CSGA Patient Information

Insurance Information

Payment
Payment is due at the time of service unless prior arrangements are made.

Medicare
We accept assignment on Medicare claims, which means the practice accepts what Medicare allows. The patient is responsible for what is not covered by secondary insurance and/or Medicare deductible.

Referrals
If a referral is required by your insurance company, please have it available in advance.

Insurance
We accept most insurances and HMOs. Please contact our office to inquire about a specific insurance company. At the time of your appointment or when surgery is scheduled, please provide us with a copy of your insurance card.

Past Due Accounts
If a bill is unpaid after 120 days, collection proceedings may commence unless prior arrangements are made with our Business Manager.

Medical Records

Click here to fill out a Medical Records Release form. Please complete this document and bring to your scheduled appointment.

How often can I get a copy of my medical records?
Federal and State laws allow everyone to have one copy of their medical records. If you want additional copied there will be a charge of $1.00 per page payable before copies are released.

Is there a charge to fill out disability papers?
Disability forms charge is $20.00. Please allow a minimum of 2 week.

Is there a charge to fill out Workers Compensation forms?
We will be happy to fill out any forms needed but there will be a charge of .50¢ per page for medical records.

Patient Privacy

Click here to view our Notice of Privacy Practices form.

Diet Information

Based on your individual situation, your physician may suggest that you follow one of the diets below: