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.
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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.If your insurance requires a referral from the primary care physician, it is the patient's responsibility to obtain the referral.

Current insurance card must be presented at each visit. It is the patient’s responsibility to insure that North Fulton Urology has current address, telephone number, insurance and billing information.

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:

Aetna-All Plans except Aexcel AmeriHealth America's Health Plan (AHP) American Medical Security Anthem Blue Cross Blue Shield Beech Street Blue Choice-All Plans Blue Cross Blue Shield-All Plans Capp Care Community Care Network-CCN Celtic Life Central States Champus/Tricare-not Tricare   Prime Cigna PPO-not HMO or POS Cigna Open Access (Card   states referral Not required) Continental General Coventry-All Plans Employers Health

First Health Fortis Benefits GEHA General American Georgia 1st Great West Group Resources Guardian Healthstar Highmark Blue Cross Blue   Shield Humana-All Plans John Alden Kaiser-ONLY if PHCS or CCN Kirke Van Orsdel Mail Handlers Medicare Part B MultiPlan

Mutual of Omaha NASE New England Financial One Health Plan Private Healthcare Systems-  PHCS Principal Financial Group Provident Preferred Southcare State Farm Tricare-NOT Tricare Prime Unicare United Healthcare-All plans USA Health Network Wausau Worker's Compensation-   (requires authorization)

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
• Emory Johns Creek Hospital - Duluth, GA