Attention Patients & Visitors: Face Coverings Required
- ELECTRODIAGNOSTIC STUDY REQUEST FORM
- DISABILITY FORM POLICY AND FORMS
- LITIGATION ASSIGNMENT – LOP
- MINOR CONSENT
- SPANISH LOSC SURGERY CONSENT FORM / CONSENTIMIENTO PARA CIRUGIA EN ESPANOL
- SPANISH LOSC SURGERY HANDOUT / INSTRUCCIONES EN ESPANOL ANTES DE LA CIRUGIA
- SPANISH LOSC SURGERY PROCEDURES / INSTRUCCIONES EN ESPANOL PARA LA CIRUGIA
If your insurance carrier allows self-referrals, you may contact LCO directly without a referral from another doctor.
If your insurance company requires primary care physician referrals, please schedule your appointment through your primary care physician. If we do not have your primary care physician information at the time of your appointment, or if you do not bring your x-rays or required records from a previous physician, we will need to reschedule your appointment.
EMERGENCIES OUTSIDE OF OFFICE HOURS
In case of an emergency outside of regular office hours including weekends, holidays, or after 5:00 PM, call the regular office number and our answering service will contact the on-call physician. If you believe the emergency is serious or life-threatening, call 911 or go directly to an emergency room for immediate care. Identify yourself as a patient of Lowcountry Orthopaedics and have someone notify our office.
We encourage you to call during office hours for a better chance to reach your regular physician and access your medical records.
CANCELING AN APPOINTMENT
Your appointment time varies according to your doctor’s hospital rounds and surgery schedule. If you are unable to keep an appointment, we ask that you provide us a minimum of 48 hours notice. This makes it possible to give your appointment to another patient. Failure to notify us of appointment cancellation may result in a $25 service fee. If you need to be seen immediately, we will do our best to accommodate you. In the event of an unforeseen delay or emergency, we will notify you and give you the option to reschedule.
At LCO, we consider the unique condition and needs of every patient. We value your time. We make every effort to provide the highest quality care while minimizing your wait time. LCO is a surgical practice and there may be times a surgery takes longer than expected. In the event of an unforeseen delay or emergency, know that every effort will be made to accommodate for unforeseen delays.
The medical records are the property of the practice.
It is maintained for the benefit of the patient and medical staff.
It is the Practice’s responsibility to protect the records against loss, defacement, and tampering, as well as authorized use a signed consent by the patient or legal guardian is required before medical records or x- rays can be released to a physician’s office, attorney, or any other organization.
ELECTRONIC MEDICAL RECORD REQUEST:
OR MAIL THE COMPLETED FORM TO: (OR FAX TO 843-793-5402)
Lowcountry Orthopaedics a member or Arcis, LLC
Release of Information 2880 Tricorn Street N.Charleston, SC 29406
Signed authorization allows release of records (as stated on the release form) to only the requesting party and is not valid for release of information to any additional parties.
The patient has the right to revoke the signed authorization to release records by submitting a written request.
Processing of the x-ray /films is handled by x-ray personnel. 843-797-5050 (ext 141)
The original signed release form is maintained in the patient’s chart.
- Patient’s name
- Social security number
- Name and address of the party requesting records
- Type of records requested
- Patient’s or legal guardian’s signature
It is the policy of the Practice to routinely charge a fee to cover the duplication expenses involved in the transfer of records outside the system and for the completion of forms requested by outside entities. In accordance with South Carolina Statute 44-115-80, you will be billed for the reproductions of your medical records as outlined below:
FEE SCHEDULE AS OF 6/23/14 FOR COPIES OF PATIENT RECORDS BASED ON FORMAT, PAPER OR ELECTRONIC, AND MAXIMUM FEES:
$.65 per page for pages 1-30
$.50 per page for all other pages
Clerical fee not to exceed $25.00
(*ELECTRONIC Records)- Maximum allowable charges not to exceed $150.00 + actual postage /applicable sales tax
(*PAPER Records)- Maximum allowable charges not to exceed $200.00 + actual postage /applicable sales tax
Any questions concerning the status of your request should be submitted by logging into the patient portal via our website, www.lowcountryortho.com. Click on quick link quick links/ Patient portal. Log-in and send a message to submit a question.
LCO utilizes a third-party company to process, deliver and bill for these requests. You will receive a statement from RecordsQuest, and you should remit your payment directly to them.
Payment address: RecordQuest, PO Box 2017, Mt Pleasant, SC 29465-2017
If you have a question about your records statement, you should contact RecordQuest directly (Phone) 888-300-7410 (Email message via website) https://www.recordquest.com/
Medical records will be forward to another physician for transfer of care at no charge.
Our insurance and billing department will assist you with your insurance claims and billing problems. We ask that you bring your present insurance card and a picture ID for verification.
Copayments are DUE AND PAYABLE at the TIME OF SERVICE. Please do not ask to be billed. All copay/co-insurances not paid the day of service may have a $10 processing fee added to your account.
If you don’t have your co-pay with you at the time of your appointment, you may be rescheduled to another date when you are able to provide payment.
All patients are required by their insurance carrier to have their co-pay and/or co-insurance at the time of service. Lowcountry Orthopaedics will be in violation of our contract with your carrier if we do not collect your co-pay and/or co-insurance at the time of service. We will make every effort to work with you regarding any past due balance issues.
If you do not participate with an insurance company, the billing department will assist you in setting up pre-payment plans. Self-pay patients are offered a 35% discount due and payable at the time of service.
While we will be able to assist you with many of these questions, the final responsibility for payment lies with you.
We participate with most insurance plans; however, it is your responsibility to call your insurance carrier to determine whether or not we participate with your particular plan. We recommend patients read their policy book or call their insurance company to learn about benefits and coverage of their policy.
Lowcountry Orthopaedics is considered a SPECIALTY practice. Many insurances will not pay for specialty practice charges unless a referral is given from the primary care physician. If your plan requires a referral from your Primary Care Physician for Specialist office visits, YOU are responsible for obtaining this referral so that our doctors can see you.
Managed care requirements make it necessary for patients who do not have their referral at the time of appointment to either reschedule their appointment or make payment at the time of service.
Phone (843) 879-9728 – Fax (843) 793-5434
Phone(843) 879-9728 – Fax (843) 793-5434
Phone (843) 793-6750 – Fax (843) 793-5418
Phone (843) 266-4867 – Fax (843) 793-5422
DR. STOVALL AND DR. BATTISTA
Phone (843) 266-4887 – Fax (843) 793-5423
Phone (843) 266-4888 – Fax (843) 793-5425
Phone (843) 569-5486 – Fax (843) 203-5728
Phone (843) 793-6758 – Fax (843) 793-5438
Phone (843) 569-5483 – Fax (843) 793-5428
HIP AND KNEE
Phone (843) 266-4880 – Fax (843) 996-1880
Phone (843) 793-6779 – Fax (843) 410-2270
FOOT & ANKLE
Phone (843) 879-9728 – Fax (843) 793-5434
Phone (843) 266-4867 – Fax (843) 793-5422
Phone (843) 266-4880 – Fax (843) 996-1880
Phone (854) 529-3414 – Fax (843) 793-5439
Our practice is affiliated with the following hospitals, surgery centers, and rehabilitation facilities.
- Trident Medical Center
- Summerville Medical Center
- Lowcountry Outpatient Surgery Center
- Roper CareAlliance
- Roper Berkeley Center
- Bon – Secour St. Francis Xavier Hospital
- Charleston Surgery Center
- East Cooper Regional Medical Center
PURPOSE: To provide privacy and protection of Protected Health Information for Lowcountry Orthopaedics patients as set forth by the standards of the Health Information Portability and Accountability Act of 1996 sections CFR parts 160 and 164.
- Access to Protected Health Information (PHI) by employee is limited by job specific duties on a need to know basis.
- Allowable disclosures of PHI are limited to Treatment, Payment, or Healthcare Operations at minimum necessary level.
- Other uses or disclosures or permitted or required by law:
- Public Health activities Disclosures about decedents (Coroner/Funeral Director)
- Health Inspection Agencies; Workers’ Compensation
- Judicial Proceedings Reporting abuse, neglect or domestic violence
- Law Enforcement purposes: Avert serious threat to public health of safety
- Specialized government functions (military or veterans’ affairs)
- Release of PHI to any other source is prohibited without written consent of the patient or guardian.
- Medical Records are stored in an employee-only access area.
- Building access is limited to the main entrance all visitors/patients must check in at Reception Desk
- After-hours security is provided by Sonitrol Security Systems.
- Computer system information access is limited by job duties access level is determined by the Practice Administrator.
- Computer system security certification and ongoing control is provided by the practice management system, computer server programming, and the authority of the Practice Administrator.
- Business Associates are held accountable and required to sign agreements.
- Security Officer is responsible for oversight of security systems.
- Employees receive initial and ongoing training
- Employees sign a confidentiality agreement
- Each employee is responsible and held accountable for compliance.
- The Privacy Officer is responsible to oversee privacy compliance.
- The Privacy Officer handles complaints and documents disposition.
- In conjunction with supervisor and practice administrator ensures violations of privacy policies are addressed.
It is always recommended to discuss prescription refill needs during your office visit. If you need to refill a prescription in between appointments, below is the Lowcountry Orthopaedics and Sports Medicine Policy:
* Prescription refill requests require 24 hours to be processed. Those received Friday after 12pm will be processed the following Monday.
* Prescription pick-ups are available between Monday – Thursday pick up by 4pm and Friday pick up by 2pm.
* The on-call physicians will not be able to fill prescription requests on Saturday, Sunday, or Holidays.
Please always check with your pharmacy to verify that the prescription is ready for pick up. A member of our team will contact you if there is a problem filling your request.
FMLA & Disability Forms
DISABILITY FORM PROTOCOL
Disability and work form requests require significant time on the part of the physician and office staff to complete, as they require parsing through medical records to find exact dates, nature of the treatment, exact diagnosis, and other required information. As such, Lowcountry Orthopaedics & Sports Medicine, a member of Arcis Healthcare, L.L.C., has developed a standard form for disability benefits that will be sent to your disability carrier.
1) We understand many of our patients depend upon the income from insurance and disability forms for support during recovery. ALL forms (disability, FMLA, loan, Return-to-work, etc.) are completed in the order in which they are received after the chart and medical records are made available. Please allow one to two weeks for the form to be completed.
2) Forms are not emergencies, it is the patient’s responsibility to supply them far enough in advance of deadlines.
3) Our office does not complete forms related to Social Security disability, veteran’s administration disability or student loan discharge forms. Submitting such forms will result in their return to your home address on record. Please request a copy of your medical records to support your claim instead.
4) A $20.00 fee applies to each form request in accordance with SC Code of Laws 44-115-90 and 44-115-110. You may pay in person at any of our offices, via the patient portal, or once contacted by text/email. After the first form has been completed, all patient account balances must be paid and kept current before any additional disability form will be completed.
5) We MUST have the authorization to send forms and medical records to third parties including employers and insurance companies. If one is not signed in the office, you will be contacted by text or email to give approval.
6) We are not responsible for employee/employer sections of forms.
7) If you are missing work, you must ask your provider for an updated copy of a “Work Status Report” at each visit EVEN if you have FMLA or Worker’s Compensation leave. Failure to do so may result in the holding of your forms for lack of documentation or the requirement of an additional visit for assessment.
8) It is suggested every patient call their employer or insurance company and verify receipt of the form after the two-week period. If they say it wasn’t received, PLEASE confirm the fax number and the claim or incident number and provide that information to us as a double-check. We will happily supply via text or personal email the date and time confirming forms were sent as well as resend them again if necessary at no additional cost to the patient.
TO SUBMIT FORMS:
Attn: Adrienne F. / M.R. Dept Rep.
Walk-in: Or in person at any of our offices.
IF YOU HAVE A QUESTION:
See the Frequent Asked Questions Section
Inquire via the Patient Portal
Leave a voicemail at: 843-793-6753
Referral Fax: 843-793-5442
LOWCOUNTRY ORTHOPAEDIC & SPORTS MEDICINE WORK COMP DEPARTMENT
Work Comp Dept Direct- PH. 843-797-5050, OPTION 6
Work Comp Dept Direct- FX. 843-793-5442
Daryan Long-Business Office Manager
4133 Direct Ph. 843-793-6766
Direct Fx. 843-793-5431
Mary Farmer: Work Comp Coordinator
4101 Direct Ph. 854-529-3403
Direct Fx. 843-323-4057
Shailesh Patel MD
David Johannesmeyer MD
Keith J Santiago MD
Patterson Owings MD
Christina Chandler PA-C
Kathleen D. Bukowsky PA-C
Candy Poston: Work Comp Coordinator
4135 Direct Ph. 843-266-4875
Direct Fx. 843-261-5717
David H Jaskwhich MD
Adam Schaaf MD
Christopher Merrell MD
Eric S. Stem, MD
Chris Battista, MD
Justin T. Runey PA-C
Marty Covington PA-C
Kelly L Merrell ANP-BC
Alyssa A Grant PA-C
Tony McCurry JR PA
Morgan Conde PA-C
Sydney Austin: Work Comp Coordinator
4269 Direct Ph. 843-266-4863
Direct Fx. 843-793-5430
James Spearman, MD
Don Stovall, MD
Richard Zimlich, MD
William Corey, MD
Savannah Spearman, FNP
Juliana Smith, NP
Kylie Smith, NP
Sarah Folk, FNP
PROUD GOLD SPONSOR
LOWCOUNTRY ORTHOPAEDICS & SPORTS MEDICINE
A MEMBER OF ARCIS HEALTHCARE, LLC
STATEMENT OF NON-DISCRIMINATION
DISCRIMINATION IS AGAINST THE LAW
Lowcountry Orthopaedics & Sports Medicine a member of Arcis Healthcare, LLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Lowcountry Orthopaedics & Sports Medicine does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Lowcountry Orthopaedics & Sports Medicine provides free aids and services to people with disabilities to communicate effectively with us, such as qualified sign language interpreters and some written information in other formats upon request (large print, accessible electronic formats, other formats). We provide free language services to people whose primary language is not English, such as qualified interpreters.
If you need these services, you may contact Erin McCauley. If you believe that Lowcountry Orthopaedics & Sports Medicine has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with Bachi Evangelist at 2880 Tricom Street, SC 29406; (843)797-5050; Bachi.Evangelist@lowcountryortho.com. You can file a grievance in person or by mail or by phone. If you need help filing a grievance, Bachi Evangelist is available to assist you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 1-800-537-7697 (TDD). Complaint forms are available at https://www.hhs.gov/ocr/office/file/index.html.
Lowcountry Orthopaedics & Sports Medicine a member of Arcis Healthcare, LLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
Lowcountry Orthopaedics & Sports Medicine a member of Arcis Healthcare, LLC cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo.
LOWCOUNTRY OUTPATIENT SURGERY CENTER
STATEMENT OF NON-DISCRIMINATION
DISCRIMINATION IS AGAINST THE LAW
Lowcountry Outpatient Surgery Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Lowcountry Outpatient Surgery Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Lowcountry Outpatient Surgery Center provides free aids and services to people with disabilities to communicate effectively with us, such as qualified sign language interpreters and some written information in other formats upon request (large print, accessible electronic formats, other formats). We provide free language services to people whose primary language is not English, such as qualified interpreters.
If you need these services, you may contact Joyce McQuiston. If you believe that Lowcountry Outpatient Surgery Center has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with Joyce McQuiston at 93A Spring View Lane Summerville, SC 29485 or (843)285-6065. You can file a grievance in person or by mail or by phone. If you need help filing a grievance, Joyce McQuiston is available to assist you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 1-800-537-7697 (TDD). Complaint forms are available at the https://www.hhs.gov/ocr/office/file/index.html OCR website.
Lowcountry Outpatient Surgery Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
Lowcountry Outpatient Surgery Center cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo.