New Patient Registration
Please arrive 15 minutes prior to your appointment time for new patient registration. You can print and complete the new patient registration form below. Please bring with to your appointment. You will need to bring your insurance card(s) and drivers license. If you have a co-pay, it is due at the time of service. We encourage the transfer of your medical record information, including immunization history, when establishing care at our clinic.
Welcome to Sanford Health Broadway Clinic Form
Billing and Insurance Information
When you receive services from Sanford Health Broadway Clinic, you assume the financial obligation of paying for the services rendered. We will be happy to bill your insurance company for you, but the obligation to pay for services remains with you.
If you are unable to pay in full, arrangements must be made with our Business Office. All accounts are due and payable within 30 days. If you are unable to pay the entire balance within 30 days, payment arrangements can be made as follows:
- Balances of $100-$300... Four (4) months of equal payments.
- Balances of $301-$500... Six (6) months of equal payments.
- Balances of $501-$1000... Ten (10) months of equal payments.
- Balances of $1001 or greater... Please contact out Business Office for special terms.
- All co-pays must be paid at the time of service.
If you have any other questions in regards to the terms and conditions of the financial policy or would like to receive a copy of the policy, please feel free to contact the Business Office at (320) 762-0399.
Our caregivers are scheduled with patients throughout the day. To stay on time with appointments, time is set aside at mid-day and the end of the day to return phone calls. When you call in, leave a specific message. The caregiver/nurse team will return your call as soon as possible.
To ensure patient safety and proper care, our caregivers will not diagnose conditions over the phone.
The staff of Sanford Health Broadway Clinic work hard to ensure the privacy of every patient. As a result, the facility is in compliance with the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA). This major piece of federal legislation protects patient privacy and defines the type of information that must be kept private.
On your first visit, a Sanford Health Broadway Clinic staff member will inform you of the Notice of Privacy Practices. This notice describes the type of medical information we collect and how we use or disclose that information. It also describes your rights as they relate to medical information.
Contact your pharmacy for authorized prescription refills. Please allow up to 48 hours for your refill to be returned to the pharmacy. Many times a visit must be scheduled to ensure the correct dosage and effect of the medication before refilling the prescription. Schedule your visit two weeks before your medication runs out.
Questions, Concerns, and Ideas
Should you have any questions, concerns, or ideas that may help us serve you better, please feel free to contact us at any time.
The decision to refer you for further care is between you and your primary caregiver. There are a variety of options available including Sanford Health Broadway Clinic physicians, independent physicians practicing in the area and visiting specialists. Please check with your insurance company regarding the requirements of your policy because some referral visits must be planned in advance for insurance coverage.
Release of Medical Information
Should you need copies of your medical records, contact our Medical Records Department. Copies will be released only with the signed consent of the patient or authorized agent.
Test Result Information
Sanford Health Broadway Clinic wants our patients to receive test results quickly. Most results are received within three days. Normal test results will be called or mailed to the patient. If a test result is of concern or requires medical attention, the caregiver/nurse team will contact the patient as soon as possible.
Treatment of Minors
Although our clinic takes pleasure in providing care for the whole family, it is our policy not to treat minors without the attendance and/or consent of a parent or legal guardian.