What to Bring to Your Appointment

• Your insurance card
• Physician referral forms if required by your insurance provider
• A list of current prescriptions and/or over-the-counter medications you are taking, including the dose and frequency
• Pertinent information about your medical and surgical history
• Patient Registration Form
• Patient History Form
• HIPAA policy
• Acknowledgement Form
• New Patient Letter
• AUA Form - Men Over 40
  You can easily view and print these patient forms using the links below.
  [printable page troubleshooting]

Insurance and Payment Information

North Fulton Urology is a provider for Medicare and most major insurance plans. We provide insurance billing. Anything not covered by insurance will be your responsibility.

We request payment at the time of your appointment for services that are not covered by insurance. Your insurance company may also require you to pay a co-payment at the time of your appointment. When necessary, our staff will work with patients who require a payment plan.

We accept the following insurance plans:

Accordia Aetna/U.S. Healthcare-all plans Allmerica Financial AmeriHealth America's Health Plan (AHP) American Medical Security Anthem Blue Cross Blue Shield BeechStreet PPO Benefit Support Blue Choice-All Plans Blue Cross Blue Shield-Federal, General Motors, State and University employees and out of state plans Board of Pensions Capp Care PPO CCN-Community Care Network Celtic Life Central States Champus/Tricare-not HMO! Cigna-PPO only! Connecticut General Continental General CoreSource CoreStar

Coventry PPO and HMO Crown Cork and Seal Company EBMS Employers Health First Health Fortis Benefits GEHA General American Georgia 1st GHI Great West PPO Group Resources Group Underwriters Guardian PPO Healthstar PPO Humana-HMO/PPO/POS John Alden Kirke Van Orsdel Mail Handlers Medicare Part B Medicaid (by direct physician referral only!) MultiPlan Mutual of Omaha NASE

New England Financial One Health Plan PHCS-Private Healthcare Systems Pioneer Life Preferred Plan of Georgia Principal Financial Group Provident Preferred SISCO Southcare PPO State Merit Starmark State Farm Tenet TPA Tricare for Life Trustmark Unicare United Chambers United Healthcare-All plans USA Health Network Wausau Worker's Compensation (only by direct referral from employer!)

If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company.

Hospital Affiliations

Should hospitalization or surgery be necessary, our doctors are on staff at the following hospitals:

• North Fulton Regional Hospital - Roswell, GA
• Northside Forsyth Hospital - Cumming, GA
• Northside Hospital - Atlanta, GA
• St. Joseph's Hospital - Atlanta, GA