Office Policies

Registered primary care patients should schedule an appointment through the UpdoxPatient Portal System.  Patients who have been referred for a consultation should use the appropriate forms to request an appointment:

If you are requiring a same day appointment, please message your doctor through the portal system.  If you do not receive a prompt reply, please call the office at: (636) 875-1140


Patients are required to arrive 20 minutes before the appointment time to complete the check-in process before their appointment starts.  If you need to cancel or reschedule your appointment, you must do so prior to 24 hours before your appointment.

A $40 fee will be charged if the patient:

  • Arrives so late that the appointment needs to be rescheduled
  • Fails to show up for their appointment
  • Cancels or reschedules with less than 24 hours notice.

Please note that breastfeeding consultations and tongue/lip tie evaluations will be charged a $40 fee for both mother and baby.  A credit card is required to be put on file for all  patients and will automatically be charged for no-show fees.

 Payment is due at the time of service, either at checkout or when you request the e-visit.  This includes any copay, co-insurance, or amount that will be applied to deductible.  Current insurance cards must be brought to every office visit.

Payment can be made by credit card, cash, or personal check. If your check is returned for any reason, you will be charged a $30.00 fee for processing.

A discount from the office fee is available for patients without insurance or those who will not be submitting the receipt for out-of-network reimbursement.  If you have significant financial difficulty and are unable to pay your bill in full, please discuss this with Dr. Grawey immediately so that a payment plan can be worked out.

If any balance remains after your insurance has been billed, then a billing statement will be sent electronically to each individual Patient Portal account.  Patients are responsible for ensuring these statements are received and paid for through the Portal system. For ALL balances, if a billing statement is sent and payment is not received within 14 days, the stored credit or debit card will be AUTOMATICALLY be charged for any balances due on the account. The stored card can be a flexible spending account card or HAS card if your plan includes such a card. If your balance is not paid by 14 days and your card is declined (for example, expired or insufficient funds), you will be assessed a charge of $15. If your card is declined, you will be notified via the Portal and will have 7 days to provide a new card. After that time, your balance will be sent to a collections company.

Balances remaining after 30 days will be sent to a collections company.  A fee up to 50% will be applied to the total balance on your account that requires collection. Should legal action be required for the collections process, an additional fee up to 50% will be applied to your account. All late fees, fees associated with collections, and legal action are the sole responsibility of the patient and or legal guardian of the patient. All late fees, fees associated with collections, and legal action are the sole responsibility of the patient and or legal guardian of the patient. 


Our office uses standardized assessment tools to provide excellent care.  These tools help ensure no medical condition is missed.  These may include the Edinburgh Post-Partum Depression screening, the MCHAT screening for autism, and other similar screenings.  These may not be covered by some insurance plans, resulting in a patient responsibility.  If you have a concern about these assessments, please discuss them with your provider during your visit.

Little Flower Family Medicine does not use e-mail for communication between physicians and patients due to the potential insecurity. 

Instead, registered patients should use the secure Updox Patient Portal for non-urgent communication with the office, such as:
  • Making/cancelling appointments
  • Medical/follow up questions, or any communication with your doctor
  • Receiving forms/documents
  • Registering newborn children

For more detailed information on using the Portal system, please visit the Patient Portal page

All communication through the Portal system is only responded to during office hours.

An E-Visit is a "virtual visit" using a secure webcam video.  The visits are perfect for issues which may need in-depth discussion, but do not require a physical exam. Examples include:
  • discussion of cholesterol results
  •  requesting /renewing perscriptions
  • troubleshooting some breastfeeding problems
  • or a visit for a stable, chronic thyroid condition.

Fees for an e-visit are as follows:

  • $65.08 for visits less than 15 minutes and $108.39 for visits 16 - 30 minutes
  • $20 for the cost of each progesterone follow-up communication

If you are interested in a Virtual Office Visit please contact the doctor through the portal and specify the condition you would like addressed. The doctor will let you know if the visit is appropriate or if you need an in-person visit.

Little Flower Family Medicine neither prescribes nor refers for contraception or sterilization. The office recommends Natural Family Planning (NFP) for family planning needs.  For more details on NFP, please visit the NaPro Technology page.

Breastfeeding medicine and lactation consultations involve the treatment of both the mother and child.  For this reason these visits will be conducted as two visits with two separate fees or co-pays, one for the mother and one for the child.  Exceptions may be made by the physician only at the time of the visit should the physician conclude that the evaluation of one member of the dyad was not needed.  If your insurance company requires a referral, it is your responsibility to make sure this is received by the office prior to the Breastfeeding medicine visit.

Little Flower Family Medicine does provide vaccinations for patients of the practice. For some vaccines that are not given frequently, such as some travel vaccinations, patients may be referred to a nurse vaccine service that makes home visits.

Little Flower physicians write prescriptions with sufficient refills to last until the doctor would next like to see the patient for follow-up. When you note that you do not have any refills left on a prescription, please schedule an appointment so that you do not run out of your medication.

Should an extenuating circumstance necessitate a refill outside of an office visit, please contact your doctor through the Portal system.

For urgent concerns call the office at 636-875-1140. If no one is available to answer, calls will go directly to voicemail which are transcribed and emailed to the doctor(s). The doctor will return calls as the urgency requires.

If you have a medical emergency, please call 911 or go to your nearest emergency room.

For all other non-urgent concerns, please use the Portal system (see the communication/e-mail policy).

Upon request, a paper or electronic copy of all or a portion of your medical records can be provided to you with a $10.00 charge plus a fee of $0.25 per page.

Dr. Grawey only practices outpatient medicine.  In the event that a patient requires admission to the hospital, the patient will be under the care of a hospitalist, a physician who specializes in inpatient medicine.