NEW PATIENT INFORMATION

We are pleased you have chosen our practice, and we look forward to meeting you. This page outlines our appointment, insurance and payment policies to help you prepare for your visit.

For your first visit:

• Register online with Intuit Health Portal.
• Please fill out the patient information form (PATIENT FORM - CLICK HERE) and bring it with you, along with your insurance card(s).
• If you are a new Aesthetic/ nonsurgical patient, you will have additional treatment specific forms to complete.
• Bring any test results or radiology films that relate to your visit. If your HMO, Medicaid or Workers' Compensation carrier requires authorization from your primary care physician, be sure you have a referral authorization at the time of your appointment.
• Plan to arrive at least 15 minutes early to check in so we can process your information.
• Bring insurance information to your appointment.
• If you cannot keep an appointment, please contact us at least 24 hours in advance by calling 734-712-2323.

Insurance and Fees

We participate with the following insurance carriers:

• Auto Insurance
• Blue Cross/ Blue Shield
  
• Blue Care Network
  
• Champus/ Tricare (Military)
  
• HAP
  
• Health Plus
  
• Medicaid
  
• Medicare
  
• Medicare Advantage
  
• Priority Health
  
• Washtenaw Health Plan
  
• Worker's Compensation

This list is not all-inclusive, so please call our office at 734-712-2323 for a complete list of insurances providers that we participate with.

Most HMO, Medicaid and Workers' Compensation carriers require a referral authorization from a primary care physician or employer before service is rendered. If we do not receive this authorization, you are responsible for payment at the time of service.

Office visit fees and copays are due at the time of service. We do accept "assignment" (the insurance carrier's payment) for many medically necessary procedures. Medical necessity is determined by your surgeon, and you will be able to discuss your financial responsibilities with your patient representative at our office.

Before your visit, contact your insurance carrier about:

• Your coverage, co-pays and deductibles
  
• Any Required authorizations
  
• Any out-of-network restrictions and/or costs

This will help you avoid unexpected out-of-pocket expenses.

We file claims for medically necessary procedures only. Referral authorizations received after services are rendered will not be processed. We accept cash, personal checks, VISA and MasterCard. Financing is available through an outside source.

For more information please call 734-712-2323 or contact us.