General Consumer Questions

1. I need the best doctor in my area; whom do I call?
We do not make referrals; however, you may call your local county medical society who may be able to refer you to a specialist. The phone number will be listed in the business white pages of the telephone directory or you can call directory assistance for the number.

2. Are complaints public information?
Section 4.05(c) of the Medical Practice Act states that all reports and investigative information are privileged and confidential, but any disciplinary action is always public. We do not do private reprimands. Formal complaints filed with the State Office of Administrative Hearings are public record.

3. What is a D.O.?
In addition to medical education, a doctor of osteopathy also studies the alignment of the spine and osteopathic manipulation. Osteopathic manipulation is the movement of the bones and joints.

4. When may a doctor refuse to see a patient or discontinue seeing a patient, and if so, what are the guidelines?
Except in limited circumstances involving transfers between hospital and emergency situations, a physician may refuse to accept a new patient. In most cases, a physician may also terminate a doctor-patient relationship upon giving the patient adequate notice and a reasonable opportunity to obtain another physician. Adequate notice will depend on the circumstances.

5. Can my physician terminate care of a patient?
Yes, a physician generally has the right to terminate the doctor/patient relationship. The doctor should give adequate notice to the patient and provide required care until the patient has had reasonable time to find a new doctor.

6. Is a physician required to have a nurse or someone else present when performing gynecological exams on a patient?
No. A physician is not necessarily required to have someone else present when performing a gynecological exam. Although a physician is best advised to have a third party present to act as a chaperon during such an exam and a patient may ask for one, if one is not present, the physician is not necessarily required to have one. If a patient requests a chaperon, such as staff or a family member, and the physician does not have or allow one, the patient is not required to undergo the exam and may wish to consider finding a physician she is more comfortable with or who utilizes a chaperon.

7. What is a UPIN?
Under Section 1861(r) of the Social Security Act of 1985, the Health Care Financing Administration, HCFA, was required to establish a unique physician identifier for each physician who provides services for which payment is made under Medicare. This includes medical doctors, osteopaths, doctors of dental surgery or dental medicine, podiatry medicine, optometry and chiropractors. HCFA developed a six-place alphanumeric unique physician number, UPIN, which is issued to all physicians, whether in solo or group practice. One UPIN is assigned to a physician, regardless of the number of practice settings, that UPIN is assigned throughout the physician's Medicare affiliation in any state.

8. When are UPIN's necessary?
Medicare is now collecting the necessary data to aggregate payment and utilization information for individual physicians. This requires that the UPIN of the ordering or referring physician be shown on all Medicare Part B claim forms involving referrals, including claims from laboratories, durable medical equipment supplies, hospitals, end stage renal disease facilities, radiology and other imaging centers, physical therapy facilities and consulting physicians.

NOTICE: As of January 1, 1993, physicians are also required to provide their UPIN to any physician or facility to whom they refer a patient, any laboratories or hospital from whom they order tests, or any supplier from whom their order supplies or equipment for a medical beneficiary.

9. How do I obtain UPIN Information?
The UPIN directory is available through a variety of sources. You can get a UPIN listing from your local Part B Medicare carrier: Dallas (972) 766-7405

or

Government Printing Office --- at 202-512-1800.

or

the Internet address at http://www.medicare.gov/Physician/Home.asp

10. Questions relating to contact prescriptions?
Link to Texas Contact Lens Prescription Act page of TDH's website, http://www.dshs.state.tx.us/plc/default.shtm

 

DISCLAIMER:
Any and all statements herein should not be construed as official policy or positions of the Texas Medical Board and are merely provided by Board staff for general guidance. No individual staff member is authorized to provide a binding opinion or statement for the full Board. Nothing herein should be construed as legal advice for any particular situation.

 

Updated: Wednesday, February 16, 2005