New Patients
New Patient Forms
(Print your forms before your visit and save some time. Click on the icon.)
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Auto Accident Patient |
Insurance Patient |
Non-Insurance-Patient |
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We accept all types of new patients, and pride ourselves in making sure you understand what will occur at the time of the first visit and what your charges will be before arriving. We are always happy to call and verify your benefits so that you are aware of your costs and can be prepared, so that there are never any surprise charges at your initial visit.
New Patient Charges and Information You Must Know
(Based on our Time of Service Discount Contract)
Office Visit: $60.00 + X-rays (this depends on area that is being treated)
X-ray: $80.00 (cervical.... neck)
$100.00 (thoracic . . . middle back)
$100.00 (lumbar. . . .low back)
***Extremity x-rays are all different rates. We will quote at time of call.***
All return visits you pay $40.00 per visit (office visit only)(point of service fee).
Filing Your Visits On Your Insurance
**OUR OFFICE IS NOW SENDING CLAIMS ELECTRONICALLY**
**A copy of your insurance card is required, and it must be verified before seeing the Dr.**
IF YOU HAVE A DEDUCTIBLE, YOU ARE RESPONSIBLE FOR THE AMOUNT MET BY OUR OFFICE, TOWARD YOUR DEDUCTIBLE. IF YOU ARE UNABLE TO PAY ALL DEDUCTIBLE'S AT ONCE, THEN YOU MUST PAY THE OFFICE VISIT. Your cost depends on what deductible and co-pay apply per your insurance. If you have no deductible then you are only responsible for your co-pay at time of each visit. If you have a deductible you must pay the office visit and x-rays (above) at time of first visit, and then upon returning you must pay the existing office visit charge until deductible is met, then you go to your copay for any remaining visits.
*Below is a list of all insurance companies we are in-network with. If your company
is not on this list, please call us and we'll verify it for you!
Auto Accidents
All auto accidents will need to be verified and authorized before your initial visit. We agree to treat with no payment until settlement!
Information Needed For First Visit:
- Police Report (We Can Get Reports from Internet)
- Attorney Information (Will Assist You if One is Needed)
- Liability Insurance Information (Person At Fault, Caused the Accident)
- Patient's Auto Insurance Information (Pip/Medpay Information, Your Own)
Workers' Compensation
Information Needed to See Our Doctor:
- You must report your accident within 48 hours.
- After the initial visit with company doctor, you can choose a specialist of your choice.
- You may be required to see their company doctor one time. If you see that doctor more than one time, he becomes the doctor of record. Then a change of physician must be filed and approved.
- A workers' compensation authorization must be filled out before you can be seen by our doctors.
Medicare
We except assignment for Medicare, but it has specific guidelines that must be followed. Please call us and we will go over them with you. If you have secondary insurance, we must verify it as well.
PPO Provider for These Insurance Companies:
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*BLUE CROSS BLUE SHIELD *FEDERAL BCBS *PREMIERCARE *UNITED HEALTHCARE *QUALCHOICE *AETNA *CIGNA *NOVASYS *USABLE *HEALTHSCOPE *AMERICAN LIFECARE *FT SMITH CHOICE *MULTIPLAN *EHC *CORVEL CORP *GREAT WEST *FIRST HEALTH *PHCS *INTEGRATED HEALTH PLAN *PREFFERED COMMUNITY CHOICE *DEFINITY *AMERICAN PPO *LIFECARE INC. *SMC INC. *PRINCIPLE FINANCIAL GROUP *HEALTH ADVANTAGE *BLUE ADVANTAGE *NAT. COMP CARE * AMERICAN HEALTHCARE PROV. *OWCP *COMMUNITY CARE OF OK * HEALTH CHOICE *PPO PLUS *MUNICIPLE HEALTH |
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**If your Insurance Company is not on this list, call and we will verify it for you.** |
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