new or returning patients

INSURANCE BILLING AND PAYMENT OPTIONS

HMO/ PPO and Medicare Plans

  We will accept any other PPO plan; however, if we are not in-network with the PPO, the patient may be responsible for a larger portion than if they see a physician that is in their network.

   HMO

    Unfortunately, we cannot bill HMOs that are out of network. If we are not in network, the insurance company will not cover the cost of your visit.  

We accept checks, cash, or credit cards. We expect copayments at the time of service and also expect prompt payment of outstanding balances.

We do offer a financial hardship self pay discount, if you do not have insurance at the time of your visit. We provide this option, to aid in making healthcare affordable for our patients. Please contact us for details.

new patient information

Insurance Info

  • If you have an HMO please contact your insurance to confirm plan participation.

  • Medicaid patients, please contact your insurance and make our office is your PCP

NEW PATIENT FORMS

Please download and print this form and bring it to your visit; or click the link to complete the form online.

What to Bring to your visit

  • Medication bottles or Medication list

  • Hospital/ER discharge paperwork

  • Medical Records

  • ID (any type, government issued preferred)

  • Insurance card (if applicable)

 Phone/Verbal Consent

Please download and print this form and bring it to your visit; or click the link to complete the form online.  This consent will doc­u­ment the pre­ferred phone num­bers to con­tact you and whether or not our staff can leave detailed mes­sages. Also use this form to list any person(s) with whom we may share details about your care, includ­ing billing infor­ma­tion. Please indi­cate whether this may include sen­si­tive health infor­ma­tion (SHI) such as men­tal health, drug and/or alco­hol abuse treat­ment, and sex­u­al­ly trans­mit­ted dis­ease (STDs) includ­ing HIV/AIDS.

Below are the other patient forms needed for your visit:

Patient information
Consent for Medical Treatment
Insurance/Payment Authorization
Notice of Privacy Practices Acknowledgment
Patient Rights & Responsibilities

Cancellation Policy/ Charges for Missed Visits

We kindly request a 24 hour notice if you need to cancel an appointment. Missed appointments without prior cancellation may be subject to a charge.

Request­ing Med­ical Records

Please note that some of the infor­ma­tion you are request­ing may be avail­able online in our patient por­tal.  We are unable to release records to other facilities without your permission.  To obtain copies of your med­ical records, you must com­plete a paper autho­riza­tion form.  This form can be down­loaded, printed, and mailed/faxed to our office, or you can request that a form be sent to you by US Mail.

To have a copy of your med­ical records sent to S.T.A.R.S. Healthcare Center from anoth­er facility, please con­tact that provider/facility directly.