NEEL RAYA MD INC.
NEW
PATIENTS
We
request the following from new patients
·
Fill & sign – NEW PATIENT PAPERWORK – (click here to download) Patient
information, Authorizations, HIPAA, Old
record release request, patient
history form · Arrive 30 minutes before scheduled appointment
time.
·
Bring your insurance card - We will call your
insurance company to verify coverage & deductibles - any deductibles will
need to be paid prior to being seen - if payment not made we reserve the right to cancel/reschedule the
appointment.
·
We reserve the right to charge $175 at visit to the
NEW PATIENT while waiting for the insurance to pay, this will be applied as a
credit after payment is received from the insurance company and refund of
credit can be issued.
· Copays & Deductibles are due prior to the visit; we will not bill you for this. We accept cash, checks; Credit cards involve a transaction fee.
·
HSA (Health Savings Accounts), Insurance cards with
VISA logo will be considered as self-pay and we will charge them at
appointment, we will also submit the charge to your Health Insurance company
and after we receive the EOB the account will be appropriately
charged/credited.
·
Bring any previous medical records if available.
·
Bring ALL your medication BOTTLES (just a LIST is
not enough).