NEW PATIENT INFO
New Patient Intake Forms
For your convenience, we’ve made these new patient forms available for online submissions. This will save you time as you arrive for your first appointment, getting you seen quickly by skipping on-site-paperwork.
Please consider submitting your form(s) prior to arriving for your first appointment. You can find the appropriate forms located on our clinic site location pages. Thank you!
Insurances We Accept
This list includes major networks and does not constitute the only payers we accept. Please contact our clinic if your insurance is not listed.
Government Payers
- Tricare
- VA
- Medicare
- Medi-Cal
Commercial
- Cigna/ ASH
- United Healthcare
- Blueshield
- Aetna
- Healthnet
- Prime Health Services
- APTN
- Anthem BC
- Rady’s Childrens
- Optum
Workers Compensation
- One Call
- Medrisk
- Dept. of Labor
- Corvel
- Homelink
- Premier Comp Solutions
- Streamline
HMOs
- Brand New Day/ Universal Care
- Community Care IPA
- Golden Physician Group
- Imperial Health Holdings
- Fireman’s Fund Insurance
- Health Now
- Molina Healthcare
- Community Health Group
- Primary Care Associates
- Regal Medical Group
- Scripps Health Plan/ Coastal
- Health Net Medi-cal
- Elite Physicians Group
- Integrated Health
- Blueshield Promise
Personal Injury Liens accepted/Commercial payers are PPO only unless otherwise noted.
We offer self pay rates for non insured patients!
Insurance Definitions
DEDUCTIBLE Your policy’s deductible is a dollar amount that you are required to pay out of pocket before your insurance benefits start to apply.
Insurance Terminology
CO-INSURANCE Your co-insurance is a percentage that represents your share of the financial responsibility for each claim’s allowed amount after your deductible is met. Because it is a percentage of the claim’s allowed amount, the amount can vary based on the service.
COPAY Your copay is a set dollar amount that represents your financial responsibility for a claim and usually does not fluctuate regardless of a claim’s allowed amount.
OUT OF POCKET MAXIMUM This amount represents the maximum dollar amount that you are personally responsible for within your policy year. Once this amount is met (for most policies), your insurance generally covers 100% of services until your next policy year.
COORDINATION OF BENEFITS To ensure accurate claim processing, it is your responsibility to ensure that any/all active insurance policies are aware of each other.
POLICY YEAR Your benefit coverage has a term in which your benefits apply. A calendar year policy resets every January 1st. A benefit-year policy resets on the same date that your policy became active.
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