Patient Information:
On the day of your appointment, please bring:
- Your insurance card and driver’s license
- Your completed Patient Information Form
- Your completed Review of Systems Form
- Your completed New Patient Questionnaire, if applicable
- Your list of questions or concerns
- Your copay, if required by your insurance
About your appointment:
If you are not able to keep your appointment, please notify our office.
We appreciate a 24 hour notice, if possible. There is a $25.00 no-show fee
charged to patients who do not provide notice of cancellation.
Insurances Accepted: (Major insurances are listed below-please contact us
if your insurance is not listed below for participation verification)
- BCBS
- HAP
- BCN
- Priority Health
- United Health Care
- Aetna
- Medicaid
- Great Lakes Health Care
- Confinity
- Medicare
- SmartHealth
Paying your bill:
Payment of co-pays and non-covered services are due at the time of service.
You will receive a statement from us showing your balance, after insurance
payments, on a monthly basis. Payment is due within 30 days after the
billing date.
For your convenience, we accept personal checks, Visa, Mastercard, and
Discover credit cards.
A 1.5% finance charge is applied to all balances that are not paid in full
within 90 days.
All billing questions may be directed to our billing department.
Patient Forms & Info
