Welcome to Your Medical Home.Patient-Partner GuideIU Health Ball Memorial HospitalFamily Medicine Residency Center

Welcome!We are happy that you have chosen the IU Health Ball Memorial Hospital Family Medicine Residency Center (FMRC) as your new medical home. As a patient here, you will take an active role in your healthcare. We hope to help you reach your health and wellness goals for years to come!

Patient Centered Medical Home.As a patient centered medical home, the FMRC will provide care that places you - the patient - at the center of medical decisions. We hope to partner with you to help you meet your goals. Knowing where to get the best care is di!cult. The doctors and nurses at FMRC will make sure you get the right care, the best specialist, and the most up-to-date advice.

Most of your medical needs can be taken care of right here in your medical home. We will provide a healthcare team, with trained doctors, nurses, scheduling specialists, educators, and behavioral health specialists.

Your suggestions will be used to improve services. We promise to support you in your e"orts to improve your health. Finally, we promise to provide timely and con#dential healthcare.

What is a “Residency” Center?The doctors at the FMRC are licensed doctors who are training to become family medicine specialists. In other words, your doctor is a “resident” training to be a “family doctor”. In a residency center you will get cutting edge treatments. While in training, these doctors are studying the latest treatments guided by research.

Also, your doctor will take care of the total medical needs of you and your family. This includes prenatal care, delivering babies, care of babies and children, and care of adults of all ages. A family doctor also helps people prevent illness. You will be encouraged to live a healthy lifestyle and take actions to avoid illness and live longer.

Things to Remember about the FMRC.Because the FMRC is a training center, some of your visits may be videotaped for training purposes. Each exam room has a small TV camera and microphone. These tapes are viewed by your doctor and FMRC teachers as a way to improve the care we provide. Parts of your medical record will be reviewed by teaching sta" of the FMRC for training your doctor. Sometimes, your doctor may take pictures of conditions, such as skin rashes. These pictures are used for educational purposes.

You may also be asked to take part in special programs or research studies. So by being a patient here, you play a key role in the training of the doctors at the FMRC! The clinic schedules at the FMRC also change on a monthly basis. This is because our doctors have training rotations at the hospital and at other clinics. They are always learning to be the best doctors so that patients will get the best care.

As a training center, there are times when the FMRC will host medical students and students in other health care #elds. Then your healthcare team will ask you if a student can help in your care that day.

FMRC Business Hours8:00 am – 4:30 pm Monday through Friday

Phone Number: 765.747.3141

When you call the FMRC, you will hear instructions about what number to press for your need. If you have an emergency, please call 911 or go to the nearest emergency department.

!"To schedule an urgent appointment, speak with a nurse, get test results, or leave a message for proivder, press 1!"To request a re#ll of a medication, press 2! To schedule a routine appointment with your doctor, press 3! To check the status of a new patient application, press 4! For any other assistance, press 5 or stay on the line. ! When calling after business hours, ask the operator for your doctor. If your doctor is not available, another doctor is available 24 hours a day.

Location and ParkingOur building is next to Ball Memorial Hospital at the corner of Celia Avenue and Gilbert Street. You will #nd parking in the lot in front of our building at 221 N. Celia Avenue. When you enter our building, you will see the reception desk directly in front of you. Please sign in as soon as you arrive so that we can provide prompt service.

Services for You and Your Family." ! Annual Physicals and Health Examinations o All Ages " ! Same Day Urgent Care by appointment" ! Women’s Health Services o Pap Testing" ! Prenatal Care and Delivery of Baby o OB Ultrasound" ! Well-Child Care o Vaccinations" ! School and Sports Physicals " ! Flu Shots" ! Family Planning o Vasectomy and Implanon o Wide range of birth control options " ! Treadmill – “Stress Test”" ! Colonoscopy and Other Cancer Screenings o Upper Endoscopy" ! Skin Procedures o Mole Removal" ! Hemorrhoid Care " ! Casting and Splinting " ! Joint Injections for Painful Joints" ! Medical Clearance for Surgery" ! Hospital Rounds

Other Services Available at the FMRC

Appointments with the Integrated Care Team

As a Patient Centered Medical Home, the FMRC provides health education, be-

havioral health counseling, and case management. Your doctor may recom-

mend that you meet with a member of the Integrated Care Team in order to

achieve all of your health goals. You can learn about how to stop smoking, how

to improve your diet, and how to start a #tness program.

If you would like to learn how to manage stress, reduce anxiety, improve mood,

or cope with illness, a member of the Integrated Care Team can help. In addi-

tion, sessions are available to help with common family concerns and common

behavioral concerns of childhood.

Appointments with Your Nurse

For blood pressure checks, baby weight checks and injections, walk-in appointments

with a member of the nursing sta" are available during normal business hours.

Laboratory Services

The FMRC o"ers IU Health Laboratory services. This onsite service allows pa-

tients to have blood studies done without having to make an extra trip to the

hospital or another facility. It also allows the doctors to quickly #nd out the

results of tests. The lab has the same hours as the FMRC.

Prescription Re#lls

When you need to re#ll your prescription please #rst call your pharmacy. Many

times they will be able to provide your medicine. If not, they will send a quick

request to your medical home. Or, you may call the FMRC at (765) 747-3141

and press 2. Please allow up to two business days for the request to be #lled.

This allows your healthcare team to check your records for the right medication,

the right dose, and the right directions.

Hospital Services.The complete services of IU Health Ball Memorial Hospital and its specialists are

available for consultation and referral when you have complex problems, such as

a need for major surgery. If hospitalization is needed, you will be admitted to IU

Health Ball Memorial Hospital under the care of your family doctor.

Preparing for Your Appointment with Your Doctor.In a Patient Centered Medical Home, we rely on a team of people from di"erent

training backgrounds to workk together to help you meet your health goals. You,

your doctor, and the rest of the treatment team will work together to make your

visit as helpful to you as possible. Here are a few things you can do to help make

every visit a good one:

! Make a list of your health questions. Ask a friend or relative for help if you

need it. Put the questions that are the most important to you at the top of

the list.

! Make a list of other health care providers you have visited. Write down

their names, addresses, phone numbers, and the reasons you visited them.

! Please arrive 15 minutes early to check in and register for your appointment.

! If you are not able to keep your appointment, please call to cancel as early

as possible so that we can o"er that appointment time to another person

in need of care.

! Bring all of your medicines in their original containers to your appointment.

Be sure to include prescription, over-the-counter, natural and herbal medicines

and vitamins.

! Bring your insurance card, proof of insurance and required co-payment to

your appointment.

! If you wish, bring a family member or trusted friend with you to your

appointment.

! Please bring your child’s immunization record to each Well Child visit.

During Your Appointment.! Write down the name of your healthcare team, including a familiar nurse

or another provider. This way if you think of a question later you may call and

leave a message for that person.

! Use your list of questions. Ask your most important questions #rst. Even if

you cannot get all of your answers on the #rst visit, having a list will help you

keep track of the answers.

! Talk with your doctor and treatment team about what health issues to work

on #rst.

! Be sure you know what you should do before you leave the o!ce

! Use your own words to repeat back the things you have discussed with your

team. This way, both you and your team will know the information is clear.

! Ask your team how to reach them if you have a question.

Insurance and Financial Policy.The FMRC participates with most insurance plans including Medicare and Medicaid.

We bill all insurance plans directly. If your insurance plan requires a co-payment,

please be ready to pay that amount at the time of checkout. For patients not

covered by insurance, we require that payment in full be made at the time of service.

For your convenience we accept cash, most credit cards and personal checks.

For information on #nancial assistance through IU Health please talk to a member

of our team.

To ensure maximum bene#t from your insurance plan:

! Check your insurance company to be sure that we participate with your plan.

! Verify your bene#ts – some plans do not cover well care visits or immunizations.

! Use legal names for all insurance and medical records.

! Newborns must be added to your policy within 30 days of birth for coverage.

! Please bring a copy of your insurance card to each visit. Patients covered by

two insurances should present both cards at check-in.

! Patients participating in Medicaid programs are required to present a

current ID.

! Patients participating in Medicaid programs may be assigned to a doctor in

the FMRC di"erent from the one listed on their Medicaid card.

! Contact your insurance company for questions about eligibility or

claim denials.

Managing Your Health Information.IU Healthe

IU Healthe is a free online health management tool that is now available to all

patients of the FMRC. You can set up an account through the front o!ce when

you check in. This allows you to get in touch with your doctor through email. It also

allows you to see important parts of your medical record. Ask for more information

at your next visit to the FMRC.

HIPAA

HIPAA (Health Insurance Portability and Accountability Act of 1996) guides your

doctor on how to use and share your protected health information. There will be

times that your health information will need to be shared with other providers. We

promise to only release your health information with your consent.

HIPAA gives you the right to inspect, copy, and add information to your health

records. It gives you the right to restrict or limit ways that your health information is

used or shared. Also, you have the right to request a list showing how your records

have been shared.

Healthcare Collaboration Policy.It is important to us to be able to o"er appointments in a timely manner to best

meet the needs of all of our patients. When patients do not show for appointments

or cancel at the last minute, those appointment times are lost and patients miss a

chance to see their doctor. If you are not able to come to an appointment, please

call to cancel and reschedule as soon as possible. If you are seen in the emergency

room, please let the ER providers know that you are a patient of the FMRC.

Unfortunately, there are times when we are not able to continue caring for patients.

The following circumstances are grounds for dismissal from the FMRC:

! 3 missed or cancelled appointments in a row.

o Cancellation the day of the appointment may be considered a

missed appointment.

! 4 missed appointments in one year.

! Failure to follow the treatment recommended by your doctor.

! Showing rude, abusive behavior with clinic sta".

! Frequent non-emergent visits to the emergency room.

If a patient is dismissed from the FMRC, we will provide 30 days of emergency

care service e"ective the day of dismissal. Records will be transferred to the

new provider upon request of the patient.

Patient Rights.You have a right to:

! Receive considerate, respectful healthcare

! Be active and informed in your healthcare

! Know the credentials of those who provide your care

! Privacy and con#dentiality

! Be informed of policies that apply to conduct of patients

! Explanation of your bill

! Informed consent for involvement in research/treatment

! Provide advanced directives such as living will

! Request an ethics committee review

! Present a complaint about the FMRC

! Prompt consideration of a complaint

Patient Responsibilities.Patients of the FMRC agree to:

! Keep or cancel appointments in a timely manner

! Provide accurate health information/medical history

! Take an active role in treatment

! Partner with your doctor to improve your health

! Ask questions to clarify information

! Pay for all services rendered

! Follow policies on rights of sta" and other patients

! In consideration of other patients, manage noise of family.

! Minors must be accompanied by a guardian to appointments

For more information on HIPAA, release of health information, and patient rights and responsibilities, please visit our website at http://iuhealth.org/patients

Health Agreement and Acknowledgement.Please read the information below. Sign and date if you agree to partner with us in your healthcare as outlined below.

! I will do my best to better my own health.! I know that the following areas are helpful to my well-being and will do my best to practice these healthy habits. I agree to start with the ones I have circled.

o Movement and/or exercise o A healthy dieto Adequate rest o A healthy weighto Avoiding harmful substanceso Healthy relationshipso Managing stresso Connecting with natureo Spiritual connectiono Maintaining a balance of work and recreation

! I understand how to make and cancel an appointment.! I understand how to handle emergencies during and after business hours of the FMRC.! I understand that I, or members of my family, may be asked to participate in special programs or studies.! I understand that parts of my, or my family’s medical records will be reviewed by teaching sta" at the residency for training my doctor.! I understand that parts of my visits may be videotaped and reviewed by the teaching sta" for training my doctor.! I understand that I will get the greatest bene#t from my visits by asking questions and following doctor’s recommendations.! I have read and agree to the Insurance and Financial Policy.! I have read and agree to the Healthcare Collaboration Policy! I have read and agree to Patient Rights and Responsibilities.

Patient Signature:________________________Date:__________

Doctor Signature:_______________________________________

221 N. Celia Avenue Muncie, IN 47303 iuhealth.org/patients

© 2012 Indiana University Health03/21/12

IU Health Ball Memorial HospitalFamily Medicine Residency Center

Monday - Friday8 am - 4:30 pm

T 765.747.3141