If you have insurance that requires preauthorization you must notify the front office before each visit. It is your responsibility to ensure that your visits are authorized so that they will be covered by your insurance. We do NOT file secondary insurance.
I hereby authorize any information needed to be released to my insurance company for the sole purpose of authorizing and processing my claims. I understand that I am fully reponsible for my bill and will assume any charges not paid by my insurance company. I understand that I will be charged in full for any appointments not kept unless 24 hours notice is given to the office. I consent for treatment necessary for the care of the above named patient. I have read, understand, and agree to the office policies attached.