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1. Patient Registration  |  2. Privacy Agreement Form  |  3. Credit Policy Form  |   4. OB/GYN History Form

Arboretum Obstetrics & Gynecology, PA is committed to providing our patients with quality medical care. In return, we respectfully request that you honor our credit policy.

If you are insured by a Managed Care Plan that specifies a co-pay when you see our physicians, our receptionist will collect your co-pay prior to your visit. We cannot bill patients for co-pays as it violates our contract with your health plan. Furthermore, if you have a commercial insurance with a deductible or coinsurance, we will also collect your responsibility prior to your visit.

Arboretum Obstetrics & Gynecology, PA verifies all patients’ benefits prior to their initial appointment, subsequent appointments and quarterly thereafter for all maternity patients. Every effort is made to secure the correct quote of insurance benefits however this is not a guarantee of benefits. In order to confirm how your insurance will pay for any services please contact your insurance at the customer service telephone number listed on your insurance card.

As a courtesy, our office will file your insurance claim within 2 business days of your service date. You will not receive a statement from Arboretum Ob/Gyn until your insurance has either paid their portion of the charges or denied payment of the claim.

Upon receiving your first statement, the balance is due immediately. Failure to pay your balance within 30 days after receipt of your statement will result in your balance being turned over to our collections agency. Once you are transferred to our collections agency we will not be able to provide any additional medical care.

Additionally, all insured patients must provide their social security number as part of the demographic information that is obtained by the practice. If you prefer not to provide your social security number our practice will not be able to provide medical services to you.

If you are a self pay patient, please keep in mind that we will do our best to advise you of any additional charges. Please advise a member of our billing staff to advise you of an approximate lab charge if you are concerned about the cost. Also, if you are interested in receiving a lab discount, please ask a staff member about our self pay discount. Any lab tests, pap smears, blood work or biopsies will be sent to Labcorp and you will be billed by Labcorp or their billing company Phytest at a later date. Please remember that you are fully responsible for any lab work performed by an outside lab as well as for all of our in office charges. If you have any concerns about being receiving lab bills, please advise your nurse or physician.

We thank you for observing our credit policy and look forward to building a positive patient/physician relationship.

If you have any questions regarding your insurance please call our office at (704) 341-1103 and press 5. We thank you for observing our credit policy and creating a good patient/physician relationship.

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Arboretum Office

3125 Springbank Ln.

Suite B

Charlotte, NC 28226

(704) 341-1103

After Hours

For gynecological emergencies: call our main number
(704-341-1103) and you will be automatically rerouted to our answering service and the on-call physician is notified.






and Billing