| Office Policies & Patient Forms |
DISCLAIMER:
Filling out these forms and emailing them to the physician does not create a physician patient relationship until the patient is physically seen by the physician.
 New Patient
We would like to remind you of a couple of items you will need to bring to your appointment please have your insurance card, co-pay, current medication bottles and any x-rays, MRI or other test results you have pertaining to your current pain problem. Please download the patient forms in order to expedite the registration process or arrive 30 minutes early to complete our registration process. Please bring someone to drive you home in the event a procedure is performed. You will not receive a procedure if a driver is not present with you. If you have any questions about your appointment, please call our office at 804-288-7246 between 8:00 am and 5:00 pm. Thank you.
Office Visit
We would like to remind you of a couple of items you will need to bring to your appointment please have your insurance card, co-pay, current medication bottles and any MRI or other test results you have pertaining to your current pain problem. Arrive 15 minutes early to complete our registration process. If you have any questions about your appointment, please call our office at 804-288-7246 between 8:00 am and 5:00 pm. Thank you.
Office Procedure
We would like to remind you of a couple of items you will need to bring to your appointment please have your insurance card and co-pay. Arrive 15 minutes early to complete our registration process. You must have a driver present with you during your procedure. A procedure will not be performed without a qualified driver to drive you home. If you have been prescribed Ativan, Valium or Xanax, please make sure to take it one hour prior to your procedure. If you are currently taking antibiotics or have been taking antibiotics as recently as 1 week ago, please call our office immediately to determine if your procedure can be performed. If you have any questions about your appointment, please call our office at 804-288-7246 between 8:00 am and 5:00 pm
Short Procedure
We would like to remind you of a couple of items you will need to bring to your appointment please have your insurance card, co-pay, current medication bottles and any MRI or other test results you have pertaining to your current pain problem. Arrive 15 minutes early to complete our registration process. If you have any questions about your appointment, please call our office at 804-288-7246 between 8:00 am and 5:00 pm.
Hospital Procedure
At the ASC office, located at 1501 Maple Ave Suite 300 St. Mary’s ASC…3rd floor or at St. Mary’s out patient registration located at 5801 Bremo Road, Medical Office Bldg North on the ground floor. Arrive 1 hour prior to your appointment to complete our registration process. If you are currently taking antibiotics or have been taking antibiotics as recently as 1 week ago, please call our office immediately to determine if your procedure can be performed. Do not have anything to eat or drink six hours prior to your procedure. If medication is required, take with sips of water. You must have a driver present with you during your procedure. A procedure will not be performed without a qualified driver to drive you home. If you have any questions about your appointment, please call our office at 804-288-7246 between 8:00 am and 5:00 pm.
Prescription Refill
We would like to remind you of a couple of items you will need to bring to your appointment please have your insurance card and co-pay. Arrive 15 minutes early to complete our registration process. If you have any questions about your appointment, please call our office at 804-288-7246 between 8:00 am and 5:00 pm. It is the policy at Commonwealth Pain Specialists that prescription refill requests by the patient must be called in during normal office hours between 8am-5pm daily, Monday through Friday. Return phone calls will be made within 24 hours of request, but not necessarily on the day of the request. Most prescriptions will not be called in to the pharmacy, but will require a face-to-face appointment. It is the patient’s responsibility to insure that enough medications are on hand until the next appointment with the physician or nurse practitioner.
NO PRESCRIPTION REFILLS OR CHANGES WILL BE MADE AFTER HOURS, NIGHTS, OR WEEKENDS OR HOLIDAYS, AND THE PHYSICIAN ON CALL WILL NOT RECEIVE THOSE CALLS.
Insurance Acceptance
Commonwealth Pain Specialists participates with Medicare, Anthem, as well as with most major medical insurance companies. For questions regarding participation with your specific insurance carrier, please contact our office at (804) 288-7246.
At the time of your visit, please be prepared to pay any insurance co-payment for which you may be responsible.
In addition, you should bring any referral from your Primary Care Physician if required by your insurance plan. We will gladly file a claim on your behalf with your insurance company.
In the event your insurance changes, we ask your cooperation in notifying our office of your new coverage. Our Business Office staff will also work with you should extenuating circumstances prevent you from paying your account when due. Please call (888) 679-1742 to speak with a patient account representative.
We also are able to work with patients who have limited/no insurance coverage/out of network coverage, etc.
We have a long history of participating with most workers compensation companies. |
