Medical Specialists Patient Fee Schedule

1. Completion of Medical Forms $25

This applies to all documents that a patient presents to our office for either the Physicians to complete and/or any medical staff.

2.  Medical Records Request for (Non-Physician Offices) $1.00 first page & .50 for each additional page + cost of postage (if being mailed) This applies to medical records request leaving our organization to a non-physician office.

3. We now offer a medication authorization service for a fee of $25.00. We require this fee be paid before we start the authorization process. With this service, our office will deal directly with your insurance company and your pharmacy and attempt to obtain “authorization” from your insurance company.

4. New Patient No-show $45

This applies to new patients who fail to either cancel or reschedule their apt w/n 24 hours. This fee will be assessed only if patients fail to inform us that they cannot make it to their scheduled appointment within 24 hours of their appointment.

This may not be a complete list and may change at any time with or without notice. Please check with our office to be sure that your insurance plan is accepted and obtain all necessary authorizations from your insurance company prior to your new patient visit.