Hassle-Free Insurance Filing and Forms
Insurance Information
As a service to our patients, we will file standardized insurance claim forms to all insurance carriers for primary, secondary, and tertiary carriers. It is the patient's responsibility to determine whether our services will be covered by their plan and obtain any necessary referrals prior to their scheduled appointment. The patient remains responsible for any charges remaining after insurance payment and for any non-covered services. You will begin receiving a monthly bill once we have received payment from your insurance.
Forms
Provided below are various forms that require completion prior to your visit and/or surgery. Please download the appropriate form as directed by your physician and/or staff by clicking on the name of the form. If you cannot access the form, please click on the Adobe box. This will allow you to download this software, providing access to the forms. Please bring the completed form/s with you to your scheduled visit. This will help expedite the registration process. Thank you.
If you cannot access the forms you can click on the icon to download the software.
Fees & Payments
We make every effort to decrease the cost of your medical care. Therefore, we request payment arrangements for all office services at the time they are rendered unless prior arrangements have been made. We accept cash, checks, MasterCard, and Visa for your convenience. Co-pays are due upon arrival. If we are a participating provider of your insurance company, we will bill them. However, payment is the patient's responsibility. We will help in any way we can to assist you in handling claims.
Prescriptions & Renewals
Please request all prescriptions and authorizations for renewals during our office hours, when our full records are available. Renewals requested at other times will be filled only for extreme or emergent circumstances.
| Preview | Attachment | Size |
|---|---|---|
| Medical History Form.pdf | 26.54 KB | |
| Medical Release Form.pdf | 6.49 KB | |
| Health Record Privacy Notice.pdf | 41.47 KB |