In Conjunction with the Family Planning Program, KVHC Will Provide Confidential Appointments

KATAHDIN VALLEY HEALTH CENTER

Protocol FO134 Confidential Family Planning Visits

In conjunction with the Family Planning program, KVHC will provide confidential appointments to those who are interested in receiving this service. Confidential appointments will be handled as follows:

 All confidential family planning appointments will be scheduled a new account created for the patient with the last name of Confidential-(then the patient’s real last name).  All confidential appointments require the patient being seen to complete a sliding fee application. There will be no co-pay or money requested from those patients seeking a confidential visit since we receive family planning funding for this service. The entire fee for the confidential visit will be slid using a slide A (make sure you slide the entire amount). No Confidential visits will ever be billed to the patient and/or their insurance company.  The reason for the visit will always be completed the words Confidential Family Planning Visit. At no time during the check in or check out should anything related to the patient’s non-confidential PM account be tied to this appointment or any follow up confidential appointments.  There will be no confirmation calls or appointment slips mailed for these appointments so anyone requesting the appointment should be informed of this at the time they make the request.  When the patient arrives the appointment will be checked in and a ticket number created using the confidential appointment account.  All follow up Confidential Family Planning Appointments for the patient will be scheduled using this account.  All Confidential family planning encounters will be locked when completed.  Confidential family planning encounters will not be printed when medical records are requested. In the patient’s address field [HEALTH CENTER ADDRESS] will be used to assure nothing is received by the patient.  Patients will not be contacted when their results are received from confidential visits. The provider or nursing staff will instruct the patient to contact the health center for the results and give them a time frame in which to contact their provider/nurse.

______Robert La Morgese, MD Medical Director

Created: May 2013 Revised: July 2013