Confidentiality and Medical Records
All of your medical records are confidential and will be only released upon your written request. Please note that we cannot communicate or release medical information to family members (i.e., parents, husband) without written permission of the patient, unless the patient is a minor child. Click here to read our complete Privacy Statement.
Medical Consent
Minor children cannot receive medical services without the written consent of a parent or legal guardian. If you cannot accompany your child to the appointment, please make arrangements with the office for written consent for treatment prior to the appointment.
Financial Policy
Payment is expected at the time of your office visit. For your convenience, we accept cash, debit cards, personal checks, money orders, Discover®, MasterCard®, Visa® or American Express® for payment.
If, at any time, you have any questions regarding your account, treatment fees, or insurance, please speak with our billing department.
In order to provide you with the best possible care, we need the most up-to-date information about you. If you are a new patient, we will need a registration form prior to your appointment.
When you come in for your appointment, you may be asked to sign a separate release form authorizing us to submit billing information to your insurance company. If you have any other questions, we will be happy to assist you at that time. Please remember to bring your insurance cards with you along with this form.
Insurance
After your visit, our staff will submit the health insurance claims for you for any services rendered. Because current insurance information is vital for proper claim submission, we ask that you present your insurance cards at each visit. If you have HMO or PPO insurance coverage, please check with your provider directory or call your insurance customer service department to see if our doctors are listed as participating in your plan.
As a courtesy to you, our staff will initiate the precertification process for hospital services and procedures. (Disability claim forms are completed for a nominal fee.)
Your insurance contract is between you and your insurance company. If any insurance claims are outstanding beyond 30 days, please contact your insurance carrier.
Prescription Refills
When you need to refill a prescription, please call your pharmacy first to see if it is renewable. If it is not renewable, please call during office hours to request a refill of the prescription. Most prescriptions require re-evaluation of the patient on a yearly basis prior to renewal of medication.
New Patient Information
You can save time at your initial appointment by printing and completing the patient information form and the Medical History From below. Please bring the completed form along with your insurance card/s to your first appointment.