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Patient Information

Appointments

Please call the office during our normal business hours to schedule your appointment. If you need an appointment on the same day, you must call ahead to schedule. Should you not be able to call and obtain an appointment before arriving at the office, you will be assessed by a member of our clinical staff to determine if you are in need of immediate medical care. If you are in need, you will be worked in between our scheduled patients. If you do not have an immediate need, you will be given an appointment to be seen by your physician at a later time.

Please help us to direct our resources to patients who need our services by calling 24 hours in advance of your appointment to cancel or reschedule. If you fail to show for an appointment more than one time over a six-month period, your patient account will be assessed a $25 charge. If you have another no-show you could receive a dismissal letter from the practice. Please make every effort to make your appointment or call us at least 24 hours in advance to cancel or reschedule your appointment with us.

Prescription Refills

To expedite the refilling of your prescription, contact your pharmacy for a refill. Even if your prescription has expired, your pharmacy may obtain a new prescription by calling our office. Calling the office directly could result in a delay in obtaining the necessary refill. If your doctor has asked to visit with you prior to providing you with a refill, please contact the office to schedule an appointment within enough time to avoid a lapse in medication. Typically, there is a 48-hour wait for your refill. Medication refills will not be called in after normal business hours. If you will require a medication refill prior to your next scheduled visit, please inform your physician during your current visit.


Patient Forms

 

Patient Forms may be faxed to 336-521-4929 or can be brought in at your next visit.


Adult Patient Registration (English)
Adult Patient Registration (Spanish)
Adult Patient History
Acknowledgement of Receipt of Privacy Notice (English)
Acknowledgement of Receipt of Privacy Notice (Spanish)
Notice of Privacy Practices (English)
Notice of Privacy Practices (Spanish)
Questionnaire - Female Urinary Incontinence
International Prostate Symptom Score I-PSS

Patient Rights and Responsibilities (English)

Patient Rights and Responsibilities (Spanish)

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Insurance Participation
 

Accepted Insurance Plans 2023-2024

  • Aetna

  • AmeriHealth Caritas NEXT

  • Ambetter Exchange (Commercial Products ONLY)

  • BCBS

  • BCBS State Health Plan

  • BCBS State Health Plan Clear Pricing Project (CPP)

  • Blue Local Wake Forest/Randolph

  • Cigna/Great West

  • Cigna—RPN for Physical Therapy ONLY

  • Humana Military/TriCare East

  • MedCost

  • Medicaid

  • Managed Medicaid

    • AmeriHealth Caritas

    • Carolina Complete Health

    • Healthy Blue

    • UHC Community Plan

    • WellCare

  • Medicare

  • Multiplan

  • NC Health Choice

  • Railroad Medicare

  • VA CCN thru UHC/Optum (replaces TriWest)

  • United Health Care

    • All Savers Health Plan

    • Heritage UHC of River Valley

    • UHC Choice and Choice Plus

    • UHC Choice Advance & Advance Choice Plus

    • UHC Edge

    • UHC Navigate

    • UHC NexusACO

    • UHC Options PPO Plans

    • UHC Tiered Benefits Plan

    • UMR

    • UHC Compass HMO (Multiple Exchange Plans)

  • Workers Comp Carriers

    • Berkley Comp Care/Med Advantage

    • Clear Comp (PT only)                

    • Corvel/CorCare/Care IQ

    • Employer's Choice Network

    • Key Scripts

    • MedRisk

    • One Call Care (Formally Align)

    • Paradigm Specialty Networks

    • Reli (formerly Workwell)

    • Select Medical/RPN

    • SP Net Clinical Solutions

    • Sedgwick Provider Network (SPN)

    • US Department of Labor


Medicare Advantage Plans 2023-2024

  • AARP Medicare Complete Plan I, II & III

  • AARP Medicare Complete Choice (PPO)

  • AARP Medicare Complete (HMO)

  • AARP Medicare Complete Essential (HMO)

  • Advantra Gold Advantage

  • Aetna Medicare Premier Plan

  • Blue Medicare HMO & PPO

  • Cigna Medicare

  • Coventry Health Care

  • Devoted Health

  • Erickson Advantage Plans (UHC Product)

  • Health Team Advantage

  • Healthy Blue + Medicare

  • Humana Medicare

  • Liberty Medicare Advantage

  • Troy Medicare Advantage

  • United Health Care Dual Complete Plans

  • United Health Care Group Medicare Advantage Plans

  • WellCare Health Plans


HMO — Health Maintenance Organization have a defined network of contracted local physicians & hospitals to provide member care.

PPO — Preferred Provider Organization offer members access to a network of contracted physicians and hospitals, but also allow them the flexibility to seek covered services from outside of the contracted network, usually at a higher cost.


Insurance Participation is subject to change. If your insurance company is not listed above, please contact Patient Accounts at 336-625-6072 to verify if the coverage is accepted.

 

Please bring your insurance card to every visit so we can verify we have the correct information to properly file your visit to the insurance company. Let the receptionist know if your insurance, address, telephone number, emergency contact or employer has changed.

Questions Concerning Your Bill or Insurance

Should you have questions concerning your bill or insurance, please contact our Billing and Insurance Department at 336-625-6072. A courteous Patient Accounts Representative will handle your call.

General Questions, Policies and Additional Information

If you have any questions regarding your health care or our practice, please call us at 336-521-4928.

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