Heart House Patient Information

Patient Forms

For your convenience, we have made available online some patient forms that you may complete prior to your office visit. If you wish, print out and complete these forms and then, bring them with you when visiting our office. (You may want to print a second copy of these forms if you want to keep a record of this information.)

Online Forms

Downloadable Forms

Heart House Privacy Statement

Insurance Coverage

Please bring your current insurance card with you every time you visit a Heart House office. Insurance coverage will be verified at every visit. As insurance policies often change, we must have up-to-date information. Also, please verify that our office is participating with your insurance plan by contacting your insurance company directly or by speaking to an account representative in our office.

Insurance Carriers

The Heart House participates with Medicare and Medicaid patients, as well as those individuals with private insurance. We also participate in most HMO and PPO Plans. Please contact our office or your insurance company directly to verify our participation in your plan. Please bring your current insurance card with you every time you visit a Heart House office. Insurance coverage will be verified at every visit. As insurance policies often change, we must have up-to-date information or by speaking to an account representative in our office.

Billing Statements

Statements are sent out on a monthly basis and payment is due upon receipt. For your convenience, the Heart House offers the option of payment by credit card or, if you prefer, you may mail your payment directly to our office. Questions regarding billing should be directed to our Business Office at 856-547-0539.

Co-Payments

Many plans require patients to pay a co-payment for each office visit. Co-payments are due when services are rendered.

Referrals

In order to see a specialist, many managed care plans require a referral from your primary care physician. It is your responsibility to obtain this referral prior to your visit. If a referral has not been approved by your insurance plan, your insurance may not pay for the visit. Without prior approval, you may be responsible for the charges associated with the visit.

Medical Records and HIPAA Privacy Rules

All requests for medical records must be received in writing. You will be notified by phone when the records are available to be picked up. Our office maintains medical records confidentiality in compliance with Federal HIPAA rules and regulations. Please follow this link to our HIPAA statement.