Authorization Form: This form allows us to receive information and talk with a provider of service such as doctor, hospital or laboratory.
Click here to open the Authorization Form
Authorization For Medicare: This form allows us to speak with Medicare freely about your medical claims and your policy. They keep this authorization on file so that we can contact them at any time. This form does not allow us to speak with Social Security who mandates Medicare, so if we need to deal with Social Security, then you would need to contact them to give verbal permission for us to speak with them.
Click here to open the Authorization For Medicare Form
Personal Information Form: This form gives us pertinent information about your insurance so we have policy and identification numbers available as well as addresses and phone numbers. Be assured, we DO NOT share this personal information with anyone outside YOUR insurance companies and providers of service. By giving this information to them, it is only identifying who you are as a client when we speak to them and confirming they have the correct account when we contact them.
Click here to open the Personal Information Form
Paper Disposal: This form lets us know your intention of all hard copies at the end of the year. We will either return them to you or dispose of them. If you do not wish to have your paperwork returned at the end of each year but wish to have hard copies for yourself, we recommend you keep a photocopy for yourself and send us the originals, because many times there is very valuable information on the back side of a claim form that would get missed if it is not copied and sent to us.