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New
Patients or Patients with a change of
address or insurance policy must
fill out a patient information form prior
to seeing the doctor. |
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We will need to photocopy
your insurance card(s) for your file. |
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CoPayments
- By law we MUST collect your carrier
designated copay at the time of service.
Please be prepared to pay that co-pay
at each visit. |
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Non-CoPay Plans
- If your plan does not require a copay
and we participate, we will accept the
designated fee. You are responsible for
any deductible and balance your plan indicated
on their explanation of benefits. |
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Non Plan Patients
- Payment is expected at the time of service
unless other financial arrangements have
been made prior to your visit. Your itemized
receipt should be attached to your insurance
form and sent to your carrier who will
reimburse you directly. |
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Medicare
- We will submit to Medicare for the Medicare
allowed amount. The patient will be responsible
for the deductible and the 20% co-insurance
which can be billed to secondary insurnace
if you have one. |
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You
are responsible for the timely payment
of your account. |
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We
accept cash, checks or credit cards. |