XXXXXX
Dear New Patient,
Please complete the enclosed questionnaire and bring it to your appointment on ______
In order for your doctor to assess your medical needs, please answer all questions pertinent to you. We may have to reschedule you if paperwork is not completed. Please bring insurance card, photo ID and co-pay with you.
We do realize that the wait to be seen in our office can be quite lengthy. We try to accommodate each person as best as we can. If for any reason you can not make your appointment with us, please contact our office a minimum of 24 hours before your scheduled appointment as a courtesy to us and to others waiting to be seen. There is a fee for no shows or late cancellations. Thank you.
It is very important that the doctor have copies of your previous medical records for evaluating your condition. Please bring a copy of your medical records with you to your appointment with us including: primary care & consultant physician’s notes, lab results, X-ray films, CT Scan, MRI, and other imaging reports.. We have attached a medical records request form for your convenience, please fill it out and forward to your physicians office in time for you to receive your records prior to your appointment with our providers.
Please bring a copy of all medications you are taking.
We do expect you to be familiar with your own insurance coverage. If referrals are required by your insurance policy, it is your responsibility to arrange for a current referral to be in place for your office visit. If pre-certification is required by your insurance company for a bone-density test in our office, please arrange for this with your ordering physician’s office. In order to avoid any complications or misunderstandings, we ask that you arrange for a hard copy of the referral or a phone call from your referring doctor’s office to be forwarded to our office prior to your visit.
If you are covered by Medicare, you should be informed that our office is Medicare non-accept assignment. This means that you will be responsible for payment at the time of service. We will then bill Medicare and Medicare will reimburse you directly.
If you have any questions, please feel free to give our office a call. We look forward to meeting you.
Sincerely,
______M.D.
Meridian Rheumatology Associates
9570 South Kingston Court, #220, Englewood, Colorado 80112
Phone: 303-762-6300, Fax: 303-703-0169
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