About Your Visit

Welcome to our practice! To save you time and make your appointment efficient, we ask all our patients to come prepared for their appointment with completed paperwork. Find the forms that apply to you below, print, and complete them before you arrive at our office. Please arrive 30 minutes early. You may still be asked for some information and signatures, but this will reduce the time spent on paperwork before your appointment. Please remember to bring your insurance card to each appointment and let us know if there are any changes to your coverage.

Existing Patients: Please log into your NEXTMD Patient Portal. Click on the logo to access.

The Patient Portal provides you with access to your health care information 24 hours a day. You can request appointments, view lab results, check your medication and more, all from your home computer or smartphone.

Patient Forms

Medical History Form

Download Form

Demographic Information

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Hippa Acknowledgement

Download Form

Hippa Privacy Policy

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New Patient OB Packet

Download Form

Safe Medication List

Download Form

Medical Insurance and Your Prenatal Care

We are happy to assist you in any way that we can in billing our charges for prenatal care and delivery to your insurance carrier. You must realize, however, that all carrier coverage is not the same and you, the patient, need to be aware of your own insurance benefits. Our Patient Financial Counselor will meet with you early in your pregnancy to explain the charges and obstetric payment plan. We request that a maternity deposit be paid prior to your 28th week of pregnancy.  This deposit includes deductibles and/or percentages not covered by your insurance company.

Most insurance companies pay a “Global Maternity Package” which includes up to 12 routine OB visits, delivery, and a post partum visit.  This package does not include visits for complications or non-obstetric medical care, which will be billed separately.  Our billing policies are in accordance with AMA-CPT guidelines.  All ultrasound(s), lab work, and services provided outside the “Global Maternity Package” must be paid upon receipt of your bill.  Please contact our billing office at 714-903-7818 to discuss any questions/explanations regarding payment.  If your insurance requires pre-certification or authorization for delivery or other services, YOU WILL BE RESPONSIBLE for NOTIFYING them PRIOR to services being rendered.  If you have any questions about what is covered and what is.

Some insurance plans may only require you to pay a single co-pay for the complete global pregnancy. Some plans may require you to pay a co-pay for the global OB care and another for each ultrasound, non-stress test, etc. Other plans may require you to pay a co-pay per visit and per service provided. We have no control over how your insurance plan is administered. You will be expected to pay the copayments as processed by your particular insurance plan. If you disagree with how those claims are processed, it will be necessary for you to contact your insurance company about their procedures.

Please contact the office manager to arrange a payment plan if you do not have insurance or insurance without maternity benefits.

Medical Billing Questions

What is my copayment*?

Your copayment amount or “copay” is determined by your insurance company and is often listed on your insurance card. Please contact your insurance for more information.

*Please note, we are typically considered a Specialist office unless otherwise specified by your insurance and copays are due at the time of service so please be prepared to pay or you may be rescheduled.

What is a deductible and a co-insurance?

A “deductible” is a set dollar amount that you may pay out of pocket for some services to any provider before your insurance company will pay. A “co-insurance” is a percentage of a charge that you pay out of pocket. Please contact your insurance to see if you have a deductible and/or co-insurance that applies to your charges.

What’s covered under my insurance plan?

We cannot quote benefits because we are not an insurance company and we do not administer benefits. Please contact your insurance company for more information about specific benefits.

How can I pay my bill and what are my payment options?

We accept the following methods of payment: cash, checks (personal and cashier), money orders, VISA and MasterCard. You may pay your bill via mail, in person, or over the phone with a credit card. Online payments are available through our website.

I paid my copayment, so why am I getting a bill?

You may have a deductible or co-insurance percentage that was applied to your charges—on top of or in lieu of your copay. Please contact your insurance for detailed claims processing information.

What if I don’t have insurance?

We understand the importance of quality healthcare and we encourage all women to seek care no matter their insurance situation. We do require that all services are paid for in full at or before the time of service. Some services are eligible for discounts when paid in full at the time of service. Please contact the office for details.

Can I make payments on my balance?

In most cases yes. Please contact the office for details.

What is “global billing?”

Global billing is most common in obstetrical (OB) care, but can also apply to other non-OB services. It is a billing method used by most insurance companies which includes office visits related to pregnancy, physician’s charge for delivery and one six week postpartum visit. The “Global Fee” is billed to your insurance by our office at the time of delivery and the hospital will bill separately. Anything above and beyond OB office visits and delivery including, but not limited to ultrasounds, blood draws, sick visits, lab and pathology services, fetal non-stress tests, amniocentesis, etc will be billed outside of global and deductibles and/or co-ins may apply.

Global billing applies to all pregnancies when you have the same insurance throughout the entire pregnancy and when you see only WHG providers throughout the entire pregnancy. If you have changes in insurance coverage or if you transfer care to or from our office, global billing no longer applies.

Global billing also applies to most surgical procedures when there are no complications or changes in insurance. Each surgery has its own number of post-operative days that vary based on the specific procedure code. It may still be necessary to charge a visit or other procedure outside the gobal post-operative days if the visit is not related to the original surgery, or if ultrasounds or further studies are required.