Patient Information
Patient Forms
- CPSC New Patient Packet
- Release of Records Form
- Pain Management Agreement / Pain Management Contract
- Notice of Privacy Practices, Patient Consent Form / Intent to Treat
- Authorization to Release PHI
- Financial Policy and other CPSC Policies
- Discharge Instructions
What should I bring to the First Visit?
- Completed new patient packet or on-line via Phreesia
- Insurance Card
- Photo ID, government-issued
- Results of any MRI, CT scan, x-ray, EMG, diagnostic tests, surgery notes or any other diagnostic tests regarding your condition
- All Medications you are currently taking, including all Pain Medications
- Copay if required by your insurance
Insurances Accepted
- AARP
- Administrative Concepts
- Aetna & Aetna/US Healthcare
- Aetna HMO / PPO
- Aetna Life Insurance Company
- All Savers Insurance
- Alternative Ins Resources
- AMA Insurance Agency
- American Continental
- American Postal Workers Union
- AmFirst
- Blue Cross / Blue Shield Federal , BC/BS Federal
- BCBS-Alabama (including PPO, HMO, POS, BEG, and other plans)
- BCBS-AR
- BCBS-AZ
- BCBS-CO
- BCBS-CT
- BCBS-FL
- BCBS-GA
- BCBS-IA
- BCBS-IL
- BCBS-KANSAS CITY
- BCBS-LA
- BCBS-MD
- BCBS-MI
- BCBS-MN
- BCBS-MO
- BCBS-NC
- BCBS-NJ
- BCBS-NY Western NY
- BCBS-OH
- BCBS-PA Highmark BCBS
- BCBS-PA Highmark Blue Shield
- BCBS-PA Independence BC
- BCBS-SC
- BCBS-TN
- BCBS-TX
- BCBS-VA
- BCBS-VT
- BCBS-WA Regence
- Benveo
- Blue Cross-CA
- Business Admin and Consult
- Champ VA
- Chubb Insurance
- Cigna
- Cigna - Healthsprings
- Cigna Health & Life Insurance
- Colonial Penn Life Ins Co
- Covenant Administrators
- Coventry WC PPO
- Employee Benefit Plan Admin
- Freedom Life Ins Co of America
- Gilsbar
- Healthspring-AL
- Humana
- Legal
- Loyal American
- Manhattan Life Insurance
- Medica
- Medicaid-AL
- Medicaid-TN
- Medicare
- Medicare B-AL
- Medicare B-Railroad Medicare
- Medicare DME (Durable Medical)
- Medicare Railroad
- Meritain Health
- Mutual of Omaha
- Optum - VA Community Care Netw
- Other Commercial
- Physicians Mutual
- S&S Healthcare Strategies
- Sedgwick - CMS
- Self-Pay (cash) (available to the uninsured only)
- Special Insurance Services
- State Farm Insurance
- THE FUNDS
- The Health Plan
- Transamerica Life Insurance Co
- Tricare
- Tricare East
- Unified Life Insurance Company
- United American Ins
- United Group Program
- United Healthcare / UHC
- United Healthcare Community
- United Medical Resources
- United Mine Worker’s Insurance plans / UMWA
- UnitedHealth Shared Services
- UnitedHealthOne
- USAA Life Insurance Company
- USDOL / US Department of Labor
- VA
- Healthcare
- VA Triwest Healthcare Alliance
- Veteran’s Choice, community care plans
- Viva Health
- Worker’s Compensation plans:
- WC - Broadspire
- WC - CNA
- WC - CorVel
- WC - ESIS
- WC - Hanover Insurance
- WC - Hartford
- WC - NY State Insurance Fund
- WC - Sedgwick CMS
- WC - Sentry Insurance
- WC - Travelers
- WC - US Dept of Labor
- WC - Workers Comp Other
- Web TPA