Patient Forms & Links
New Patient Form Forma de Paciente Nuevo Records Request Form
Questions About Your Bill
For billing questions call (407) 313-0044 and ask to speak with our medical billing specialist.
How long will it take to get things settled with the insurance company?
If you insurance requires a referral or authorization, please make sure we have received it prior to your appointment date. It is the patients responsibility to have a valid referral or authorization on the day of your appointment.
Do I have a copay, deductible or co-insurance due?
At the time of the visit, we are going to collect your estimated financial responsibility according to your insurance contract. We recommend you become familiar with the following terms: Copay, Co-insurance, and deductible. After your office visit, we will send the claim to your insurance company. Sometimes, we may under charge and your insurance will make you responsible for a different amount, in those cases you will receive a bill from our office. If we over charged you, your insurance will let us know and we will reimburse you the over charged amount. Remember to review your explanation of benefits from your insurance.
Why did I receive a bill for my missed appointment?
We understand that emergencies can occur that require you to reschedule your appointment. When you do not cancel your appointment it affects other patients who wish to be seen and cannot due to limited availability. A charge of $25 will be applied to your account for events that are not canceled in advance. In the event that you cancel or reschedule your appointment we ask you to do with 24 hours in advance to avoid any charges.
Patient Education Resources
- Cigna -Cigna Alligence (Orlando Health) Cigna Springs
- Blue Cross Blue Shield (Except Blue Select)
- United Healthcare
- Tricare (only as a secondary insurance)
- Golden Rule
- Tufts Carelink Insurance
-Self Pay Options available for those without insurance