Extended Hours Appointments

Avance Care Policies


We will make every effort to see acutely ill patients within 24 hours. If a call is received by noon, urgent appointments can usually be made the same day. Click Here to get more details.

For your visit, please remember to bring insurance card, driver’s license or picture identification, and payment for co-pay or deductible. Please note that a valid, government issued photo ID is required for new patients. If you have health insurance, we cannot see you without making a copy of your insurance card. Co-pay or deductible is collected at check-in.

Our schedule has been designed to minimize wait time; however, emergencies are given first priority. If your physician is treating an emergency patient, we will try to keep you informed of the wait time and give you the option of rescheduling your appointment for another day.


Unless cancelled at least 24 hours in advance, a fee of $35 may be charged for missed appointments. For Nutrition Services visit, the no-show fee is $75.


  • Prescriptions last written over 1 year ago cannot be refilled without an appointment
  • Prescriptions written by another doctor cannot be refilled without an appointment
  • We may not write prescription for controlled substances (including narcotic pain medicines and stimulant ADD medicines).  Please see our Policy on Controlled Substances.
  • If a pharmacy or insurance company requests that we change a prescription, we will not make any modifications without our patient’s understanding and permission

After-Hours Care

  • Emergencies must be evaluated promptly in the nearest Emergency Department
  • An on-call doctor is available by telephone for non-emergent issues. Please call your office’s primary phone number after hours to be directed to the physician on call
  • Because we cannot examine a patient over the telephone, the doctors may be unable to diagnose or treat all symptoms by telephone
  • Unfortunately, we cannot provide telephone advice to non-established patients, even if they are the spouse or child of an existing patient.  Patients must be established patients, who receive primary care services from Avance Care, to use the on-call service
  • Messages left on after-hour voice mail will result in a direct call to our provider’s cell phone number.  Please, do not wake up our providers for non-emergent issues such as prescription requests or appointment related requests.  Such non-emergent calls may result in a fifty dollar after hours service fee.

Additional Fees for Extended Hours Service

In order to help compensate for our higher operating costs during evenings (starting 6 PM),weekends, and holidays, Avance Care uses Extended Hours Service specialty code while submitting insurance claims on your behalf for non-preventive care visits. The fee for this service code is up to $50. This fee is added to the baseline charges for your visit. Most insurance companies recognize this billable charge and will provide full or partial reimbursement. You may be responsible for only the allowable portion of this charge in the event that your insurance company assigns it to your deductible or coinsurance. If you have additional questions, please contact your insurance plan for specific details regarding this service.

For self-pay patients, the fee for the Extended Hours Service is $15 for the non-preventive care visit.

Please see our Disclosures and Consent form acknowledging your understanding of the content above.

What is and Isn’t Considered During My Yearly Physical Exam?

This notice pertains to the components of a physical examination (preventive services) that are normally covered by your medical health plan. Also, it includes what services are not normally covered by your medical health plan during a physical examination.

Services NOT Normally Covered by Insurance Plans During a Physical Exam/Preventive Service:

  • Evaluation and Management of specific acute problems or illness. (Examples would be discussion of a recent cough, sore throat, pain, or injury.)
  • Procedures other than a pap smear. (Examples would be mole removals, joint injections, and skin biopsies.)

Physical Examination Components Normally Covered by Insurance Plans Include:

  • Screenings for common or preventable diseases (Examples would be screenings for high blood pressure, obesity, high cholesterol, diabetes, and certain forms of cancer.)
  • Complete physical examinations (Paps for women included)
  • Review of immunization history and administration of any if necessary
  • Counseling on healthy living choices, normal development and recommendations for proper diet and exercise
  • Diagnostic testing, if appropriate. (Examples would be pap smear, fasting cholesterol and blood sugar tests, colonoscopy, bone density, and prostate blood test.)

Our providers will welcome discussing and/or providing any of the services that may not be covered by your medical health plan during your physical examination. However, please keep in mind that if your medical health care plan does not allow for or cover this additional service on the day of your physical, then you will be responsible for any charges related to that additional service.

The above information will be given to you to sign as your acknowledgement of this content before your yearly physical with us. 

Telephone Calls

Our staff is available to answer your questions and schedule appointments during regular office hours. If your concern is urgent, please inform the receptionist so that your call will be addressed immediately. If you have lengthy or complicated issues, we ask that you schedule an appointment with one of our providers for an evaluation/consultation.

We are pleased to offer alternate methods of communication with us – Live Chat with our receptionist for appointments, walk-ins, or general questions, online Appointment Request, and Patient Portal where you can review test results, request appointments, request referrals, review statements, and much more.

Lab Work

In order to provide you the highest standard of care, if your lab results are abnormal you will be contacted by our staff and you will be asked to make a follow up appointment with your doctor to discuss those results. This follow up appointment will allow you time to ask your doctor questions about your lab work and give your doctor an opportunity to discuss further testing and follow up that is needed. This follow up can be vital for your health and cannot adequately be done over the phone or by email so our doctors cannot discuss abnormal lab results with you over the phone or by email.

If you need blood work in the future to monitor a chronic condition (i.e. high cholesterol, diabetes, high blood pressure, hypothyroidism, etc), you will be asked to have your blood work drawn at least 2 days PRIOR to this appointment. If lab work is required but is not done prior to a chronic condition follow up visit you may be asked to reschedule your visit.

Did you know you can view and print your lab results online? As part of our continuing efforts to provide innovative and convenient medical care we offer you the ability to view most of your lab results online. Please contact us to obtain a login for our patient portal to view your lab work.

      • If your lab test is normal, you will NOT receive a phone call from us.  Normal labs will be published within 1 week to your patient portal account.  Please check your email for a notification once it is published.
      • You WILL be contacted by phone for any abnormal results that require a discussion with your provider, otherwise they will be published to your portal account.
      • You will not be able to view your lab test results until they are received and reviewed by your provider.

Fees & Payments

Full payment, including any co-payment that your insurance may require, is expected at the time of service. If you are experiencing financial difficulties and need to make special payment arrangements, please ask to speak with a member of our billing office or the practice manager. We are here to help you.

Insurance and Self-Pay

It is the policy of Avance Care to help keep your health care costs as low as possible. To do this, we need to keep our billing costs to a minimum. Please help us in the following ways:

      • Always bring your current health insurance card to the office.
      • Please notify us at time of check-in of any changes in insurance, address, telephone or family status.
      • Please pay your co-pay or deductible balance and co-insurance amount at the time of service.
      • You will be expected to pay in full (Self-Pay) if:
        • You do not have insurance
        • Avance Care does not participate with your health plan
        • You are unable to present a valid member identification card from your insurance carrier at your visit
        • We are unable to verify your insurance coverage.

Please take the time to review your insurance plan so that you understand what your benefits are. It is important to know what to do in case of an emergency or if your child becomes ill while you are out of town. If your insurance requires authorization, please call our office within 24 hours with all relevant information

Returned Checks

There is a fee (currently $25.00) for any checks returned by the bank. This amount may change.

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