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If this is your first visit to Montgomery Vascular Surgery, please take a look at

our Patient Information below and feel free to call us with any questions (334) 284-6500.

 

 

 

New Patients

Please print off and fill out the forms below before your appointment.

 

Patient Information Sheet
Medical Information Sheet
Financial Policy
Notice of Privacy Practices
Medicare Part B Signature Authorization

 

 

We make every effort to keep the cost of your medical care to a minimum. We think it is important that you understand our payment policies. Your portion of the charges is due at the time of service. In the event that timely payment cannot be made, special arrangements may be made for a payment schedule.

 

 

 

Please understand that insurance coverage is an arrangement between YOU and YOUR INSURANCE COMPANY. As a courtesy, we will be happy to help you by submitting your charges to the insurance company. We need to have a copy of your current insurance card on file at all times. As your insurance situation changes, please keep us informed.

 

Medicare:

Our office accepts Medicare assignment which means that we accept the amount that Medicare allows for the service. Medicare pays only 80% for the charge which means that YOU, the patient, are responsible the 20%. If you have an insurance policy which is "secondary" to Medicare, it will usually pay the 20%. It is against the law for us to "write off" the 20%. If your Medicare deductible has not been met for that calendar year, you will be responsible for the deductible amount.

 

Medicaid:

Those with Patient First policies need a referral from your physician or you will be responsible for the bill.

 

TRICARE:

We need a copy of your referral from TRICARE.

 
Ultimately, you are responsible for your portion of the bill regardless of the status of your insurance claim.
 
 

 

We will make arrangements for your surgery and hospitalization. Our bill is only for Dr. Charles Ingalls, Dr. Robert Engles or Dr. Ralph Redd. You will receive separate bills from the hospital, radiologist, anesthesiologist and other physicians involved in your care.

 

 

Since parking is limited in the area, there is a parking deck located at the back of the hospital, valet service at the entrance of the Morrow Medical Tower as well as a parking lot to the side of the medical tower.