This form is for initial contact purposes. All information provided to us, whether verbally or in writing, will be held in strict confidence and will not be sold/marketed by Beringer Medical Group, PLLC (the "Group"). This form does not constitute enrollment in any programs, memberships, or covered services of the Group. An initial meeting with the Group is necessary to proceed with actual enrollment with the Group. Additional forms and documents will be required for enrollment purposes.
The Group provides retainer based medical care services for an annual membership fee. This fee is not covered by insurance or Medicare/Medicaid. The Group does not accept private insurance and has opted out of participation with CMS Medicare/Medicaid programs. Your insurance or medicare provider should still be utilized to cover any services received outside of those items covered by us, such as third party referrals, lab work, hospitalization, prescriptions, etc. More information is available on our website.