Avance Care Policies

Telephone calls

Our staff is available to answer your questions and schedule appointments during regular office hours. If you have an urgent concern, please inform the receptionist so that your call will be addressed immediately. If you have lengthy or complicated issues, we ask that you schedule an appointment with one of our providers for an evaluation/consultation. We are pleased to offer alternate communication methods, including online appointment requests and messaging capabilities through the patient portal where you can also review test results, request appointments, request referrals and review statements.


We will make every effort to see acutely ill patients within 24 hours. If a call is received by noon, urgent appointments can usually be made the same day. For your visit, please remember to bring your insurance card, driver’s license or picture identification and payment for co-pay or deductible. Please note that a valid, government issued photo ID is required for new patients. If you have health insurance, we cannot see you without making a copy of your insurance card. Co-pay or deductible is collected at check-in. Our schedule has been designed to minimize wait time; however, emergencies are given first priority. If your physician is treating an emergency patient, we will try to keep you informed of the wait time and give you the option of rescheduling your appointment for another day.

No-Show Appointment Fees

Unless an appointment is cancelled at least 24 hours in advance, a fee of $35 may be charged for missed primary care appointments. For Nutrition Services, the no-show fee is $75. For missed Behavioral Health visits, the fee is $50.

Lab work

In order to provide you the highest standard of care, if your lab results are abnormal you will be contacted by our staff and you will be asked to make a follow up appointment with your doctor to discuss those results. This follow up appointment will allow you time to ask your doctor questions about your lab work and give your doctor an opportunity to discuss further testing and follow up that may be needed. This follow up can be vital for your health and cannot adequately be done over the phone or by email so our doctors cannot discuss abnormal lab results with you over the phone or by email.

If you need blood work in the future to monitor a chronic condition (i.e. high cholesterol, diabetes, high blood pressure, hypothyroidism, etc), you will be asked to have your blood work drawn at least 2 days PRIOR to this appointment. If lab work is required but is not done prior to a chronic condition follow up visit you may be asked to reschedule your visit.

Did you know you can view and print your lab results online? As part of our continuing efforts to provide innovative and convenient medical care, we offer you the ability to view most of your lab results online. Please contact us to obtain a login for our patient portal to view your lab work.

If your lab test is normal, you will NOT receive a phone call from us.  Normal labs will be published within 1 week to your patient portal account.  Please check your email for a notification once it is published.

You WILL be contacted by phone for any abnormal results that require a discussion with your provider, otherwise they will be published to your portal account.
You will not be able to view your lab test results until they are received and reviewed by your provider.


  • Prescriptions last written over 1 year ago cannot be refilled without an appointment
  • Prescriptions written by another doctor cannot be refilled without an appointment
  • We may not write prescription for controlled substances (including narcotic pain medicines and stimulant ADD medicines). Please see our Policy on Controlled Substances
  • If a pharmacy or insurance company requests that we change a prescription, we will not make any modifications without our patient’s understanding and permission

Controlled Substances

  • Controlled substance prescriptions are for pick up at the office only. We do not e-prescribe or fax these prescriptions.
  • Prescriptions are given for only one month at a time, so a new prescription will need to be picked up at the office each month.
  • Therefore NO 90 days supply of medications through online services will be prescribed.
  • Prescriptions can only be picked up by the patient whose name is on the medicine, UNLESS we have a signed form noting a specific family member can pick up the prescription on behalf of the patient. Minor children are NOT able to pick up prescriptions for parents.
  • Patients should submit requests for refills with a minimum of 5 days BEFORE the medication is going to run out to give their provider a sufficient amount of time to respond to the request.
  • The patient will be required to have an appointment in the office every 3 months to recheck the problem that is leading to the use of controlled substances.
  • If there is any suspicious behavior including frequent, early refill requests or multiple “lost” prescriptions we have the right to terminate this agreement and refuse further prescription requests.
  • We will run a report on the NC Controlled Substance Report System at each visit.

Patients on controlled substance treatment are required to sign a Controlled Substance Agreement. Some of the conditions of this agreement are:

  • Patient will take this medication only as prescribed and will not change the amount or frequency without authorization from the prescribing physician.
  • We will not provide early refills or receive replacement of lost or stolen medication.
  • Patient is required to obtain the prescription only at a pre-agreed pharmacy location.
  • Patient is required to submit random urine or blood tests to assess compliance to treatment.
  • Patient-Physician relationship is terminated if regularly scheduled appointments are not kept or the prescribed treatment plan is not followed.
  • Patient is required to confirm by signature that they have not given any false health facts and are not seeking treatment under false pretense.
  • Patient is required to release Avance Care from any liability related to their misuse of the controlled substance prescribed.
  • If you have further questions regarding our Controlled Substance Policy, please contact our office or speak with your provider.

After-Hours Care

  • Emergencies must be evaluated promptly in the nearest Emergency Department
  • An on-call doctor is available by telephone for non-emergent issues. Please call your office’s primary phone number after hours to be directed to the physician on call
  • Because we cannot examine a patient over the telephone, the doctors may be unable to diagnose or treat all symptoms by telephone
  • Unfortunately, we cannot provide telephone advice to non-established patients, even if they are the spouse or child of an existing patient.  Patients must be established patients, who receive primary care services from Avance Care, to use the on-call service
  • Messages left on after-hour voice mail will result in a direct call to our provider’s cell phone number, so please, do not contact our providers for non-emergent issues such as prescription requests or appointment related requests or you may incur a $50.00 after hours service fee.

Additional Fees for Extended Hours Service

In order to help compensate for our higher operating costs during evenings (starting 6 PM), weekends and holidays, Avance Care uses Extended Hours Service specialty code while submitting insurance claims on your behalf for non-preventive care visits. The fee for this service code is up to $50.00. This fee is added to the baseline charges for your visit. Most insurance companies recognize this billable charge and will provide full or partial reimbursement. You may be responsible for only the allowable portion of this charge in the event that your insurance company assigns it to your deductible or coinsurance. If you have additional questions, please contact your insurance plan for specific details regarding this service.

For self-pay patients, the fee for the Extended Hours Service is $15.00 for the non-preventive care visit.

Please see our Disclosures and Consent form acknowledging your understanding of the content above.

Fees & Payments

Full payment, including any co-payment that your insurance may require, is expected at the time of service. If you are experiencing financial difficulties and need to make special payment arrangements, please ask to speak with a member of our billing office or the practice manager. We are here to help you.

Insurance and Self-Pay

It is the policy of Avance Care to help keep your health care costs as low as possible. To do this, we need to keep our billing costs to a minimum. Please help us in the following ways:

  • Always bring your current health insurance card to your appointments
  • Please notify us at time of check-in of any changes in insurance, address, telephone, or family status
  • Please pay your co-pay or deductible balance and co-insurance amount at the time of service
  • You will be expected to pay in full (self-pay) if: you do not have insurance, we are out-of-network with your insurance plan, we are unable to verify your insurance cover, or you are unable to present a valid member identification card from your insurance carrier at the time of service

Please take the time to review your insurance plan so that you understand what your benefits are. It is important to know what to do in case of an emergency or if your child becomes ill while you are out of town. If your insurance requires authorization, please call our office within 24 hours with all relevant information

Annual Examination Coverage

This notice pertains to the components of a physical examination (preventive services) that are normally covered by your medical health plan. Also, it includes what services are not normally covered by your medical health plan during a physical examination.

Services NOT Normally Covered by Insurance Plans During a Physical Exam/Preventive Service:

  • Evaluation and Management of specific acute problems or illness, such as discussion of a recent cough, sore throat, pain, or injury
  • Procedures other than a pap smear, such as mole removals, joint injections and skin biopsies

Physical Examination Components Normally Covered by Insurance Plans Include:

  • Screenings for common or preventable diseases, such as screenings for high blood pressure, obesity, high cholesterol, diabetes and certain forms of cancer
  • Complete physical examinations (PAP smears for women included)
  • Review of immunization history and administration of any, if necessary
  • Counseling on healthy living choices, normal development and recommendations for proper diet and exercise
  • Diagnostic testing, if appropriate, such as PAP smear, fasting cholesterol and blood sugar tests, colonoscopy, bone density and prostate blood test

Our providers welcome discussing and/or providing any of the services that may not be covered by your medical health plan during your physical examination. However, please keep in mind that if your medical health care plan does not allow for, or cover this additional service on the day of your physical, then you will be responsible for any charges related to that additional service.

The above information will be given to you to sign as your acknowledgement of this content before your yearly physical with us. 

Returned Checks

There is a fee (currently $25.00) for any checks returned by the bank. This amount may change.

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