We want to make every patient visit a pleasant and efficient experience. To help us reach this goal, please bring the following information with you for your appointment:
Authorization/Referral:If you are enrolled in a managed care plan, your insurance company may require you to obtain a referral or authorization from your primary care physician before your office visit or surgery. If we do not receive your referral in advance of your visit, you will be financially responsible for those services.
Photo Identification:
For security purposes, we require you to bring a valid driver's license or a current photo ID to every appointment.
Insurance Card/Billing Information:Be sure to bring your insurance identification card to each appointment. As a courtesy to our patients, we will bill your insurance company for office visits, injections, x-rays and surgical procedures. Based on your insurance or plan benefit coverage, it may be necessary to collect a deposit/co-pay at the time of each visit. Please contact your carrier prior to your visit to obtain complete benefit coverage information.
We accept cash, personal checks, debit cards, MasterCard, and Visa.
Radiology Films:Please be sure to bring all existing radiology films (hard copies and/or CDs) that relate to the medical condition for which you are being treated. This may include X-rays, CT scans and MRIs.
Completion of Forms:
We will charge a minimal fee for completing disability, FMLA, and other forms. There is also a fee for copying medical records and films.
Authorization/Referral:If you are enrolled in a managed care plan, your insurance company may require you to obtain a referral or authorization from your primary care physician before your office visit or surgery. If we do not receive your referral in advance of your visit, you will be financially responsible for those services.
Photo Identification:
For security purposes, we require you to bring a valid driver's license or a current photo ID to every appointment.
Insurance Card/Billing Information:Be sure to bring your insurance identification card to each appointment. As a courtesy to our patients, we will bill your insurance company for office visits, injections, x-rays and surgical procedures. Based on your insurance or plan benefit coverage, it may be necessary to collect a deposit/co-pay at the time of each visit. Please contact your carrier prior to your visit to obtain complete benefit coverage information.
We accept cash, personal checks, debit cards, MasterCard, and Visa.
Radiology Films:Please be sure to bring all existing radiology films (hard copies and/or CDs) that relate to the medical condition for which you are being treated. This may include X-rays, CT scans and MRIs.
Completion of Forms:
We will charge a minimal fee for completing disability, FMLA, and other forms. There is also a fee for copying medical records and films.
Office Policies
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Good Samaritan Pain Clinic®, P.C.
7011 Crider Road, Suite 101
Mars, PA 16046
Phone: (724) 591-5583 | Fax: (724) 591-5563
Good Samaritan Pain Clinic®, P.C.
7011 Crider Road, Suite 101
Mars, PA 16046
Phone: (724) 591-5583 | Fax: (724) 591-5563
