Office Policies for Patients-English

Specialist Referral Policy: In the case that we refer you to a specialist, some insurance companies require us to submit a request to them for approval prior to your appointment. Our office will prepare you a referral letter within (5) business days of your provider’s office visit. This letter will be available to you through our patient portal or by mail on request. You will be responsible for contacting that provider to book your appointment. Once your specialist appointment has been booked or we receive a referral request from your specialist’s office, if there is a need for a referral authorization number, one of our referral coordinators will obtain that authorization and send it directly to your specialist within (5) days. Your specialist’s office can also access any approved referral authorizations prepared by our office directly from your insurance. 

If you schedule an appointment with a specialist prior to receiving your referral, please contact our referral coordinator as soon as possible so we can make sure your visit is approved by your insurance prior to the appointment day. 

We cannot backdate any referrals or refer to providers outside of your medical network. Please do not see a specialist without authorization when needed through your insurance. The insurance company may deny payment, requiring you to pay for services in full. We reserve the right to decline a referral if your specialist does not follow up with our office as recommended and needed by our providers.

Dr. Rafael E. Pinero, M.D.

Dr. Giovanni Velez, M.D.

And the staff of Pinero Preventive Medical Care 

Welcome to Pinero Preventive Medical Care!

Here are some important things for you to know about our office.

Hours of Operation: Our office is open Monday through Friday from 7:00am to 6:00pm. On Saturday’s, we are open from 9:00am to 2:00pm.

24/7 Coverage: One of our providers is available 24/7, including holidays, to take care of urgent medical matters after office hours. Call the office phone number and follow the prompts to speak with the provider or leave a voice message if they are not available at the time. NO PRESCRIPTION REFILLS will be approved using the after-hours service. (Please refer to the prescription section.)

Patient Portal Information: Our website is www.PineroMedical.com. From our website, you can access the patient portal to access all your medical information. The portal is the easiest and fastest way to communicate directly with office staff, without having to play “telephone tag.”

Access to these records does not negate the necessity for office visits. Medical review with a provider is still required for all laboratory, radiology, and specialty test results, either in office or by telemedicine visit.

Please DO NOT send emails containing any of your protected health information. Regular emails are not HIPAA compliant. Please use your secure patient portal to send us messages and to upload documentation you would like us to receive. All documentation in the patient portal will be part of your permanent medical records and we reserve the right to restrict its access if we feel the portal is not used appropriately. 

Appointment Reminders and Cancellation Policy: As a courtesy to you, Pinero Preventive Medical Care will send you a text or automated phone message to remind you of your appointment 2 days prior to the date. Please follow the prompts to either confirm or cancel your appointment.

All appointments that are not kept or cancelled 24 hours in advance of your appointment will be charged $25. Failure to keep or cancel up to three appointments can result in the discharge from PPMC. The decision to discharge a patient from our care will be at our discretion. We encourage you to be compliant with your medical visits. 

Nurse Practitioners/Physician Assistants: To provide you with the best and the easiest access to care, our office has advanced practice registered nurses and physician assistant certified clinicians. These providers are trained in medicine (master’s or doctoral degrees) and can provide quality medical care as a physician does. Our office policy is that you may see any APRN or PA up to three times in a row and then you need to see a physician to follow up. Please be aware that if you are scheduled with these clinicians, this has been approved by your physician already. You are expected to keep the appointments and comply with their choice of treatment plans as you would with your physician.

Emergency Rooms/Hospitals: As your primary care, it is our intention to keep you healthy and out of the hospital, emergency room or urgent care clinics. We do have same day urgent care appointments to accommodate patients needing immediate attention, so always contact the office any time of the day or time before you head out to these other medical settings. Also, we work closely with hospitalists to make sure you are well taken care of in a hospital setting.  If you still need to be seen in the emergency room or urgent care or have been admitted to the hospital, expect a call from one of our staff to book a follow-up within a week of your visit there. Please follow up with your provider immediately so we can provide the best possible follow-up care. 

Prescription Medications: It is the patient’s responsibility to make sure the correct pharmacy is documented in their charts. If you prefer a mail order pharmacy, we ask that you also list a local pharmacy for any urgent medications. You are expected to call your pharmacy to have them send us an electronic prescription refill request from our office at least 7 days before you run out if medication. Once we receive the request from your pharmacy, please allow 48 hours to process the refill. Prior authorizations required by your insurance carrier take up to 7 business days. Patients that have not been seen in our office as instructed may be required to schedule an appointment before their refills are approved.

Controlled substance prescriptions (INCLUDING Adderall, Xanax, Vyvanse, etc.) are required by law to be sent electronically to the pharmacy by our office. We encourage you to submit a refill request directly through the patient portal to expedite the process, even if it is for a controlled substance.

Medical Records: You may use the patient portal to access your medical records. You can print your office notes, lab results, medication list and the other elements of your medical record from your home. Once a signed release of information form is received, records requested for continuation of care by a medical professional will be sent to them at no cost. Copies of medical records that you request for personal use may be printed for a few of $1.00 per page.

Forms (INCLUDING: FMLA, Disability, Certifications, etc.): We will complete any of the listed forms if your provider finds it appropriate. These forms may take up to 10 business days to be completed. If additional information is needed, additional time will be required to complete it. A $30.00 fee will be charged per form, however surgical clearances are completed at no cost to you once you are seen by one of our providers in the office. No patients can be medically cleared without an office appointment. Our office does not accept department of transportation or workers compensation affiliated evaluations or certifications. (DOT/Workers Comp).

Payment and Payment Methods: Payment is expected at the time of service for any self-pay patients and patients with co-pays, deductibles, coinsurance, or balances. Our office accepts cash, check, debit, credit cards including Visa, Mastercard, American Express, Care Credit. It is your responsibility to notify us of any changes in your health insurance to not prolong the insurance reimbursement process. It is also your responsibility to know the benefits of your insurance plan, including how much you are expected to pay in co-pays, deductibles, or coinsurance. Our office will not be responsible for benefit denials due to lack of coverage.

A payment arrangement is available to you if you are unable to pay your portion of the visit at the time of service. Please feel free to ask one of the front desk staff to set an arrangement up that works with your financial budget.