Insurance
Dr. Huelskoetter participates with most insurance companies in the area, including:
- Blue Cross/Blue Shield (BCNS)
- Blue Care Network (BCN)
- HealthPlus
- Aetna
- Great-West
- PriorityHealth
- UnitedHealthcare
Copays are to be paid at the time the service is rendered. It is required by your insurance carrier that we collect copays at that time.
Patient Forms
Here you will find some of the more typical forms used within our office as part of maintaining your health records, insurance, and billing information. Please print the necessary forms, complete them, and remember to bring them with you during your office visit. The forms below require Adobe Acrobat Reader. If you do not have Acrobat Reader, you can download it free from Adobe. Click here to get the program.
New Patient Forms:
- New Patient Form - personal, contact, and insurance information for new patients.
- Financial Policy Form - Dr. Huelskoetter's policy with regard to billing and payments.
- Consent for Use and Disclosure of Health Information Form - HIPAA form for designating to whom Dr. Huelskoetter can release medical information.
- Patient History Form - reason for your visit.
- Review of Systems Form
Existing Patient Forms:
- Existing Patient Form - personal, contact, and insurance information for existing patients.
- Financial Policy Form - Dr. Huelskoetter's policy with regard to billing and payments.
- Consent for Use and Disclosure of Health Information Form - HIPAA form for designating to whom Dr. Huelskoetter can release medical information.
- Patient History Form - reason for your visit.
- Review of Systems Form