Practice Policies

Office Policies

VISION FOR THE COMMUNITY

Baisley Medical Services is an open door family health  center, that delivers outstanding quality health for the medically underserved, with integrity, compassion, respect, and linguistic diversity. “Come and be part of our family.”

Baisley Medical Services has an open door policy. We provide services on a walk in basis and by appointment. Please be on time for all appointments. If you are not able to keep your appointment, please notify our office as soon as possible to reschedule your office visit. If you want to be seen as an emergency walk in, you will be triaged accordingly and seen as fast as possible. Your patience is appreciated when serving all our patients.
We pride ourselves on our availability to discuss urgent problems at any time. Should you have a true life threatening

emergency, call 911 immediately. For anything else, please call us first. Use of hospital emergency rooms should be limited to such severe situations, or if you are directed to go there by the nurse or physician on call. In the majority of cases, you can call us and together we can decide how to approach the problem.
The staff and facilities for meeting your needs are obviously more limited at night than during the day. We encourage you to call if you have an urgent problem or are concerned. However, if the call is about a long standing problem or a medication refill, we would appreciate it if you would consider the possibility of calling in the morning when we are better able to serve you.

How to Reach Us During Business Hours
1. Via phone by calling 718-484-8985. Calls regarding non urgent appointments, prescription refills medications, billing problems and insurance questions will be handled by our front office staff.
2. Acute or urgent medical problems will be discussed at any time. Routine medical concerns such as dosages for common over-the-counter medications, simple first aid measures, fever control etc. will be screened by our office and / or nursing staff.
How to Reach Us after Office Hours
1. Call (718) 484-8985  or 646-460-2959
2. Please to not call the on call cell phone 646-460-2959 during the day 9 am to 5pm, you call will not be answered. During office hours, you must call our business hour phone number 718-484-8985 for all your medical needs.
3. If a problem arises outside of our normal office hours, there is a doctor on call 24 hours a day. During late night hours, calls will be returned by the physician on call that may refer all serious problems to the emergency room.
4. If you feel that you have a potentially serious or life threatening condition, call 911 immediately.
Note: If you need to be seen at the start of office hours, the doctor or the answering service can make a limited number of appointments for emergencies only.
How to Make the Most of Your Telephone Call
All phone calls should be directed to the office. Coverage is provided 24 hours a day, seven days a week. Things to tell your doctor or nurse when you call:
If a child
1. Your age.
2. What you are concerned about, how long it has been going on and has it been getting worse.
3. What you have done about your illness.
4. Your temperature.
5. Your child's state of alertness.
6. Your child's intake of fluids
If an adult (over 18 y/o)
1. Your age.
2. The medications you are on must be available
3. What you are concerned about, how long it has been going on and has it been getting worse.
4. What you have done about your illness.
5. Your temperature.
We pride ourselves on our availability to discuss urgent problems at any time during the day and on call. Should you have a true life threatening emergency, call 911 immediately. For anything else, please call us first. Use of hospital emergency rooms should be limited to such severe situations, or if you are directed to go there by the nurse or physician on call. In the majority of cases, you can call us and together we can decide how to approach the problem.
The staff and facilities for meeting your needs are obviously more limited at night than during the day. We encourage you to call if you have an urgent problem or are concerned. However, if the call is about a long standing problem, non-urgent matter, or a medication refill, we would appreciate it if you would consider the possibility of calling in the morning when we are better able to serve you.
What not to do when trying to reach the office:
1. Do not call on a phone when your number cannot be identified. The call will not be answered. It is a medical liability, and in the event of an emergency when communications is lost, the answering service, the doctor, or the staff will not be able to return your call.

2. We urge you not to call the doctors for non-urgent matters on their cell phones. That is reserved for emergency after office hours only. Please address all issues with the office staff and your call will be returned by the end of the working day.
If you have a true emergency, call 911 immediately. If you feel that 911 is not necessary, but the situation is urgent, your call will be directed to a physician on call.

On-line Appointments
By agreeing to the terms of our Online Appointment policies related to our web site or hosting server, you will enter a secure area on our site. All personal identifying information is encrypted and your message will not be internally or externally forwarded to other third parties.
Our on–line appointments are for non-urgent appointments only, and Well Check-ups, Annual physicals, Consults, lab tests, Well woman exams, ……….
To make an appointment, go on line, visit our web site at Baisleymedidalservices.com, and go to our services, than to existing patient, attest disclaimer, and log in with your ID and password given to you at our offices. After you log on to the patient web portal, look for appointments at the bottom left corner to make your appointment. Under Facility enter Baisley Medical Services, select provider, reason for visit, date, and time. Select the search button to find an available time appointment.

We will confirm your appointment via e-mail within 2 to 3 days, Monday - Friday, 9:30 am - 5:00 pm. If you do not hear from us within that time frame or should have any questions regarding your appointment, please call our office by phone at 718-484-8985


What else can I do on Line?
1. Prescription refill request
2. Request referral
3. Look at my lab results
4. Ask a question
5. Look at by bill
6. Preregister as a new patient
7. Virtual visits to discuss results
8. Get health information
9. Purchase medical equipment
10. Pharmacies hours and how to request refill from pharmacists on your behalf.
11. And many more…..
To go on line, visit our web site at
Baisleymedidalservices.com, go to our services, than to existing patient, attest disclaimer, and log in with your ID and password given to you at our offices.
 
ON LINE or PHONE PRESCRIPTION RENEWAL SERVICES
 Prescription renewals may be handled:
1. Via phone by calling 718-484-8985. When the phone is answered, please leave your name, the patient's name, the patient’s date of birth, your phone number, the name of the medications, the strength of the medication, the dosage instructions (e.g. 1 tsp. 3 times a day), the pharmacy name, and phone number. In addition, please state whether you would like the medicine called in, or written as a prescription to be picked up at the doctor’s office (specify which office).  Please keep in mind that a controlled substance prescription cannot be called in or sent by electronic prescription.  Please be sure to include all of this information. Failure to do so will make it impossible to fulfill your refill request.
2. Renewals can also be requested on-line through our practice secure web portal. How?
If requested through the web portal, please leave your name, the patient's name, your phone number, the name of the medications, the strength of the medication, the dosage instructions (e.g. 1 tsp. 3 times a day), the pharmacy name and phone number. In addition, please state whether you would like the medication e-prescribed to your pharmacy, or a written as a prescription to be picked up at the doctor’s office (specify which office).  Please keep in mind that a controlled substance prescription cannot be called in or sent by electronic prescription.  Please be sure to include all of this information. Failure to do so will make it impossible to fulfill your refill request.
3. Please be aware that regular medical supervision is required to refill some prescriptions and you may be asked to make an appointment.
Prescriptions will be filled within 2 to 3 days since it is a non-urgent matter. Prescription requests received on Friday, weekend days and holidays, will be handled Monday or next business day. Prescription refills are NOT done on the weekend and holidays.
Please note:  Controlled substances, schedule II and III medication, can be requested on line, however, you must make appointment to discuss your medication with the doctor, and pick up your prescription. You must have been seen in our office for a medical evaluation within the past three months - They cannot be called in to a pharmacy, and an original prescription is required for this service. Be prepared for request for urine drug test at any time when you request refill for schedule II and III drugs. Your service will be terminated if illicit drugs are found after discussion with MD. NO EXCEPTIONS.
Questions concerning any of the above will be handled during regular business hours at (718) 484-8985 (9:00am-5:00pm, Monday-Friday).
Most Commonly Asked Questions
Q: How would I request a copy of an Immunization Record or Physical Form (for school, daycare, camp, etc.) for my child?
A: Call our office or send e-mail via our patient portal. There is a $10.00 charge for duplication of our Physical Form.
Q. How long will it take for these requests to be completed?
A: 2 to 3 days.
Q.  Is there a charge for school, daycare, etc. forms to be completed?
A: If form is a New York STATE form there is NO charge. If form is other than a New York State form, YES, there is a $10.00 charge for these forms to be completed, because it requires a review of medical records, and it is a cost to our office not covered by your insurance company.
Q.  How do I request a copy of my medical records?
A: Complete fill out a: "HIPAA Authorization Form to Release Information" at our office. Once request is received by our office, it takes 7 to 10 business days to be completed. We will soon provide forms on line for your convenience, and the can be faxed or e-mail through our patient portal.
Q.  How do I return to Baisley Medical Services if I am an old patient of the practice?
A:  1. Call our office to schedule an appointmentPatient Referral Request
If one of our Doctors has given you a referral, or you need to renew a referral, please follow the procedure below “Step to help your referral process”. You may also call our Referral department at 718-484-8985 if you have any questions.
 Notification to Patients, Parents or Guardians The Referral Department does not schedule appointment unless instructed by the provider in an urgent situation. We no longer make appointments since 75 % of the patients do not comply with referral dates and time. This is costly to our offices. Therefore as a patient, you are responsible for you appointment and referral recommendation. You may request alist of Doctors from our referral department, if you are referred to a specialist by one of our doctors
The Referral Department will call you within 3 business days of your request. If you do not hear from our referral Department in that time frame, please call to follow-up with our office.


Steps To Help Your Referral Process Referrals to Specialist
1. Check with your insurance company to see who is a participating specialist/vendor.
2. Make your appointment and verify that the specialist/vendor is still a participating provider with you insurance.
3. Some insurance companies require a referral form that must be generated by our Referral Department. MVP HMO, Aetna, USHC, Empire Blue Cross Blue Shield HMO, CDPHP Wellcare, GHI/HMO, Oxford HMO, as well as a few others require this.
4. If your insurance company requires a special referral form, a prescription, or referral letter, please contact our office with the following information so we can generate your referral.
A. the name of your insurance,
B. specialist name,
C. Specialist phone number,
D. Specialist fax number, as well as
E. Your appointment time and date
Note**If you go to an appointment and your referral is not there or you don’t have it in hand you will be charged by the specialist. Before being seen you should have received a copy of the referral by mail or if you had requested it to be faxed to the specialist check to see that the specialist has received it. If you have not received it by mail and the specialist doesn’t have it, call our office to make sure the referral has been done. In many cases we cannot backdate the referral and any charges due to the lack of a referral will be your responsibility as per the insurance company. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
5. If you insurance does not require a special referral form you may take the prescription given to you to the specialist’s office and nothing else will be needed.Referrals for Testing:
1. If you were given a script/referral for other testing such as EEG, EKG, sleep studies, physical therapy, 24 hour Holter monitor, a radiology x-ray, CAT scan or MRI please check with our office to see if prior authorization is needed.

Most of these tests require a referral and/or prior authorization depending on the insurance company. We can help you make that determination. Ultrasounds and Nerve Conduction Studies can be done in our offices. Our referral department can also direct you to a participating facility; our office will obtain the needed authorizations for you. After obtaining the authorization, we will contact you so that you can write the authorization number on the script/referral. All you will need for your appointment is the script/referral with the authorization number. We cannot obtain the authorization after you have the procedure. If you go prior to having the authorization you will be responsible for any charges incurred. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
On-line Patient Registration By agreeing to the terms of our Online Patient Registration form, you will enter a secure area of our site. Baisley Medical Services will be held harmless should your electronic message not be transmitted due to technical problems

related to this site or hosting server. All personal identifying information is encrypted and your message will not be internally or externally forwarded to other third parties.
We will respond to your request within 48 hours, Monday - Friday, 9:30 am - 5:00 pm. If you do not hear from us within that timeframe or should have any questions regarding your registration or this on-line form, please contact us by phone at 718-484-8985
If you do not accept the terms of this site disclaimer, you will not be able to process your patient registration request on-line.
Baisley Medical Services Health Form Policies Health forms are completed based on information on your medical records. If you feel you may not have given all information required, you need to make an appointment to have the form filled. All forms are reviewed by a physician for completeness and accuracy. In some cases, forms mandate that only the physician may complete them. Insurance companies do not reimburse for form completion. Forms are completed on the basis of examinations conducted by the physicians at

Baisley Medical Services.
It is the policy that our patients have a physical examination within the past 12 months in order to complete a form. If a physical examination has not occurred within the past 12 months, an appointment for a physical examination will bescheduled, at which time the form will be completed.
We do not charge a fee for forms attached to well-baby checkups up to 3 years of age. It is necessary to charge forms not generated by our practice, which include but are not limited to college, camps, sports and the reproduction of our Physical/Immunization forms. At each yearly physical exam you will receive a Physical/Immunization form from our office.

This form may be accepted by schools, and other organizations. Please keep a copy of this form for future use.
Turnaround time for form completion is 48 hours. Please be sure to fill out the patient's name and date of birth to expedite this process. Remember that each of these forms has to be carefully reviewed by a physician before it is released.
There will be a $5.00 charge for the following forms:
• Reproduction of Physical/Immunization form for 3 years and above.
There will be a $10.00 charge for the following forms:
• All Non-Basely Medical Services forms that need a physician to review the patient's chart to complete the form.
*The fee is applied to all requests; regardless how the form is delivered. i.e. mailed, faxed, or picked up.* Payment Policy
Thank you for choosing us as your primary care provider. We are committed to providing you with quality and affordable health care. Because some of our patients have had questions regarding patient and insurance responsibility for services rendered, we have been advised to develop this payment policy. Please read it, ask us any questions you may have, and sign in the space provided. A copy will be provided to you upon request.


1. Insurance. We participate in most insurance plans, including Medicare. If you are not insured by a plan we do business with, payment in full is expected at each visit. If you are insured by a plan we do business with, but don’t have an up-to-date insurance card, payment in full for each visit is required until we can verify your coverage. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.
2. Co-payments and deductibles. All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment at each visit.
3. Non-covered services. Please be aware that some – and perhaps all – of the services you receive may be non-covered or not considered reasonable or necessary by Medicare or other insurers. You must pay for these services in full at the time of visit.
4. Proof of insurance. All patients must complete our patient information form before seeing the doctor. We must obtain a copy of your driver’s license and current valid insurance to provide proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you may be responsible for the balance of a claim.
 5. Claims submission. We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
6. Coverage changes. If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim in 45 days, the balance will automatically be billed to you.


7. Nonpayment. If your account is over 90 days past due, you will receive a letter stating that you have 20 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated. Please be aware that if a balance remains unpaid, we may refer your account to a collection agency and you and your immediate family members may be discharged from this practice. If this is to occur, you will be notified by regular and certified mail that you have 30 days to find alternative medical care. During that 30-day period, our physician will only be able to treat you on an emergency basis.
8. Missed appointments. Our policy is to charge for missed appointments not canceled within a reasonable amount of time.

These charges will be your responsibility and billed directly to you. Please help us to serve you better by keeping your regularly scheduled appointment.
Our practice is committed to providing the best treatment to our patients. Our prices are representative of the usual and customary charges for our area.
Thank you for understanding our payment policy. Please let us know if you have any questions or concerns.


On-Line Services
Baisley Medical Services cares about your family and want to services them better. We know as patients, you time is valuable. Our Patient Services area is a convenient on-line alternative to interacting with our practice. We offer many services that can be completed on-line including:
• Prescription Refills
• Appointments
• Lab results
• Ask a question
• Supplies
• PE / Immunization Request
• New Patient Registration
• Bill Pay
And much more…


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Baisley Medical Services

321 Pennsylvania Ave.
Brooklyn, NY 11207

Serving New York all 5 Boroughs

Queens, Brooklyn, Staten Island, Long Island, Manhattan, Nassau County, Suffolk County



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