FairDoctor Patient Advocacy GuideNPI: 1437174000
Patient Appointment & Billing Prep Checklist
Bring this sheet to your appointment. It outlines expected visit times, billing baselines, and protective questions to ask before receiving care.
DoctorDr. Michael Johnson, MDHospitalist · Charlotte, NC
Patient Name & Date
Name: ____________________ Date: _________
Expected Consultation Time36 MinutesBased on clinical documentation
Pricing Markup Tier2.8x BaselineModerate Markup
Standard Office Visit Baseline$130 to $210Customary allowable rate
4 Essential Questions to Ask at the Reception Desk
1. In-Network Confirmation: "Can you verify that Dr. Johnson and this specific facility address are actively in-network with my insurance plan?"
2. Laboratory Routing: "If blood work, biopsies, or cultures are collected today, will they be sent strictly to an in-network lab?"
3. Itemized Procedure Estimates: "If any in-office scope, injection, or minor procedure is recommended today, can you provide a written estimate before performing it?"
4. Self-Pay / Prompt Pay Discount: "If I pay out-of-pocket today, what is your discounted cash settlement rate?"
My Health Priorities for Today’s Visit (Write Down Before Entering)
1. Main symptom or question: ____________________________________________________________________
2. Secondary concern or medication refill: ____________________________________________________________
3. Treatment plan or follow-up steps agreed upon: ___________________________________________________
FairDoctor Independent Patient Directory · fairdoctor.orgIndependent healthcare transparency reference