hours in advance if you need to cancel an
appointment. Cancellations that occur with less than a 24-hour notice
are considered a No Show. In order to provide timely appointments and
allow access to our providers we monitor No Show appointments. A
notification letter will be sent after the first and second missed
appointments. After the third missed appointment you may be
discharged from the practice. If you missed your appointment due to
hospitalization or other unforeseen circumstances, please let us know
and you will not be penalized. For more information regarding this policy
please ask a front desk representative.
SERVICES OFFERED





Payments/Insurance
Many of the services provided at The Center for Integrative Medicine are
not covered by insurance. In those instances when services are covered
and University of Colorado Hospital is a contracted provider, we will
work with you to obtain necessary authorization from your insurance
company. We bill as a facility and thus some plans have a different
deductible, coinsurance or co-pays reflective of this. If this is the case,
you will be billed for the additional amount and responsible for payment
as you are held accountable for understanding your plan. If you check
your benefits, be sure to specify that we bill as an outpatient facility. If
you have questions about what this means, please contact us so we can
provide any clarifications on the difference from professional billing.
Cash, check, Discover, MasterCard, Visa or American Express are
accepted methods of payment. Payment is due at the time of service.
Your Visit
We ask that you arrive 15 minutes ahead of time to ensure a smooth
flow through the registration. Please bring a photo ID, your insurance
card and your co-pay amount if required. Self-pay patients must pay at
the time of check-in.





Biofeedback
Chiropractic Therapy
Counseling
Behavioral/Psychological
Spiritual (in conjunction with pastoral care)
Massage Therapy
Integrative Medicine Health and Wellness
Consultations (Covered by most plans)
A physician or physician’s assistant will
provide individual personalized advice on
blending complementary medicine with
conventional care for patient who:
-Have a complicated diagnosis
-Are uncertain which complementary and
alternative medicine service would best meet
their needs
-Would like general wellness advice
Nutritional and Dietary Counseling
Pharmaceutical/Herbal Supplement Consults
Traditional Chinese Medicine (TCM)
Acupuncture
Chinese Herbal
Supplements/Consultations
Workshops and classes
For more information on classes please
contact The Center for Integrative Medicine
THE CENTER FOR INTEGRATIVE MEDICINE
ANSCHUTZ OUTPATIENT PAVILION
1635 Aurora Court, MS F743
Fifth Floor, Suite 5501
Aurora, Colorado 80045
Directions (please click link below or view webpage):
http://www.uch.edu/imgs/map/TCFIM_AOP_Map.pdf
My Health Connection (MHC)
You are able to securely manage your health care from the comfort of
your own home by signing up for our free online service. MHC allows
you to request an appointment, request prescription refills, view your
labs online, communicate with your provider, and update your insurance
information. www.uch.edu/myhealthconnection
Medical Records
You may obtain medical records by calling 720-848-1031. Please
remember in order to obtain your medical records and to allow a family
member and/or spouse to obtain your medical records, a medical
release form must be signed.
P: 720.848.1090 | F: 720.848.1277
Clinic hours: Monday through Friday 8:00-4:30pm
Check out our Facebook and LinkedIn pages:
“The Center for Integrative Medicine
at University Colorado Hospital”
or view our webpage through the link below:
http://www.uch.edu/integrativemed
MEET THE TEAM
Anyone on our team can assist you with general questions about our services, your appointment,
scheduling, taking payments, product sales, referrals, medical record requests, receiving our enewsletter or My Health Connection.
Please read about our Care Team members and their positions so you know who to refer to for any
specific issues or questions you may have.
Steve Tung, Practice Manager
Phone: 720-848-1080 / Email: Stephen.Tung@uchealth.org
If you have questions, comments, concerns or inquiries regarding the service
you received at The Center for Integrative Medicine.
Kayla Engebretson, Care Team Specialist
Phone: 720-848-1061 / Email: Kayla.Engebretson@uchealth.org
If you have questions regarding billing issues, insurance authorization, or IVF
acupuncture.
Tina Gillett, Medical Assistant & Care Team Assistant
Phone: 720-848-1091 / Email: Tina.Gillett@uchealth,org
If you have medical-related questions, prescription refill requests, or
questions on a psychology referral.
Katie Hodgson, Care Team Assistant
Phone: 720-848-1788 / Email: Katherine.Hodgson@uchealth.org
If you are not sure who to refer your inquiry to and need additional support,
please refer to Katie for guidance.
NAME: __________________________
DATE OF BIRTH: ___________________
1635 Aurora Court, Suite 5501
Aurora, CO 80045
Phone: 720-848-1090
Fax: 720-848-1277
The Center for Integrative Medicine: Health and Wellness Assessment
Emphasizing wellness and healing through the integration of Western and complementary medicine.
How did you hear about our center?
 Brochure  Newspaper/Radio/TV  Internet  Walk-in  Conference/Lecture/Seminar
 Word of Mouth  Physician/Nurse/Other: ____________________________________________
(Please write in name)
Reasons You are Seeking Care:
Please list any specific symptoms you would like help with below. If you are not experiencing any symptoms
please note below your health goals related to this visit.
Please rate your primary complaint of __________________________ or current pain level, from zero (no
pain/complaint) to 10 (worst):
0
1
2
3
4
5
6
7
8
9
10
What have you done to help the problems listed above? _____________________________________________
__________________________________________________________________________________________
How do these symptoms affect you? ____________________________________________________________
__________________________________________________________________________________________
Please state your treatment goal(s): _____________________________________________________________
__________________________________________________________________________________________
If you are seeing the chiropractor, please list dates of any pertinent spinal x-rays, MRI or CT scans please list the
areas images (i.e. Neck X-Ray August 2012): _______________________________________________________
___________________________________________________________________________________________
General Interest in Complementary / Alternative Medicine Therapies:
Please check the therapies you may be interested in discussing:
 Psychological Counseling
 Nutritional/Dietary Counseling
 Mind/body therapies
 Spiritual Counseling
 Herb/Supplement Counseling
 Stress Management
 Chiropractic
 Acupuncture / Chinese Medicine
 Massage Therapy
 Other (please list): ________________________________________________________________
Are you interested in receiving our e-newsletter?
 YES  NO
If yes, please provide us with your email: _____________________________________________
Download