Tuesday, December 12, 2017

Monday – Friday, 8 a.m. – 5 p.m.

231.347.5155 • 800.968.5155

Patient Forms

In order to save time during the check in process, you are welcome to print, complete, and bring these forms to your scheduled appointment.

 

Resource Forms & Flyers 

 

 

Insurances 

We are formally participating physicians with:

  • Medicare & most Medicare HMO
  • Medicaid & most Medicaid HMO’s
  • BCBS of Michigan
  • Blue Care Network
  • Aetna/Cofinity
  • Tribal Insurance
  • Priority Health
  • Tricare Automobile & Workman’s Compensation

Payments

The patient is responsible for payment regarding medical services rendered including automotive, Workmens Compensation and liability claims.

To better assist you, please provide us with:

  • Insurance Carrier Name and Address
  • Insurance Adjustor’s Name and Address
  • Valid Claim Number

It is our policy to only bill insurance carriers or the patient. Claims denied become the patient’s financial responsibility.

Co-Pays and Deductibles

Co-pays and deductibles are due at the time services are rendered. Non-insured patients are offered a 10% discount for a full payment at the time services are rendered.

Patient Education 

Orthopaedic Links