Your First Appointment
Insurance and Payment Information | Privacy Practices
Your First Appointment
Please bring the following:* Patient's insurance card
* Referral(s) and pre-authorization(s)
* List of current prescriptions and/or over-the-counter medication, including dose and frequency
* Information about patient's medical and surgical history
* Recent test results, x-rays, CT scans, or MRI scans: films, reports or relevant recordsDownload and bring the following New Patient Forms completed prior to your visit:
Acknowledgement of Receipt of Privacy PracticesAcknowledgement of Receipt of Privacy PracticesConsent for Use and Disclosure of Health InformationFinancial AgreementPatient HistoryPatient Information SheetOr please arrive early so that we can complete your initial paperwork.
Insurance and Payment Information
Dr. Mautner's is a provider for Aetna, United, Avmed, JMH, Careplus, Blue Cross, Vista, medicare and most major insurance plans, and provides insurance billing. You are responsible for co-payments or charges that are not covered by your insurance. If you have questions regarding billing or which insurance plans we accept, please contact us. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.Privacy Practices
Our Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. It is given to all new patients, and a copy is available to download or available upon request
