top of page
How is this supposed to go? The "Billing Information Form" (page 2 - linked above) gives detailed information about estimating your out-of-pocket expense, timelines, and what to expect through the billing process.
How much will this cost? Fill out the "Billing Information Form" and send it to our office with a copy of your insurance card. We will contact your insurance company and email you an estimate within 2 business days.
I need a statements / superbill / receipt! You can login to the Kareo Patient Portal (blue button above) to view your account, print a statement / superbill, and access details about your account and claims. If you need information in addition to the reports available in the Kareo Patient Portal, please send us a message, letting us know what you need, and we will do our best to make sure you get it.
These forms won't open! If you can't open our forms, you may not have a compatible PDF program. Click the "Free Adobe Reader DC" button to download a free Adobe Acrobat Reader program above.
How are we doing? We want to hear from you whether you think that the billing process was smooth as silk or a catastrophic train wreck. Please send your feedback to firstname.lastname@example.org so that it can be addressed proactively and appropriately. Feel free to include constructive criticism, suggestions, affirmation, overall impressions, and anything else that you would like to share with us regarding your experience with the billing office. Please be sure to include the provider's name, your name, and all other applicable details.
bottom of page