Coastal Physicians and Surgeons, P.C.



Thursday, August 28 2008

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INITIAL VISIT REGISTRATION
Welcome! Your first visit to Coastal Physicians will require you to provide us with information to create your patient record. We will need you to fill out a form that gives the doctor necessary details regarding your address, phone number, date of birth, social security number, occupation, emergency contact and referring physician. Our staff will assist you as needed and all the information you provide to us will be kept confidential.

INSURANCE
We will submit the fees for your office visit to your insurance carrier(s) for reimbursement on your behalf and continue to follow up until all of the benefits you are entitled to get paid. All deductibles and any non-covered portion of your bill will then be your responsibility. Your co-pay (if applicable) is due the same day the services are rendered.
Information you will need to provide for us:
* Type of insurance
  • Insurance company name (please bring your card)
  • Policy & group numbers (if not shown on card)
    * Mailing address to submit claims
    * For Worker's Compensation, we will need your employer's phone number
    * If your insurance is a managed care product, you may need to bring a referral from your family doctor before our physicians can see you. If you are not sure you need a referral, you should call your insurance company and they will tell you what is required by your benefit plan.

    PRESCRIPTIONS
    Medication may be prescribed as part of your treatment plan. It would be very helpful if you know the phone number of your pharmacy. When you need to call our office regarding refills please call during regular office hours so, we can refer to your chart. Our office hours are 8:30 am to 5:30pm, Monday through Friday.

    APPOINTMENTS
    We will do our best to accommodate your schedule when making your appointments and we will appreciate you arriving on time. Our staff will make every effort to have the doctor see you as scheduled, if an emergency does occur; we will inform you as far in advance as possible. If you need to cancel, please call as soon as possible to reschedule, this will enable us to bring in another patient needing to see one of our doctors.



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