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Patient Information


 

 

Patient Rights & Responsibilities

 

Remember to bring ALL of the following information to each visit

  • A photo ID
  • Your insurance card, if applicable. Please let us know at the time of your visit if you change your insurance
  • A list of all the medications that you are currently taking, if applicable
  • Any forms that your provider or doctor needs to fill out for you
  • Your current address, phone number and date of birth

 

If you are a new patient

  • Please come in 15 to 30 minutes early to your first appointment to fill out paperwork
  • For dental visits, bring your dental records and current dental x-rays
  • For medical visits, bring your immunization records
  • We will ask you for your social security number, but we will not deny our services if you do not have one. Please do not use an incorrect social security number

 

If you are Uninsured

  • If you do not have insurance we can help you figure out what programs you might be eligible for. 
  • Our Patient Services Representatives will help you apply for Medical Assistance, Minnesota Family Planning program, and other programs that might cover your services.
  • If you have been denied Medical Assistance within the last 6 months, bring the letter of denial to your appointment in order to apply for the sliding fee scale. 
  • Uninsured patients seeking Behavioral Health services are required to seek care in the county where they live. Patients outside Hennepin County will be referred to their county of residence for services.

 

All Patients, Annual Proof of Family Income

  • All patients will be asked to provide proof of household income. CUHCC needs to show household income because it receives federal assistance in order to provide its services.
  • Please bring a photo ID and one of the following: current check stubs; a copy of income tax return; retirement benefits; workers compensation or unemployment benefits; disability or social security benefits or a letter from employer if paid in cash.
  • Be sure to return income verification within 14 days of your visit or you will be charged the full fee. 

 

Scheduled and Missed Appointments

  • We will call you the night before your appointment. Please press 1 to confirm your appointment and press 3 to cancel.
  • You must cancel your appointment at least 4 hours in advance or that appointment will be counted as a missed appointment.
  • if you miss several appointments, we will only be able to offer you walk-in services.
  • If you are more than 10 minutes late you may lose you appointment. 

 

Payment and Prepayment Options

  • Sliding Fee Scale
  • If you do not have insurance and are paying according to a sliding fee scale, we will ask for $20 at check-in for medical and dental services. If you are on a sliding fee scale plan exceptions are made for: Children seen in the dental clinic, Pharmacy visits, Lab services, and Nursing visits
  • If you do not have insurance and are not eligible for the sliding fee scale, we will ask for $40 at check-in. 
  • If you pay the full amount for your visit on the same day of your appointment, you will receive 5% off your payment. 
  • If you have insurance, we will ask for your insurance co-pay at check-in, if applicable. 
  • We accept: cash, check, Visa or MasterCard.
  • CUHCC billing can help you set up a payment plan if you are having problems paying off your account.
  • Nobody will be turned away based on their ability to pay.

 

 

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