In order to ensure a smooth process with your visit, we must obtain proper information from you.


  • Scheduling and Registration
    • Verification of Date of Birth, Address, Phone Numbers & Insurance
    • At each appointment, we will ask to see your insurance card and a form of picture identification. Please have your insurance information ready upon check-in.
    • Subscriber (Policy Holder) for Insurance-If you are a dependent under the policy, we will need the subscriber information-Full Name, DOB and relationship to subscriber.


  • Copay
    • It is our responsibility to your insurance company to collect any copay amounts at the time of service. Please have your payment at each visit to avoid the possibility of rescheduling your appointment.
  • Balances and Deductibles
    • Any outstanding balances are expected at the time of service unless prior arrangements have been made.
  • For your Information
    • You will receive a statement for your current services each month for any outstanding balances.
    • We recommend you keep a record of your health care by following the Explanation of Benefits (EOB) provided by your insurance company. The EOB identifies the financial responsibility of the insurance plan along with any negotiated discounts between our office and the insurance company, leaving the remaining balance to you.
    • Amounts billed to the patient are expected to be paid within 30 days. If you should need additional payment options, please contact our office for additional assistance.
    • All payments are applied to the oldest invoices first unless specified to avoid any collection activity.
    • It is the patient’s responsibility to understand his/her benefit plan. We recommend you contact your insurance company prior to receiving any services to verify your level of coverage and provider participation. As a courtesy, we also verify the office visit benefits prior to your visit.
    • We do not bill for auto related accidents. We will collect the fees from you at the time of service and provide an invoice to be forwarded to your insurance company by you.
    • If you need to cancel or reschedule an appointment, we ask that you kindly provide at least 24 hours notice so we can offer your time slot to another patient that needs to be seen.
    • Request Medical Records-click here for form. Medical records may be requested from our office. However, a medical records form must be completed along with pre-payment of medical records. Once payment is received please allow 10-14 business days for processing.
    • Medical Records Release Fees are as follow;
      • Pages 1-20: $25.00
      • Each page thereafter: $.50 w/a maximum charge of $50.00
    • If you need a referral, please contact our office at (972) 562-8388 and allow 72 business hours for completion.
    • Please provide us with: Full Name and spelling of Last Name, DOB, phone number, insurance, reason for referral, specialist name/facility w/ address and phone and fax number (scheduled appt time if available. NOTE: We cannot provide referrals for patients we have not seen. If this is a referral for a new condition, an appointment will be required.
    • How to request a prescription refill
      • Go to MY PAGE; Log in and complete refill request.
      • Have your pharmacy fax the refill request to (972) 540-2219
      • Call our office at (972) 562-8388 and choose option 3- please provide us with: Patient Name and spelling of last name, DOB, phone number, medication and dosage with directions, pharmacy and phone number.
      • Please allow 48 hours for your request to be processed. New prescriptions will require an office visit.