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Welcome to our practice. We appreciate the opportunity to serve your health care needs. The following information is intended to provide a brief overview of our practice’s policies and procedures, from scheduling your appointment to billing. You may also contact our office staff by phone during regular business hours and we will be happy to answer your questions.

Bullet Journal

Appointment Policies

Requesting Appointments

For current patients, there are several ways to request an appointment.

  1. You can call us at 956-412-2836 and leave us a detailed message with the reason for your appointment as well as the time frame (date range, day of the week, time of day) you are seeking an appointment; 

  2. You can request an appointment through the Spruce Health App (download at Don't forget to give us the reason for the appointment and the time frame (date range, day of the week, time of day) you are seeking so we can try to accommodate you the best our schedule allows; and 

  3. You can send us a text message to 956-412-2836 requesting an appointment. However, it is important to note text/SMS is not a secure method of communication.
Confirming Appointments

When you schedule an appointment, we reserve that time specifically for you with our medical staff and doctor. We are committed to honoring appointment times, so it is critical that you confirm your appointment within 24 hours of your appointment time.  All unconfirmed appointments may be  subject to cancellation which is why we offer three ways to confirm your appointment:

  1. E-mail - If we have your e-mail on file, our electronic medical system sends an email to alert you of your upcoming appointment.  All you have to do is reply.

  2. Text Message  - Our electronic medical system sends a text message to alert you of your upcoming appointment.  To confirm your appointment, be sure to reply back via text.

  3. Phone call - You can confirm your appointment by calling us day or night and letting us know over the phone or via voicemail.  We check our messages periodically throughout the day.


As a courtesy, we try our very best to call all of our patients with unconfirmed appointments the day before.   However, some days are more hectic than other and we are not always able to call , so we kindly ask that you confirm either via e-mail or text message.  


Please call the office 24 hours in advance to cancel appointments.  This allows other patients who are on the waiting list to be seen.

Late Arrivals

We are committed to prompt service, and will work very hard, barring emergencies, to stay on time. Please arrive 10 minutes early for your appointment to complete any paperwork associated with your visit.  Please be prepared to show your ID and insurance card(s). Patients arriving after their scheduled appointment time may be asked to reschedule.

Missed/No-Show Appointments

It is necessary for us to make appointments in order to see our patients as efficiently as possible. Missed / no-show appointments including late-cancellations cause problems that impact our medical practice. When an appointment is made and not kept, it takes an available time slot away and delays the delivery of health care to other patients, some who are quite ill. As such, a failure to be present at the time of your confirmed appointment will be recorded in your medical record as a no-show and may be subject to a fee as well as possible dismissal.

Female Patient With Receptionist In Doct

Billing Policies

Financial Responsibilities

All payments including co-payments, co-insurance, and balances are due at the time of service. We accept cash, checks and most major credit cards. As a service, we will bill your insurance for you.  If there is a balance due after payment is rendered by the insurance company, we will expect your prompt payment of that balance.

Patient's Responsibilities

As a service to our patients, we provide insurance billing services.  However, in order to provide accurate billing of services, it is the patient’s responsibility to provide us with current insurance plan information prior to services rendered.  We strive to offer our patients quality medical care and assist the patient to receive maximum benefit from their insurance plan.  As such, there are times where we may require your intervention to be able to expedite the billing and/or payment process.

Visits related to motor vehicle accidents We do not do any third party billing at this time.  However, at your request, we will submit a claim to your primary health insurance carrier.  You may receive an accident questionnaire from them to be completed by you.  However, be advised that if the questionnaire in not returned to your medical insurance company and/or we receive a denial on your claim, you will be responsible for payment in full.  


Visits related to worker's compensation:   Our provider does not accept workers’ compensation insurance at this time.  We recommend you contact your workers' compensation insurance provider to get a list of approved medical providers. 

old couple

Patient Policies

Required Annual Wellness or Annual Physical Visit 

All patients are required to complete their Annual Wellness or Annual Physical visit on a yearly basis. This is done to ensure we catch things EARLY and can be proactive about keeping you healthy!


We strongly recommend you let us know 1 week in advance of needing any medication refills  as some medication refills will require an office visit and/or pre-authorization from your insurance.  For patients not requiring an office visit or pre-authorization, the turnaround time is generally 72 business hours for prescription refills.  You can request prescription refills:

  • Through the Spruce Health App (download at

  • Calling the office and leaving a message in the prescription voice mailbox (OPTION 4) Important: please note that leaving a message with a member of our staff will cause delays as the information makes its way to the appropriate person.


If your health insurance plan requires referral authorization, it is your responsibility to contact us prior to making an appointment with a specialist. Failure to do so could result in lack of authorization for the specialist visit, which may cause your insurance company to deny payment. Retroactive referral authorizations will not be made. Generally, patients need to be seen by their primary care physician before a referral can be requested.

Depending on a variety of factors and the requirements set forth by the patient's insurance company, referrals typically take up to ten business days to complete. To better understand why the process of referrals can take so long, please read more about it HERE


Once our office has submitted the referral and insurance paperwork, we STRONGLY encourage all of our patients to keep their referral appointments to avoid delays in treatment.  This is especially important since the pandemic as some specialists have extremely long delays in appointment availability.   In some cases, failing to go to a referral appointment within a specified period of time can restart the entire referral process.  If you are unable to maintain your appointment for whatever reason, we ask that you immediately contact the office you are being referred to reschedule.  On the same note, if you would like a sooner appointment with the specialist we recommend calling the specialist's office on a weekly or biweekly basis to see if there are any cancellations that would allow you to be seen sooner.  In the event you are rescheduled to a later appointment with the specialist, we kindly ask that you let us know so we can change any follow-up appointments and prevent unnecessary visits.

Emergencies and OnCall

If you experience a medical emergency, such as chest pain, severe shortness of breath, severe headache, or bleeding, call 911 or proceed directly to the nearest hospital emergency room. You can always call the office with any questions about acute medical problems after hours and our answering system will page the provider on call. If the provider on call does not return your call within 30 minutes, please recall the office.

Release of Records

Incoming:  Please complete a records release form so we may obtain your medical records from your previous family physician and any specialists you may have consulted or may be currently consulting. 

Outgoing:  Please have the physician's office needing your records send over a  signed medical release and we will send them the records being requested.  If you are wishing to obtain copies of your medical records for personal use, you are able to view them via the patient portal.

Appointment Requests
Prescription Refill Request
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