Back

Center for Urogynecology - Resources

To make an appointment, call

407-296-1990

Resources

We are dedicated to providing quality personal health care to each of our patients. Below, you will find additional information regarding your upcoming appointment.

New Patients

In order to facilitate your first visit, please print and complete the confidential patient information form prior to your appointment.

We ask that you arrive 30 minutes prior to your scheduled appointment time so that our staff may prepare your chart. Failure to arrive in advance may result in rescheduling of your appointment.

Please bring the following information with you:

  • Most current insurance card
  • Driver’s license or state-issued identification with correct/current legal name
  • Your medications (in original containers) and/or a list of your medications
  • Previous medical records, if this is a consultation or second opinion
  • Referral from your primary care, if necessary
  • Payment is due at the time of your appointment.  We accept: cash, check, Visa, MasterCard, Discover and American Express.

Established Patients

We ask that you arrive 15 minutes prior to your scheduled appointment time so that our staff may prepare your chart.  Failure to arrive in advance may result in rescheduling of your appointment.    Please bring the following information with you:

  • Most current insurance card
  • Driver’s license or state-issued identification with correct/current legal name
  • Your medications (in original containers) and/or a list of your medications
  • Referral from your primary care, if necessary
  • Payment is due at the time of your appointment.  We accept: cash, check, Visa, MasterCard, Discover and American Express.

Minors

If the patient is younger than 18, a legal guardian must be present. If someone other than a legal guardian, a notarized letter must accompany him or her. The patient information form must be completed by the adult attending appointment, and he or she is responsible for the bills incurred.

Cancellations

We require a 24-hour cancellation notice. If you do not notify us within 24 hours before your appointment, there will be a charge of $25 for office appointments and a charge of $75 for office procedures.

Insurance

As a courtesy, we file most insurances. It is your responsibility to make sure we are providers for your insurance company’s network and that you have the proper authorizations or referrals needed to meet your insurance carrier requirements. You will be responsible at the time of service for any monies your insurance company determines as your responsibility.

Your health insurance is a contract between the insured and the insurance company. Please be aware that not all insurance coverage is the same.

HMO or PPO Plans

If you are a member of an HMO or PPO plan, please let our receptionist know so that the proper forms and authorizations can be obtained to assure payment of your treatment. We share the concern of our patients about the cost of medical care and participate with many of our local programs. You are responsible for obtaining your authorization if required.  Copayments will be collected upon registering with the receptionist.

Medicare Patients

Our office has made an agreement with the Medicare program to accept assignment on all Medicare claims. This means we will submit all Medicare claims and accept (as payment in full) their approved charges. Medicare patients will be billed for non-covered services, their deductible and 20 percent co-insurance.

Participating Plans

  • Aetna
  • AvMed
  • Beechstreet
  • Blue Cross/Blue Shield
  • Care Plus Health Plans, Inc
  • Cigna Healthcare
  • Coventry/First Health
  • Evolutions
  • Freedom Health
  • Great West Healthcare
  • Healthchoice
  • Humana
  • Medicare
  • Multiplan Network
  • Physicians United Plan
  • Private Healthcare Systems
  • Tricare Standard
  • United Healthcare

This is a general list and is not a guarantee. It is the responsibility of the patient to confirm if our doctor is on their insurance’s “In-Network” list of providers. There are insurance plans that have a different “In-Network” list of providers for each product they sell.  Please check with your insurance company before making an appointment.

Medical Records
Medical Records are a permanent part of your medical record. We do not release our originals. These are not copied on demand or at the time of office visits. You must complete a medical release form in advance. There is a fee of $1 per page for the first 25 pages and 25 cents per page thereafter.

Doctor of Osteopathic Medicine

Minimally Invasive Surgery

Urogynecology

Menopausal Management