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Patient Information


 

Insurance Plan Accepted & Health Network Affiliations

Most major insurance plans are accepted including various PPO, HMO, Medi-Cal, Cal-Optima and secondary to Medicare plans. Our office is contracted with the insurance companies including but not limited to,

PPO/HMO: Cigna, Aetna, HealthNet, Blue Cross, Blue Shield, Blue Card, UnitedCare, PNOA, Nippon Life, Kaiser, ASH, Humana, Molina and others

IPA: CalOptima, Prospect Medical, Optum HCP, Monarch Healthcare, CHOC, Regal Medical, Providence Health, ADOC, AltaMed, Noble AMA, Noble Mid-Orange, Alignment Healthcare, Astiva, OC Advantage Medical, Clever Care Health Plan, Center IPA, Central Health, Seoul Medical, AMVI, Gateway, Astiva Health, AMVI and others

Senior: Most plan accepted including Bluecross, Blueshield, AARP, Easy Choice, SCAN, HealthNet and other plans

Workers Compensation: State Fund MPN, One Call Physical Therapy, Medrisk, Prime Health, Harbor Health System and other eligible plans

Auto: Most insurance plans aceepted

Military: TriWest Healthcare

Traveler's Insurance & Student Insurance plans accepted

Affordable discount options are also given to patients without health insurance plans.

 

Before Your Appointment

To help ensure your visit runs smoothly and efficiently, we would like to ask you to complete some forms prior to your first appointment. Please either forward them to us or bring them with you to your appointment before your appointment. If you want to prepare your 1st visit documentation via online access, please feel free to let us know.

Also, remember to prepare the following items to your first appointment.

• Photo ID
• Insurance card(s)
• A list of previous treatments and/or medications for your current condition with medical records if available
• Any Lab result, X-rays, MRIs (images and reports)
• Referral or authorization letter (if required) for HMO, IPA, Worker's Compensation patients

 

New Patient Registration

 

New Patient Registration (Spanish)

 

Medical Record Release

 

Accident Questionnaire

 

Physician Referral Form  

 

Progress Evaluation Form

 

Payment Options

Patient co-payments are due at the time of service. We accept all four major credit and debit cards, as well as checks and cash.

 

Affiliations

  • In order to provide top-quality services, our office is affiliated with the following organizations.
  • Prospect Medical Group
  • CHOC (Children's Hospital OC)
  • CalOptima
  • Healthcare Partners Medical Group
  • Family Choice Medical Group
  • AltaMed Medical Group
  • Heritage ADOC
  • Regal Medical Group
  • Noble AMA IPA
  • AMVI Medical Group
  • OC Advantage Medical Group
  • Seoul Medical Group
Our Locations

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