Frequently Asked Questions

Are you accepting new patients?

Yes, we are happily accepting new patients; however, we are unable to accept new Medicare patients at this time.

What are your office hours?

8:30 am to 5:30 pm, Monday-Thursday; 8:30 am-3:30 pm Friday.

What do I do if I get sick when the office is closed?

A nurse or nurse practitioner will always be on emergency call to answer your urgent questions outside of office hours; call the office phone number (404.817.0062) for after-hours contact instructions. A physician is always in charge during these hours as well, and is available to the nurse or nurse practitioner on call for consultation as needed. For true emergencies, or if in doubt, you should call 911 or go directly to the nearest emergency room. We do ask that you address non-emergencies and medication refill needs during office hours. No narcotic prescriptions or maintenance medication refills will be given over the weekend; please plan ahead for these needs during business hours.

How long is an office visit?

The length of the office visit varies. Dr. Johnson or Nurse Practitioner Gloria Carusi will typically spend an average of 30 to 90 minutes with each patient, but there may also be nursing, lab, and/or procedure time involved in your visit. As you know, doctor's offices are notorious for keeping people waiting. We don't do this intentionally! We ask that you help us reduce prolonged wait times for yourself and others by letting us know the number or complexity of the problems you want to address when scheduling your appointment. You can also help us by organizing any questions or concerns you want to discuss with the doctor or nurse practitioner prior to the appointment.

What is a Nurse Practitioner?

As defined by the American College of Nurse Practitioners, "a nurse practitioner (NP) is a registered nurse with advanced academic and clinical experience, which enables him or her to diagnose and manage most common and many chronic illnesses, either independently or as part of a health care team. [NPs provide] some care previously offered only by physicians and in most states [have] the ability to prescribe medications. Working in collaboration with a physician, a nurse practitioner provides high-quality, cost-effective and individualized care for the lifespan of patient's special needs."

What does the Doctor or Nurse Practitioner charge?

In short, because there are so many variables, it is very difficult to accurately estimate the cost of an office visit in advance. Fees for office visits are based on what is done for you as well as the time spent with you; of course, any necessary lab work, tests, or procedures that are performed incur additional fees. In order to properly assess the problem(s) that prompted your visit, the doctor or nurse practitioner must review your past medical history, family medical history, and any medications you are currently taking. Vital signs are taken and recorded at each visit, and in most cases some level of physical examination will be conducted. It may also be necessary to request medical records from or to consult with others who have treated you. The complexity of the problem is another factor in fees; a "cold" can obviously be assessed and treated much more easily than can more complicated issues such as cancer, Hepatitis C, HIV, or hormonal therapy. Another component of the office visit is the time spent educating you, the patient, about your treatment options and the potential risks involved if you choose not to be treated or tested. We will gladly explain any of our fees to you, and we will assist you in filing claims with your insurer by using accurate and appropriate diagnosis and procedure codes. We are aware that medical crises can be quite costly; in cases of special financial hardship regarding your bill, we will make every effort to provide fair and reasonable payment options for you. However, we must adhere to good business practices in order to maintain our high quality of care.

Is Midtown West Medical on my PPO/POS/EPO/other network?

We are contracted with selected insurance plan networks, and may add more over time, but it is not feasible for us to be contracted with every patient's insurer. Some insurers impose restrictions on pricing that are based on volume rather that quality of service; while larger healthcare provider groups may be able to offer care at volume rates -- seeing 25-30 patients per day -- we are not able or willing to do so. However, many insurance plans now pay benefits for services provided by "out-of-network" physicians, generally subject to a deductible and co-pay percentage. Please feel free to speak with our front office staff or our Practice Manager, Suzanne Combs, RN, about your specific insurance plan. We will be happy to do an eligibility check and let you know exactly what the reimbursement rules are for your coverage. We currently work with and see patients either out-of-network or in-network with most PPO's and all indemnity plans. We are not on any HMO or capitated plans.

Why are your fees sometimes higher than what my insurance company allows for a specific service?

Generally speaking, the fee schedules determined by insurers are based on broad statistical data and the economic dictates of the insurance industry. Often, these fee schedules do not accurately reflect the costs involved in providing the standard of care required to practice good medicine; in fact, Medicare and certain other insurers reimburse less than half of the cost that is charged by laboratories and medical supply companies for some tests and supplies. In addition to direct costs, our fees must take into consideration rental/real estate fees, staff salaries, rising malpractice premiums, privacy compliance, and other office overhead. Of course, we always balance business concerns against the fact that our patients may themselves be facing both personal illness and financial challenges. We are also guided by the inherent altruistic desire that influenced us to become physicians and nurses in the first place. Still, the current reality is that physicians must operate their practices like any other business in many ways. We must set fees that allow us to stay in operation and provide the level of quality care and attention that sets us apart from the typical, volume-based clinic setting found in urban centers.

To whom do I speak if I have a question about my bill or insurance claim?

Please address any financial or insurance concerns with our Practice Manager, Suzanne Combs, RN. We do ask that you not discuss these matters with the physician or nurse practitioner, as this takes away from their time with patients. Any matters that cannot be satisfactorily resolved by you and Suzanne will be brought to the attention of Dr. Johnson at an appropriate time by Suzanne.