Patient Information and Forms
About your Visit
Thank you for choosing us for your healthcare needs. All patients are expected to arrive with Photo ID, Insurance Card and complete New Patient Forms if you are available to download and print the forms. Failure to provide correct information at the time of your visit could result in having to reschedule the appointment or the cost of the visit would be your responsibility.
Please excuse any delays. We will do our best to see you at your designated appointment time as we recognize your time is valuable. We will give you the same careful attention as soon as possible. As a courtesy to other patients and staff, please call the office as soon as possible if you are unable to keep your appointment or are going to be late. We may be able to reschedule your appointment for a later time that day; however, due to the schedule, this may not be possible and you may need to reschedule for another day.
Our office will submit a claim for any service rendered to the patient. If you have a secondary insurance payer we will automatically file a claim with them also. It is the patient's responsibility to provide our office with all insurance information.
Payment of co-payment, deductibles and co-insurance are due at the time of your visit. Any remaining balance on your account after the insurance company has processed your claim is due at the time upon receipt of a statement from our office. For our patients with no medical insurance, payment will be due at the time of service.
Methods of Payments
Cash, Check, Visa, Mastercard. American Express, Discover and some HRA Debit/Credit Cards are acceptable methods of payment. Also we accept over the phone payments. We also accept CareCredit to help with your financial needs. There is a charge for a returned check and balance must be paid before another appointment is made.
Fees for obstetrical care are billed globally and include routine prenatal care (normally 13 to 15 visits), vaginal or cesarean delivery and routine postpartum care following delivery (normally includes 1 to 2 visits depending on type of delivery). Additional fees may be assessed for any other test or procedure rendered during your obstetrical care. We offer payment plans for these services.
Surgical fees may vary depending on the procedure performed. Any required pre-operative testing or facility fees are not included in our fee and will be billed by other service providers. You may be required to pay copay's and deductibles before services are rendered. If you are unable to pay any remaining balances after surgery, we offer plans to assist you with payment.
Download, print and complete the forms to bring to your visit if you are a new patient.