Please take a few minutes and read through the policies and guidelines used to direct how the practice works. You can click on the title of the policy to open and then print.

Online Communication Policy (Email/Passport Portal)

Every patient is encouraged to register to use the Elation Passport Portal which is a secure system for online messaging. Use of the portal is preferred over regular email now.

All online messaging has potential concerns:

This policy describes the risks of using online communication and how Carla manages online messages. Describes the types of messages appropriate for online communications vs in-office visit and when emails will trigger a billable charge. You are encouraged to read it thoroughly. You can download and print it and bring in a signed copy to your appointment.  


Financial Policy 

This policy explains expectations regarding payment for services provided by the practice. In particular, please note the first section which explains charges for services provided outside in-office visits.  You are encouraged to read it thoroughly. You can print it and bring in a signed copy to your appointment.  

Preventive Visit Financial Policy

If you are scheduled for a preventive visit please read this addendum to the financial policy regarding combining problem visits with preventive visits.

General Communication Guidelines:

Email or the Elation Passport Portal works best given my office setup. Please read the Online Communication policy! Use of the Portal is preferred over regular email. Clinical information should be limited to short updates that don't require me to review your chart, prescribe new medications or exercise significant amount of professional judgement (see below re: criteria for when a visit is billed). I do check email and the portal for messages after hours and on weekends and often deal with issues after hours but there may be only once a day on the weekends . Please keep reading below for how to reach me for truly urgent problems when you need to speak to me.

Phone: Leave detailed messages that allow me to take care of your need without having to call you back to ask more questions (if possible). I'll try to let you know by message or email when I've taken care of what you needed. 

If you really need to talk directly with me for a non-urgent issue- schedule a 5 Minute Return Phone Call using the online scheduler. These return calls should take no longer than 5 minutes. The return phone call schedule will allow up to 10 patients to sign up for return phone calls in one hour. If your call is going to take longer than 5 minutes, you should either schedule an office visit or schedule a phone visit using the Virtual Visit link on the website.

Urgent Problems: For urgent issues where you need to talk to me immediately there is an option to reach me using the phone menu prompts. It is appropriate to use this for clinically urgent problems or questions. It will interrupt me with a patient when you call during office hours, so it should be used judiciously. Just follow the phone prompts to "Reach Carla Urgently".

Examples of a clinically urgent problem or question include but are not limited to:

  • you're having abdominal pain and aren't certain what to do

  • you're late for your appointment and want to let me know you're on your way because you know I'm waiting for you -or check if you should keep trying to make it 

  • you have a bladder infection or other clinical issue that needs attention and it's after hours or the weekend .

If you're ever in doubt as to whether you should go to the emergency department and you cannot reach me immediately, my advice is generally to go! Another option is to use the Nurse on Call program at Community Hospital (406-327-4770). Generally, I should always be available within the hour except for very rare circumstances such as cell phone outages.

Unscheduled Drop-Ins: I discourage walk-ins. I usually have same-day openings on the schedule but if you cannot find one, and need an appointment that day, I have a system on the schedule page where you complete a short form to notify me of your need. Often I can find a time to squeeze you in or I can take care of what you need by phone. However, just showing up is disruptive to other patients.

Lastly, dropping by the office hoping to catch me to talk is generally not a good idea. I use what little time I have in between patients to prepare for the next visit. Interrupting me means that my next patient is shortchanged.

Billing for Communication Outside an Office Visit: If your inquiry is likely going to be a billable visit, please use the Virtual Visit system on the website or schedule an in-office visit. I now bill for any interactions by phone or email that meet the criteria for a visit regardless of how the visit was arranged. Criteria for a visit includes:

  • when I have to review your chart,

  • prescribe a new medication or change the dosing of a current medication,

  • document an extended phone conversation (longer than 5 minutes), or

  • exercise a certain degree of professional judgement.

Insurance rarely pays for non-office 'visits' and are not billed to insurance unless you direct me to at the time of the interaction. If you request a claim be sent at a later date, I will provide you with an invoice you can send in to your insurance company.

Privacy Policy

Please read the above Privacy Policy re: your rights to privacy and how your personal health information may and may not be used.