Dr. Saenz and the Temecula Valley Family Physicians accept most insurance plans. Give us a call or consult your insurance carrier with any questions regarding insurance acceptance. Please bring your insurance card each time you visit.-
Dr. Guillermo Saenz and the providers of Temecula Valley Family Physicians (TVFP) accept patients by appointment only. TVFP accepts over 500 same-day appointments to cater patients who immediately need to see their primary care physician. Our same day appointment slots are not a replacement for Urgent Care or Emergency Room services.
Patient Termination Policy
Payment is expected at time services are rendered. Please remember that payment is your responsibility regardless of insurance.
- All co-pays are due at the time of your office visit.
- If you are a Medicare beneficiary, Medicare will be billed for you. You will be responsible for deductibles, all non-covered services, etc., according to the Medicare guidelines. We must have a copy of your Medicare and any secondary insurance you may have at each visit.
- Please note that certain insurance carrier’s routine exams and preventative care are not covered services.
- If Temecula Valley Family Physicians, Inc. is contracted with your insurance company, we will bill for you. If we receive notification that you are not eligible for coverage, you will be responsible for all charges incurred.
- For PPO and Private Insurance, we must have a copy of your insurance card(s) each visit.
- Amounts over 60 days past due by an insurance company immediately become the responsibility of the patient. Amounts over 90 days past due are subject to collection procedures, which could include small claims court or a service charge of 1 1⁄2 times the unpaid balance per month.
- If at any time you should experience financial hardship, please notify any of Temecula Valley Family Physicians, Inc. office staff. We are willing to make special arrangements for patients who need extra help.
Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
We are required by law to provide you this notice that explains our privacy practices with regards to your medical information and how we may use and disclose your protected health information for treatment, payment and health care operations, as well as for other purposes that are permitted or required by law. This notice is effective August 7, 2007 and applies to all protected health information as defined by federal regulations. You have certain rights regarding the privacy of your protected health information and we also describe them in this notice.
Each time you visit Temecula Valley Family Physicians a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnosis, treatment, and a plan for future care or treatment this health information is often referred to as your health or medical record.
WAYS IN WHICH WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTHCARE INFORMATION
The following paragraphs describe different ways that we use and disclose your protected health information. We have provided an example for each category, but these examples are not meant to be exhaustive. We assure you that all the ways we are permitted to use and disclose your health information fall within one of these categories.
Treatment: We will use and disclose your protected health information to provide, coordinate or manage your health care and any related services. We will also disclose your health information to other physicians who may be treating you. Additionally we may from time to time disclose your health information to another physician who we have requested to be involved in your care. For example – We would disclose your health information to a specialist to whom we have referred you for a diagnosis to help in your treatment.
Payment: We will use and disclose your protected health information to obtain payment for the health care services we provide you. For example – We may include information with a bill to a third-party payer that identifies you, your diagnosis, procedures performed and supplies used in rendering the service.
HEALTH CARE OPERATIONS
We will use and disclose your protected health information to support the business activities of our practice. For example – We may use medical information about you to review and evaluate our treatment and services of to evaluate our staff’s performance while caring for you. In addition, we may disclose your health information to third part business associates who perform billing, consulting or transcription services for our practice.
OTHER WAYS WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTHCARE INFORMATION
Appointment Reminders: We will use and disclose your protected health information to inform you of any upcoming appointments in our office the day before the appointment.
Others Involved in your Care: We will use and disclose your protected health information to a family member, a relative, a close friend or any other person you identify in writing that is involved in your medical care or payment of care.
Research: We will use and disclose your protected health information to researchers provided the research has been approved by an institutional review board that had reviewed the research proposal and established protocols to ensure the privacy of your health information.
As Required By Law: We will use and disclose your protected health information when required to by federal, state or local law. You will be notified of any such disclosures.
To Avert A Serious Threat To Public Health or Safety: We will disclose your protected health information to a public health authority that is permitted to collect or receive the information for purpose of controlling disease, injury or disability. If directed by that health authority we will also disclose your health information to a foreign government agency that is collaborating with that public health authority.
Worker’s Compensation: We will use and disclose your protected health information for worker’s compensation or similar programs that provide benefits for work-related injuries or illness.
Inmates: We will use and disclose your protected health information to a correctional institution or law enforcement official if you are an inmate of that correctional institution or under the custody of law enforcement official. This information would be necessary for the institution to provide you with health care; to protect the health and safety and security of the correctional institution.
Your Health Information Rights
Although your health record is the physical property of the health care practitioner of facility that compiled it, the information belongs to you. You have the right to:
A Paper Copy Of This Notice: you have the right to receive a paper copy of this notice upon request. You may obtain a copy by asking our office staff at your next visit or by calling and asking us to mail you a copy.
Inspect And Copy: You have the right to inspect and copy your protected health information that we maintain about you in our designated record set for as long as we maintain that information. This designated record set includes your medical and billing records, as well as any other records we use for making decisions about you. Any psychotherapy notes that may have been included in records we received about you are not available for your inspection or copying by law. We may charge you for the cost of copying, mailing or other supplies used in fulfilling your request. If you wish to inspect a copy of your medical information, you must submit your request in writing to:
Temecula Valley Family Physicians, Inc. 31720 Temecula Valley Parkway Suite 203 Temecula, CA 92592
You may mail in your request or bring it to our office. We will have 30 days to respond to your request for information that we maintain at our practice site. If the information is stored off-site, we are allowed up to 60 days to respond, but must inform you of this delay.
Request Amendment: You have the right to request that we amend your medical information if you feel that it is incomplete or inaccurate. You must make this request in writing, stating exactly what information is incomplete or inaccurate and your reasoning that supports your request. We are permitted to deny your request if it is not in writing or does not include a reason to support the request. We may also deny your request if: the information was not created by us or the person who created it is no longer available to make the amendment, the information is not part of the record which you are permitted to inspect and copy, the information is not part of the designated record set kept by this practice, or if it is the opinion of the health care provider that the information is accurate and complete.
Request Restrictions: you have the right to request a restriction or limitation of how we use or disclose your medical information for treatment, payment or health care operations. For example – you could request that we not disclose information about a prior treatment to a family member or friend who may be involved in your medical care or payment of care. Your request must be in writing. We are not required to agree to your request if we feel it is in your best interest to use or disclose that information. However if we do agree, we will comply with your request unless that information is needed for emergency treatment.
An Accounting of Disclosures: You have the right to request a list of the disclosures of your health information we have made outside of our practice that were not for treatment payment of health care operations. Your request must be made in writing and must state the time period of the requested information. You may not request information for any date prior to April 14, 2003 (the compliance date for the Federal Regulation) nor for a period of time greater than six years (our legal obligation to retain information). Your first request for a list of disclosures within a 12-month period will be free. If you request an additional list within 12 months of the first request, we may charge you for a fee for the costs of providing the subsequent list. We will notify you of such cost and afford you the opportunity to withdraw your request before any costs are incurred.
Request Confidential Communications: You have the right to request how we communicate with you to preserve your privacy. For example – you may request that we call you only at your work number or by mail at a special address or postal box. Your request must be made in writing and must specify how or where we are to contact you. We will accommodate all reasonable requests.
File a Complaint: If you believe we have violated your medical information privacy rights, you have the right to file a complaint with our practice directly to the Secretary of the United States Department of Health and Human Services. To file a complaint with our practice, you must make it in writing within 180 days of the suspected violation. Provide as much detail as you can, about the suspected violation and sent it to:
Temecula Valley Family Physicians, Inc. 31720 Temecula Valley Parkway Suite 203 Temecula, CA 92952
You should know that there would be no retaliation for your filing a complaint.
Use or Disclosures Not Covered: Uses or disclosures of your health information, not covered by this notice of the laws that apply to us, may only be made with your written authorization. You may revoke such authorization in writing at any time and we will no longer disclose health information about you for the reasons stated in your written authorization. Uses and disclosures prior to the revocation are not affected by the revocation.
For More information: if you have questions about this notice or would like additional information, you may contact the Practice Administrator at (951) 302-4700.
Notice Informing Individuals About Nondiscrimination and Accessibility Requirements
Temecula Valley Family Physicians, Inc:
- Written information in other formats (large print, audio, accessible electronic formats, other formats)
- Provides free language services to people whose primary language is not English, such as:
- Information written in other languages
- Will contact your insurance for interpretation assistance If needed
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, 800-537-7697 (TDD) Complaint forms are available here.