Peoria: 623-977-1212
Mesa: 480-985-6764
FAX: 623-875-1815

Policy & Procedures

Welcome to CCA® 

(Continence Center of America ™  /  Center for female Sexual Health ™  /  Urodynamic testing Center ™)

CCA specializes in the evaluation and nonsurgical treatment of male & female urinary and fecal incontinence, voiding dysfunctions, female pelvic organ prolapse and female sexual health. Providing superior healthcare is our number one priority. CCA is a practice where you can be seen for your very personal and private medical needs. The following information details our policies and procedures. As with many things in life exceptions to the rules are sometimes needed.  If you have special or unique requests please let us know. Thank you for letting us help with your very private healthcare needs.  We look forward to being of service.

Office hours: Monday-Thursday 8-5, Friday 9-4, Lunch 12-1

Financial Policy
Due to the ever-changing insurance policies' rules and regulations, it has become necessary to make it the patient's responsibility to understand their coverage and provide the correct health insurance information at the time of service.  At your initial visit, you, the patient are responsible for your copayment/coinsurance amount plus any deductible.  If our office cannot verify insurance benefits, payment in full is due when you check in for your appointment.  If your insurance carrier sends payment directly to you, payment in full is due at each visit.  Should an overpayment occur on the deductible or percentage amounts charged, a credit will be applied to your account with us.

Patients are expected to know what types of medical care require prior authorization from their insurance carriers and that they must obtain approval before receiving that care.  If these steps are not taken in the correct order, payment can be denied and the patient may be left to foot the bill for the services.  Patient must understand that their policies may fully cover only in-network providers and must additionally know who is in-network and who is not.  Failure to do so may result in you being personally responsible for any and all changes.

Lastly, in order to avoid complications and claims, we will only bill two health insurance carriers per account.

:  Please fill out your forms carefully, completely and as accurately as possible.  We will only ask you to complete this paperwork once.  However, we ask that you bring your insurance card and ID to each visit.

Referrals & Prior Authorizations
: The healthcare industry standard for the processing of referrals and prior authorizations is 14 days. At CCA we strive to beat industry standards in every aspect. Please allow 7-14 days for the processing of referrals and prior authorizations. We are our patient’s biggest advocates and believe in attacking ailments and disease processes aggressively. The CCA providers and staff work diligently to obtain approval for the studies and treatments our patients need. Sometimes this process may take longer than we like, but please be patient as we work with your insurance company and primary care provider to get you the superior healthcare you deserve. Please be advised that you the patient are the one ultimately responsible for making sure referrals and prior authorizations are obtained before being seen in our office.

: All co-pays are due at the time of service including follow-up visits and tests. All fees, co-pays and outstanding balances are due at the time of service.  Failure to collect such balances as a result of oversight or misinformation provided by the payer does not void or negate balances due and may be subject to additional late and collection fees. A $10 convenience fee will be charged for all uncollected co-pays.

Office Visit Basics
: An office visit is comprised of an evaluation by a trained medical professional. An office visit in no way guarantees that any form of medication, treatment, referral, diagnostic study, doctor's excuse, or any other request made by the patient will be granted. It is at the sole discretion of the provider to consider what is most prudent and requests for refunds will not be taken into consideration. CCA allows for patient-provider interactions: differing, conflicting, opposing, contradictory, inaccurate opinions and/or diagnoses do not void balances due. Our providers encourage patients to research and provide scientific data, published articles and/or reviews for consideration of their evaluation and treatment options. 

Cancellations/ No-Shows
: We kindly request at least 24 hour notice when canceling appointments, Many appointments are scheduled with two members of our staff for up to 1 hour.  Last minute changes are costly and inefficient. CCA reserves the right to charge $50 for cancelled or no-show appointments with less than 24 hour notice. Additionally, patients who miss 3 appointments without doctor's excuses will be asked to leave the practice.

Please arrive on time for your appointment.   Your time as well as ours is valuable.  We do our best not to keep you waiting.  If you are 15 minutes or more late, you may be asked to reschedule.

Refills & Prescriptions
: Medication errors involving prescription drugs account for 1.5 million injuries and deaths per year according to the esteemed I
nstitute of Medicine. Of this number, 400,000 cases of medication errors are preventable. In order to minimize preventable medication errors and provide the highest quality care, medication refills are best addressed at the time of your visit with your provider.  Please bring an updated medication list with you every office visit.

Once an ailment or disease process is stabilized or controlled, you may receive a 3-6 month supply of medication. Prior to running out, we ask that you return to us for re-evaluation and to obtain refills as they will not be refilled over the phone or via fax. As is customary with industry standards, multiple refills will not be granted for patients seen on an emergent basis. Refills on antibiotics are strictly prohibited without an office visit. Please note that lost prescriptions will not be refilled and will require a new office visit (this includes self-pay patients.)

Lab & Study Results
: In order to minimize miscommunication of study results, details will be addressed with our patients during the time of an office visit. Specific details of lab and study results will not be discussed over the phone. In the event of an abnormal result, we ask our patients to come in for an office visit for interpretation of results, further evaluation, and to discuss the abnormal findings and treatment plan with a Provider. You will receive a call from our office with instructions on when you should return. If you have questions or concerns about normal study results, we invite you to come in for an office visit and have a Provider interpret the results & discuss any of your remaining questions and/or concerns. There will be a charge for these visits.

: With the exception of bottled water, food is prohibited within the office.

Please do not use perfumes or heavy scents.  Our sensitive patients and staff members thank you for this consideration.

Telephone Messages
: When leaving a telephone message, please allow 24-48 hours for a return call from one of our office staff. Please also remember that the providers at CCA are not able to refill medications, dispense medical advice or make changes to any treatment modalities over the telephone. If your needs must be addressed sooner, please schedule an office visit any time during office hours.

Copies of Records
: We are happy to provide copies of any and all of your medical records upon your request. We hope you will be happy to know we are a paperless office and eliminate waste whenever possible. To aid in this effort, we provide our patients with a personal electronic copy within 3 business days (72 hours) for a fee of $25. A personal electronic copy may be expedited within one business day (24 hours) for a $50 fee.

Forms & Letters
: In order to provide patients with requested forms and letters in a timely manner, a charge to complete each individual and separately identifiable form will be assessed. If a Provider must write a letter or fill out forms and documents on behalf of the patient, a flat fee will be required to complete the request. Please allow 3 business days (72 hours) for this process to be completed. All fees are due at the time of request.
  • Forms $25
  • Narrative Report $100

Medical Excuse of Absence
: An excuse of absence will be granted by the provider based on medical necessity. If an extension is required for an excuse of absence, the patient will need to be re-evaluated with an additional office visit. An excuse of absence or an extension for an excuse of absence cannot be granted without an evaluation by a Provider during an office visit.

Cell Phones
: In consideration of the medical clinic and other patients, we ask that you turn off cell phones or use the vibrate setting when visiting us. Please do not answer or talk on your cell phone while in the exam room.

Disruptive Behavior
 CCA Code of Conduct defines disruptive behavior as anything that an individual might do which may (A) interfere with the orderly conduct of the clinic (B) interfere with the ability of others to effectively carry out their duties (C) interfere with patient care (D) undermine a patient’s confidence in the facility or any member of the healthcare team (E) behavior and/or language which may be interpreted as being offensive, disrespectful, demeaning, abusive, combative, confrontational, or deemed to be inappropriate in any manner. CCA is fully committed to protecting its staff, providers and patients against any form of disruptive behavior.  Once the cornerstone of the Provider/Patient relationship is eroded, the facility reserves the right to discharge the patient from the practice permanently. CCA will aggressively pursue and litigate against any disparaging statements and/or behavior which may be deemed as defamatory, libel, or slanderous.

Arizona law makes it a felony to assault a healthcare worker who is performing his/her duties. CCA will prosecute to the full extent of the law. Harassment and/or intimidation may be considered assault.
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