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■ YOUR COMPLETED REGISTRATION FORMS - Be sure to bring your completed patient information forms. Completing these forms prior to your appointment date gives you the time to gather necessary information and makes your wait to see the doctor shorter. ■ YOUR CURRENT MEDICATION LIST - Please list all of the medications that you are currently taking and their dosage on your forms. It is vital for us to know exactly what you are taking, how often, its strength, and the physician who prescribed it. Sometimes the pharmacy bottles will provide us with all of this information. ■ YOUR CURRENT INSURANCE CARD/S AND CO-PAY OR COINSURANCE - We scan your insurance card into our system to have on file. Please make us aware if there has been a change in your coverage or carrier. Co-pays, deductibles and co-insurance amounts will be collected before you are seen by the physician. Failure to pay your co-pay or co-insurance will result in your appointment being rescheduled. ■ YOUR PHOTO IDENTIFICATION - To help protect you from becoming a victim of Identity Theft, our practice will verify the identity of all new and returning patients of the practice; therefore, requiring a photo ID at each visit. Additionally, federal law requires all health care practices to obtain, verify and record information that identifies each new patient. ■ YOUR REFERRAL FROM YOUR PRIMARY CARE PHYSICIAN (if your insurance carrier requires it) - If your insurance requires authorization to see a specialist it is your responsibility to make sure this is received in our office prior to your appointment. Your visit will be rescheduled or a wavier must be signed making you responsible for payment if authorization is not obtained prior to seeing the physician. ■ BRING ALL MRI AND X-RAY FILM AND /OR CD’S THAT PERTAIN TO YOUR CURRENT ILLNESS - Diagnostic studies are essential to a complete examination. If you have had an MRI, CT, Myelogram, Arteriogram, or plain x-ray completed in the last five years, bring the films or CD and reports with you. It is usually necessary to contact the location where the tests were completed. Ask them to ready your studies (both films and reports) for you to pick up. It is a good idea to pick up your studies prior to the date of your appointment. DO NOT depend on a doctor's office, courier service, or testing center, to send them. Diagnostic tests, such as blood work, EMG, Nerve Conduction Study, etc., do not use films. But, the results are equally important. If you have had a recent test in these areas, please bring those reports with you as well. ■ PLEASE BRING ANY RECORDS FROM YOUR REFERRING PHYSICIAN IF NOT ALREADY PROVIDED -If you have seen another physician regarding the same condition, it is important that you bring all pertinent medical records with you. It is particularly helpful for you to bring your doctor's notes regarding medications, treatments, physical therapy, test results, etc. If you would like the doctor's office to fax the notes to us, our fax number is (919) 783-7778. Ask them to include on the cover sheet your name, the date of your upcoming appointment, and the name of the physician you will be seeing. ■ IF YOU DO NOT HAVE INSURANCE, BE PREPARED TO PAY FOR YOUR VISIT AT THE TIME OF SERVICE - On average, office visits are $110.00 for established patients and $220.00 for new patients. Your appointment will be rescheduled if you are unable to pay for your visit at the time of service. |
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