Scheduling appointments: Please make sure your follow-up appointment is scheduled before leaving the office. You may also schedule appointments by calling the front office or through the Patient Portal.

Canceling appointments: Appointments are confirmed at least 24 – 48 hours in advance. If you need to cancel your appointment, please do so at least 24 hours (48 hours for new patient appointments) prior to your appointment in order to allow another patient the opportunity for that appointment slot. There is a nation-wide shortage of Rheumatologists. A 6 month wait for a new patient appointment is not unusual. Unconfirmed new patient appointments will be canceled.  In order to enforce our cancellation policy, patients who do not show up for confirmed appointments will be assessed a $100 no-show fee. This fee is not covered by your medical insurance.

Card on file: At the time of registration, we will request your credit card information. Our office stores credit card information in a secure, encrypted manner. We only charge your card for outstanding balances due. Your credit card on file can be used for the following reasons: No-show or late cancellation charges, visit payments not collected at the beginning of the visit, insurance discrepancies, or outstanding balances greater than 31 days past due. Telehealth visits require a card on file. See our “Credit Card on File” FAQs for more information.

Refilling medications: Most medications are prescribed electronically (e-prescribe).  Please obtain all of your medication refills at the time of your office visit. This ensures accurate and timely refills and prevents necessitating multiple telephone calls. Keep in mind that we only refill medications we prescribe. You will need to obtain your other medications from your other physicians. If you need a refill between appointments, please ask your pharmacist to initiate an electronic refill request. You also may leave a refill request on the prescription line voicemail.  Allow at least 48 hours for processing of refill requests. A refill request may trigger a call for you to schedule an appropriate office visit for management of your condition and monitoring of your medications. Schedule II narcotic medications prescriptions require office visits every 3 months (state law). Controlled medications will not be refilled after hours or during weekends.

Urgent follow-up appointments: In order to better serve you and to avoid excessive appointment waits, you may be asked to schedule with Devin Weidman, APRN for urgent appointments, or to keep your regular follow ups on schedule when Dr. Houri, Dr. Fiske and Dr. Rivera have fully booked schedules. Devin has been working closely with our physicians for over 20 years and is highly skilled in the field of Rheumatology.

Communicating with the doctor: To avoid busy phone lines and excessive telephone on-hold times we have a secure voicemail system for you to leave messages for the doctors. Messages are retrieved throughout day and reviewed by the doctors. The staff is well trained to answer most messages as instructed by the doctors. If needed, the doctor will return phone calls after office hours.  Remember to leave your contact number! We also have a secure patient portal available for brief communications in between regular follow up visits. Most of these messages are free, however, responses that require your physician’s clinical time and expertise to answer may be billed to you or your insurance. Please see our pricing disclosure for current fees associated with electronic communications.

Mutual Respect: We are dedicated to the safety of every patient, visitor, and caregiver. We will not tolerate any form of threatening or aggressive behavior towards our caregiver team. Violation of this policy, will result in discharge from the practice.

After hours calls: If you have a medical emergency, please call 911 or go to the emergency room. If you have a rheumatologic emergency that cannot wait until we reopen, please call 283-8380 and leave a message for the doctor on call. Please do not leave non-emergency calls such as appointment changes or prescription refill requests on the after-hours voicemail. This will help keep the voice messaging system clear for those with emergency rheumatology needs.

All patients must have a Primary Care Physician:  Our practice is limited to the specialty of rheumatology. Therefore, you need to have a PCP for non-rheumatology medical care. Dr. Houri, Dr. Fiske and Dr. Rivera do not admit patients to the hospital. Hospital consultation services are provided on a limited basis only at Cleveland Clinic Martin Health North.

Patient privacy: Your privacy is very important to us and to ensure your privacy you may be asked to provide a picture ID to verify your identity upon arrival at the office.  Please refer to the HIPPA privacy policy booklet in the waiting area.

Request for medical records: We will gladly forward your medical records to your doctor.  You may be asked to sign a medical records authorization form. Copy charges will apply for personal records requests.

Requests for radiograph copies: Radiographs represent your permanent medical records in this office and are stored digitally. You may request a CD copy of your radiographs. Copy charges will apply.

Insurances: We accept Traditional Medicare, Aetna, Blue Cross, Cigna, and Devoted Health Plan. Please check with our office or your insurance company regarding specific network participation as we may not be in network with all plans within the listed insurance companies. We do NOT accept any Medicare Advantage Plans other than Devoted Health Plan. We do not treat for any motor vehicle accidents (MVA) or slip and fall cases (Personal Injury). Our office does not accept Medicaid.

We are striving to add additional insurance plans as the patient need grows. If we are not in network with your plan, or you do not have medical insurance, we can often see you as a cash-paying patient. Please contact our office for questions.

You are responsible for your co-pays and deductibles.  By federal law and contract, deductibles and co-pays may not be waived.

Patients enrolled in Affordable Care Act (ACA) plans and have allowed their grace period on their premium payments to lapse will be required to show proof of premium payment at each future visit to prevent “retroactive disenrollment” costs being incurred by our office.

Insurance office visit authorization: Some insurance companies require a referral authorization from your PCP or insurance company prior to being seen. This is your responsibility to obtain and keep track of insurance authorizations. Please ensure your authorization is on file BEFORE your appointment. Please notify our office of any insurance changes before your appointment.

Medicare Assignment:  We accept Medicare assignment which means we accept the Medicare fee schedule.  This is subject to change in the future. We will file your Medicare insurance. We do not file secondary insurances unless we participate with that plan. We do not file tertiary insurances. You are responsible for Medicare deductible and co-pays according to federal law. We only accept Traditional Medicare. We do not accept Medicare replacement insurance, Medicare Advantage Plans, or Medicare Part C other than Devoted Health Plan. If you change your insurance to a Medicare Advantage Plan, make sure you notify our office before you are seen. Our office does not accept Medicaid even as a secondary plan to Medicare.

Principal Care Management:  Our office is pleased to offer Principal Care Management (PCM) services as part of our commitment to ensuring patients with chronic conditions are receiving the highest standard of care. If you would like to opt out of Principal Care Management Services, please speak with our staff. At this time, PCM services are only available to Traditional Medicare patients and regular co-insurance and deductible fees will apply.