Please download the form below, complete, and bring to first appointment.
For your convenience, new patients can expedite registration by providing the following information:
- Treatment and Medication History
- Hard copy CD of all diagnostic studies, including, x-rays, MRI’s, CT-scans, bone scans etc.
- Insurance Information
- Follow Up Visits
Please download the form below, complete, and bring to appointment.
Make An Appointment Today!
“Our goal is to treat you with the best quality care to ensure optimal health for your hips, knees & shoulders.”- Rajan M. Patel, MD
First and Foremost, we want to express our appreciation to you for selecting Tower Orthopaedics. The mission of Tower Orthopaedics is to provide you with high quality health care. Our relationship with you is our first priority. As a physician, I want to emphasize my relationship is with you and not your insurance company.
Therefore, our financial policy allows us to continue to accept and treat patients with most insurances. In order for us to provide you with quality medical care and current technology, we must insure that we are able to meet the expenses necessary to operate this facility. To ensure that these expenses are met, we provide you with this document to acquaint you with our financial policy.
Payment at Time of Service
Tower Orthopaedics will bill your insurance for all office visits and surgeries. However, we ask that you pay any portion not covered by your insurance due to deductibles, copayments or a balance forward on the day of service. Payments for surgery will be collected prior to your procedure as the doctor does not collect payment at the time of service at the hospital. Also, we will collect outstanding balances at the time of service. Full payment is requested. (A minimum of one third of outstanding balances is required.)
If we are a participating provider for your insurance we will file your claim for you. When your insurance processes the claim, we will make the appropriate adjustments. Please note that you will be responsible for any copayments or coinsurance amounts as set forth by your insurance company. Your copayments are due at the time services are rendered.
We require a copy of your current insurance card prior to or at the time of your visit. If you are unable to present your card before seeing the doctor, the visit may be considered fee for services, and full payment may be collected. If you are an established patient, please verify all information and notify us of any changes.
As a rule, we try to verify all benefits prior to your appointment, but in some cases this is not possible. It is ultimately your responsibility to make sure we are a provider, know what your benefits are, that you have active insurance and have supplied us with valid insurance information. When required, it is the responsibility of the patient to obtain all needed insurance referrals. In the event your insurance claim is denied you will be responsible for the services rendered.
We accept cash, personal checks, MasterCard and Visa. There will be a $25.00 charge for any and all returned checks.