Call 325-703-6670
  Call  325-703-6670

Insurance Information

We accept most types of insurance.  We will bill your visit directly to your insurance provider if you supply an updated proof of insurance at each visit. Please check with us to see if our practice is included in your health insurance network.  Also, if we are not your Primary Care Provider (PCP), and you want to be seen for an acute problem, please verify before your visit whether you require a referral from your PCP. 

 

The office will file your insurance claim for you.  You are responsible for any co-pay prior to seeing the nurse practitioner.  Any amount not covered by your insurance policy is due immediately after you receive your first invoice from us.


MEDICARE: For Medicare patients, as a courtesy, we will also bill your secondary insurance provider directly. You may be asked to sign an Advanced Beneficiary Notice for services not covered under Medicare. You shall be accountable for covering these services if they are not paid for by your insurance providers.

Call: 325-703-6670

Our business hours

Monday - Thursday08:00 AM - 12:00 PM
01:00 PM - 05:00 PM
Friday08:00 AM - 02:00 PM
If you have an emergency outside of business hours, please go to the nearest Emergency room. If you have a problem that can not wait until regular business hours, please go to an urgent care clinic or ER; otherwise, leave a message and we will get back with you promptly during regular business hours.

Patient Registration Information
PatientRegistrationForm.pdf
Adobe Acrobat document [163.4 KB]
Assignment of Benefits Form
Assignment of Benefits Form.pdf
Adobe Acrobat document [158.4 KB]
Authorization for release of Medical Information
Authorization-for-release-of-Medical-Inf[...]
Adobe Acrobat document [131.9 KB]
Authorization to Release Medical Information to Family Member
Authorization to release medical info to[...]
Adobe Acrobat document [57.9 KB]
HIPAA Privacy Rules and Notice
HIPAA Privacy Rules and Notice.pdf
Adobe Acrobat document [285.9 KB]
Privacy Practices Acknowledgment
Privacy Practices Acknowledgment.pdf
Adobe Acrobat document [77.1 KB]

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