Patient Forms & Resources

Patient Forms

New Patient Forms

Insurance Billing

This list contains most of the insurance plans that we currently accept. Even if your insurance is not listed here, we may still be on your plan. Please call the office and we will check for you. If we are not a part of your insurance plan, we can still provide your care, but out-of-network benefits will apply. We will be happy to contact your provider to determine your out-of-network benefits.

  • ACCOUNTABLE PPO
  • AETNA HMO/POS/PPO
  • AFFILIATED HEALTHCARE PPO
  • BCBS HMO
  • BCBS PPO/POS/EPO
  • BEECH STREET PPO
  • CCNCHOICE
  • CARECIGNA PPO/HMO
  • FIRST HEALTH
  • GALLAGHER (UNDER PHCS)
  • GOLDEN RULEGREAT WEST HMO/PPO
  • HEALTHSMART PPO/POS/EPO
  • HUMANA ( UNDER CHOICE CARE)
  • MEDICARE
  • MULTIPLAN PPO
  • MUNICIPAL HEALTH PLANS
  • NTHN PPO/POS/EPO
  • ONE HEALTH PLAN HMO/PPO (UNDER GREAT WEST)
  • PACIFICARE PPO
  • PACIFICARE HMO
  • PHCS PPOPHCS
  • OPEN ACCESSPLAN
  • VISTA SOLUTIONSPPO
  • NEXT (HLTHSTAR, MED CONTROL, PREF HLTH)
  • PRO AMERICA PPO
  • PRO NET PPO
  • TEXAS TRUE CHOICE PPO
  • UNICARE PPO
  • UHC PPO/HMO/POS/EPO
  • UNITED AMERICAN INS CO

Billing Policies

  • Office charges are due and payable at the time of service.
  • Our Billing Office can help facilitate insurance claims and questions you may have. Accounts 60 days old are considered delinquent and those at 90 days will be reviewed for action.
  • Professional services are rendered to the patient, not an insurance company. Since every insurance plan is different, please be sure to check your coverage and ask questions before services are rendered. We are here to help in any way we can.
  • The doctor may perform certain procedures or services that are necessary as part of your evaluation and treatment, for example, a scopeof your nose or throat. Because this procedure, according to the American Medical Association, is considered an office surgery, your insurance company may or may not apply these procedures to your deductible. You will be responsible for your co-insurance at the time that services are rendered and also any portion of your bill that your insurance plan does not cover.
  • If you have questions about your specific insurance plan and your financial responsibility please ask one of the receptionists prior to seeing the doctor. Your insurance can deny payment for services or procedures after they are performed. We advise that you know the benefits of your individual plan.
  • Payment may be made by cash, check, Visa or MasterCard.The office participates in a variety of health insurance programs.
  • If you are a participant in a Managed Care program, you are expected to pay your co-payment at each visit. Failure to do so can result in action by your insurance carrier. Managed Care patients are liable for co-payments, per their carrier, for appointments not canceled in advance.
  • The Billing Office files claims for all carriers that we accept. Payments by the insurance carriers will be made directly to our office. They will provide you with an Explanation of Benefits (EOB) of the charges, amount covered by your policy, and payments made to our office on your behalf.
  • Your insurance may or may not allow a portion of your bill, the remaining balance is your responsibility. If you have a secondary plan, as a courtesy, the billing office will submit the primary payment information to the secondary carrier.
  • The Billing Office submits all Medicare claims for you. We also provide Medicare with your secondary insurance information. Through their crossover program, your secondary insurance will be billed directly by Medicare. Please check to see if your secondary insurance requires a signed waiver in order for this to happen. Our office will bill insurances not included in the crossover program.
  • You are responsible for yearly deductibles, non-covered services, and co-payments when there is no secondary insurance. As a courtesy, the Billing Office files claims to carriers that we do not accept. Payments by the insurance carriers may be sent directly to the patient instead of our office. It is the responsibility of the patient to remit payment to our office in these cases. If you have a secondary plan, as a courtesy, the billing office will submit the primary payment information to the secondary carrier.
  • Special consideration will be given to patients financially unable to pay in full at the time of service. Arrangements should be made in advance with the Billing Office.

Online Bill Payment

Coming Soon

Office Hours

Appointments. Patients are seen by appointment only, however, if there is an emergency, every effort will be made to provide care. Please call the office to schedule your appointment. Should you need to reschedule or cancel, please notify the office as quickly as possible.

Telephone Consultations.
 Patients are encouraged to call the office with questions they may have regarding medical problems. The office staff is trained to handle many of the questions you may have. If they are unable to answer a particular question, the Doctor will return your call.

Emergency Care.
 If you have a true emergency, please call 911. For other concerns, please do not hesitate to contact the office and explain the urgency of your call. After regular office hours, call the office number for instructions on how to reach one of our physicians on-call.

Office Hours

WeekdaysPhysicians*Audiologists
Monday9 am - 4:30 pm9 am - 4:30 pm
Tuesday9 am - 4:30 pm9 am - 4:30 pm
Wednesday9 am - 4:30 pm9 am - 4:30 pm
Thursday9 am - 4:30 pm9 am - 4:30 pm
Friday9 am - 4:00 pm9 am - 4:00 pm

*Not all physicians may be available at all times. Surgical hours are not reflected.

Billing Department hours are Monday – Thursday, 8:30 am – 5:00 pm; Friday, 8:30 am – 4:00 pm. Appointments are recommended. Please call ( 214) 382-5100.