Financial Policy
Office Visits
Surgery, ENGs, Allergy Testing, In-Office Imaging
Insurance Coverage
Liability Actions, Third Party Payers
If you have any questions about our FINANCIAL POLICY or your health care insurance, please call our Business Office at 817-952-5508.
Outstanding Balance
Fees for Forms
Any paperwork to be completed by the physician or physician delegate at the request of the patient can generate a fee which is not covered by insurance. Payment is due at the time forms are dropped off, and is to be collected prior to completion.
- FMLA forms- $25.00 per set of forms
- Disability forms- $75.00 per set of forms
- All other form requests- $10.00 per set of forms
Cancellation Policy
Medical Records
Medical records are handled through an outsourced 3rd party. Please contact Vital Chart at 972-399-0914 to request copies of your records. You can also, contact them directly at www.vitalrecordscontrol.com. Click Request Medical Records.
For CT scans done in office, please contact 817-952-5508 to request a copy. There is a $25 fee for the CT scan disc.
Please note that we have up to 15 days to complete records requests in the State of Texas.
If you have any questions about our FINANCIAL POLICY, please call our Business Office at 817-952-5508. If you have questions regarding your insurance benefits or network providers, please contact your insurance carrier directly.
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