Office Policies


Payment is due at time of service. Cash, personal checks, and debit/credit cards are accepted. If you have a financial difficulty making a payment, please contact us to make alternative arrangements. If you write a check that is not honored by our bank, any bank charges incurred by our practice will be passed on to you and you will be assessed an additional $25 Returned Check Fee.

Cancellation Policy

Because a significant amount of time is set aside for each patient, we require at least a 48-hour notice for cancellations of new and established patient appointments, In the case of a missed appointment, future appointments will not be scheduled until the missed appointment fee has been paid in full. Our no call, no show visit fee is $35.

Appointment Scheduling and Office Hours

A patient appointment can be made by doing one of the following:
  • Office hours: by appointment only
  • Calling the office directly
  • Scheduling your appointment online (see patient portal page)
  • House Calls: Available upon request
  • Telemedicine appointments: Available anytime, anywhere

Appointment Reminders

You will receive an email and text appointment reminder at least 48 hours before appointments to allow adequate time to cancel, if needed. It is your responsibility to make sure we have your current phone number and email address. Telephone and Email Consultations An appointment fee will be assessed at our discretion for telephone or email consultations in which more than 10 telephone calls per month occur, phone calls lasting more than 15 minutes, and frequent or lengthy email communications of 10 or more emails per month.

Vacations and After Hours Call

We are available almost 24-hours a day by phone or text. As a courtesy to us and our families, please do not call after 9pm or before 8am unless it is an urgent matter. If you leave a message, we will call you back as soon as possible. When leaving a message, please leave your first and last name, a phone number where you can be reached, and the purpose of your call. In case of any life-threatening emergency, do not call the office or Dr. Houtman! Instead you should always call 911 or go to the nearest hospital for any emergency.

Prescription Orders and Refills

If you need a refill for a prescription medication that you take on a daily or continuous basis, please contact the pharmacy first. They will either fill the prescription or contact our office to request a refill authorization. If you have not been seen within the past year, you will need to schedule an appointment in order to continue receiving medication refills. If you need a refill for a prescription medication that you do not take regularly, in most cases you will need to schedule an appointment first, especially if it has been more than one year since you were last seen. Except for a few situations, new medications will not be prescribed over the telephone. For medical legal reasons, We will usually need to evaluate you first whenever a new prescription is written.

Insurance Plans

We do not participate with any insurance providers, including Medicare or Medicaid for payment of any medical services. We can still see Medicaid patients! Some insurance plans will reimburse you for seeing an out-of-network provider. Upon request, we can provide you with an office visit summary that you can try to submit to your insurance for reimbursement. (This does not apply to Medicare.) Most insurance, including Medicare, should cover the cost of any testing ordered the same as a participating provider, but you should check your insurance plan to confirm this. (This does not apply to HMO plans.) If you have a Health Savings Account (HSA) or Flex Spending Account (FSA), you may be able to use those funds to pay for office fees. Check with your Accountant. It is your responsibility to know the details of your insurance coverage by checking with your employer, insurance agent, or other appropriate person. It is your responsibility to notify the office of any changes in your medical coverage.

Secure Messaging (Patient Portal)

You can register for Patient Portal, a secure messaging system, to communicate with us and access your electronic health record. Once you have agreed to sign up for Patient Portal, an invitation will be emailed to you with registration instructions. You will need to click on the link in the email and a secure invitation code will be texted to your phone to complete the registration. *If you do not see the invitation email in your inbox, check your spam folder for the invite.

Confidentiality and Its Limits

Discussions are strictly confidential and will not be shared with anyone without your expressed permission given in writing to Dr. Houtman. There are, however, certain exceptions that you should be aware of:
  1. Suspected cases of child abuse must be reported to the police and Child Protective Services.
  2. Elder abuse must be reported to the police and Adult Protective Services.
  3. We may need to report you to public safety officers if we feel that you may be in imminent danger of harming yourself or others.
  4. We are obligated to attempt to warn and protect intended victims if we have reason to believe you are likely to inflict bodily harm on someone else.
  5. We may be ordered by a court of law to testify or to release medical records.
Last Updated 06/14/2022 Please see written office policy in the office for full list of policies.