Prior To Your Visit
For your convenience, we have compiled the paperwork that you’ll need to complete prior to your new patient appointment and for your annual Preventative Care Visits (PCV). Please print, complete and bring your new patient forms to your first appointment and your Preventative Care Visit (PCV) forms to your annual PCV appointment.
Downloadable Patient Forms
New Patient Packet
Click the icon to download the forms. Please bring all completed forms to your new patient appointment. If you do not have access to a printer, please call the office, and we will mail you the required paperwork.
Preventative Care Visit (PCV) Paperwork
Click the icon to download the forms. Please bring all completed forms to your PCV appointment. If you do not have access to a printer, please call the office, and we will mail you the required paperwork.
What are copay, coinsurance, secondary insurance, and deductibles?
A copay (or copayment) is a flat fee that you pay on the spot each time you go to your doctor or fill a prescription.
A deductible is the amount your insurance provider requires you to pay each year for eligible medical services or medications before your health plan begins to share in the cost of covered services.
Coinsurance is the portion of the medical cost you pay after your deductible has been met. Coinsurance is a way of saying that you and your insurance provider each pay a share of the eligible costs, adding up to 100% of the bill.
Secondary insurance plans work along with your primary medical plan to help cover gaps in cost, services, or both. Supplemental health plans like vision, dental, and cancer insurance can provide coverage for care and services not typically covered under your medical plan
We take most secondary plans as long as they are not from Health Maintenance Organizations (HMOs). Patients with United Healthcare (UHC) plans will have out-of-network benefits when processed as a secondary plan. AARP is a Medicare supplemental policy and will pick up Medicare coinsurance, depending on the plan type. AARP is part of UHC but is a primary insurance. There is a difference between secondary insurance and a Medicare supplemental policy. We take all Medicare supplemental plans.
What insurances do you accept?
As of October 2019
- Aetna – PPO Only
- Aetna – Meritain – PPO Only
- BCBS Ameriben – PPO
- BCBS Federal – PPO
- BCBS Gilsbar – PPO
- BCBS Meridian – PPO
- BCBS of AZ – PPO No HMO’s or Marketplace (Obama Care)
- BCBS Summit Inc. – PPO
- BCBS SW Administrators – PPO
- BCBS- Western Grower Assurance Trust – PPO
- ChampVA – Not VA
- Christian Care Medi Share – Very limited benefits, must verify before being seen
- Cigna – Secondary only
- Freedom of Life-ICA – Very limited benefits, must verify before being seen
- GEHA FEHB & MCR supplement – Both primary and secondary
- GEHA-ASA (Aetna only) – Primary only
- Golden Rule – NO-Part of UHC
- Health Net Federal Services, LLC – Also known at Tricare
- Humana – PPO
- LHS/MedCost Solutions LLC – Very limited benefits, must verify before being seen
- MCR – Aena Medicare HMO – Medicare Advantage Plan HOM
- MCR – Aena Medicare PPO – Medicare Advantage Plan PPO
- MCR-BCBS Medicare HMO/PPO – Medicare Advantage Plan HOM/PPO
- MCR – Humana Choice PPO – Medicare Advantage Plan PPO
- MCR – Humana Gold HMO – Medicare Advantage Plan HOM
- MCR – Medicare
- MCR Railroad Medicare
- MCR – United Healthcare PPO – Medicare Advantage – Only for AZ State Retirees
- Meritain Health – Very limited benefits, must verify before being seen
- Tricare West Region before 01/01/2018 – Use healthnet Federal Services
- UMR – No, this is part of UHC
- United HealthCare 0 No UHC with the exception of one Medicare Advantage Plan
We take most secondary plans as long as they are not HMO’s. Patient with United Healthcare (UHC) will have out of network benefits when processed as secondary. AARP is a Medicare Supplemental policy and will pick up Medicare coinsurance depending on plan type. AARP is part of UHC but is a primary insurance. There is a difference between a secondary insurance and a Medicare Supplemental policy. We take all Medical Supplement Plans.
Are you accepting new patients?
Yes, we are accepting new patients and our practice is always open to your friends and family.
What is your prescription refill time frame?
New prescriptions will be sent electronically to your pharmacy, as required by Medicare and commercial insurers. Periodic visits are required to monitor prescriptions for chronic medications. Refills will not be given if you have not been seen within the last 12 months or have failed to keep routine follow-up visits. You should contact your pharmacy for routine refill requests. You can also request refills in the Patient Portal. Please allow a minimum of three business days for these to be processed by our office and the pharmacy. Prescription refills will not be processed after regular business hours, on weekends, or on holidays. Controlled substances require a written prescription, and the patient must be seen in the office periodically (monthly or every three months) for renewals.
Are there charges for medical records or filling out forms?
Yes, Travel documents are $75.00 and all other documents are $50.00. All patient portions of the documents must be filled out prior to the Physicians review.
What does Apurva mean?
pronounced ah POOHR vah
In Sanskrit, Apurva means unique, extraordinary, wonderful, incomparable, having no predecessor, unprecedented.
We chose a Sanskrit word to describe our practice because it is the language of the first literate, scholarly system of medicine.
We believe our patients are unique and, therefore, we provide services that are unique.
Please arrive 1o minutes prior to your appointment time for routine visits and 15 minutes prior to your annual preventative care visits.
Please notify us in advance at least 48 hours (2 business days) if you must cancel or reschedule. There is a $50.00 charge for missed appointments not canceled or rescheduled appropriately.
Billing & Charges
You are responsible for paying at the time of service, all co-pays, deductibles, and other allowable charges not covered by insurance.
What to Bring
Please bring your insurance cards, photo id, your medication list, as well as any new patient paperwork (see links above).
Please note that ONLY 1 person other than the patient will be allowed in the exam room. We can arrange a family meeting with the doctor if it is requested in advance.