Humboldt Neurological Medical Group
Making Your First Appointment
What to Bring to Your Appointment
Please be prepared for your appointment. Bring the following with you:
1. Have all of your paper work completed upon arrival:
2. Insurance cards
3. Applicable co-pays, deposits, share of cost payments.
4. List of all current medications and dosage instructions.
5. An English-speaking interpreter, if needed.
Please note: Some patients may wish to have their spouse, partner, adult child or caretaker present with them at appointment
time. Due to privacy laws, our office will not be able to discuss patient care with a person that does not accompany the patient to
the appointment. See HIPAA.
Appointments for minor children / legal dependents:
All minor children must be accompanied by a parent or legal guardian. Patients must always be present at their appointment.
(Example: If we are discussing medication changes or testing results for a young child, the patient still needs to be present.)
Many of our patients and staff are extremely sensitive to smells. Please avoid using excessive amounts of perfumes and
colognes on your appointment day. Patients are asked to have respectable body hygiene.
Humboldt Neurological Medical Group is a specialty practice treating patients by referral only
from their primary care or other specialty provider. In order to assure quality care, there are
several steps which occur before we can schedule your initial visit.
1. Your referring physician will fax a referral request to our office which should include:
A. Your name and demographics (address, phone, date of birth, etc.).
B. Your insurance information, copies of insurance cards and any insurance
authorizations necessary for the visit.
C. Reason for referral.
D. Chart notes and related information from the referring office.
E. Results of related diagnostic testing already completed.
2. Our appointment coordinator will preview the request for completeness and then This process can take up to several days. We work as efficiently as possible, however, there
provide it to one of our physicians for review.
3. A neurologist will review the material and then make a decision as to whether our
services would be beneficial to the particular patient.
4. Our appointment coordinator will attempt to contact the patient to schedule the
are obstacles that can delay this process, such as inaccurate demographics, incomplete
insurance authorizations or lack of chart notes justifying the referral. Also, past history of poor
patient / office relationship (ie: bad debts or non-compliance of care) will require increased
Fax: New Referrals only: Fax (707) 442-2362 as of 7-21-14
Appointment Confirmations / Cancellations / No Shows
As a courtesy, our office will attempt to call you to confirm your appointment. However, it is your responsibility to confirm your
appointment at least 24 hours in advance. Unconfirmed appointments are subject to cancellation. Missed appointments, if not
cancelled 24 hours in advance, may be charged a “no-show” fee of $150.00. This is billed to the patient, not the insurance
carrier, and payment will be required prior to rescheduling.
If our physician requests testing or referral to a physician outside of our office, there are several steps that need to take place
before that appointment can be made:
- Completion of a typed dictation from our physician
- Appropriate authorizations obtained form your insurance provider
- Gathering of all pertinent information regarding your referral
This process can take from several days up to a few weeks. Once completed, we will forward all information to the referral
party. The referral facility or physician will contact you to schedule your appointment.
Please allow adequate time for the referral agency to contact you. If we have any questions or difficulties completing our
process, we will contact you.
This page updated 01-19-16
|Phone (707) 443-9385 2828 O'Neil Lane, Eureka, CA 95503 Fax (707) 443-0258
Referral Fax (707) 442-2362