1414 Woodbine Road
Bloomington, IL 61704
Phone: (309) 662-2273
Fax: (309) 662-2014

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Appointment Information & Forms

Forms

Patient Intake Form

Patient History Form

Medical Records Release

HIPAA Privacy Notice

Appointment Information

Providers and staff at OBGYN Care routinely see patients from 7:30 AM to 4:30 P.M., Monday through Thursday. It is necessary to schedule an appointment, as we do not take walk-in patients. If you have an emergency, please call our office. We will work you in as quickly as possible, when medically indicated.

Annual exams should be made six weeks in advance. Postpartum and postoperative appointments should be made as soon as you return home from the hospital, if not previously scheduled. We are always accepting new patients. To avoid unnecessary out-of-pocket expenses, be sure that our doctors are listed on your plan.

We recognize the value of your time, so we do our best to keep your appointment on schedule. However, unforeseen delays may arise from surgical complications or emergency patients. If your provider is delayed, we will attempt to notify you before you come to the office or upon your arrival. You may wait for the provider, see another provider in our office, or reschedule your appointment. Your patience in these matters is greatly appreciated.

The office is closed on the following holidays: New Year's Day, Memorial Day, July 4th, Labor Day, Thanksgiving Day, Christmas Eve and Christmas Day.

Please make note that our office may be closed for training and education for our staff members. We will try to announce these in advance.

Telephones

You may call our office from 7:30 AM to 4:30 PM, Monday through Thursday.

We have many incoming lines. If your call is not an emergency, you may be asked to be placed on hold when you call. Please bear with us. Your call will be taken as promptly as possible.

A nurse is a phone call away! During office hours, you may speak with our triage nurse who provides information on a wide range of medical topics.

When the providers are with patients, they are interrupted for emergencies only. If you call with a medical problem or question, your call will be returned at the earliest possible opportunity.

We request that you reserve evening, night, and weekend calls for urgent or emergency conditions only. Prescription refills are not an emergency. These should be obtained during regular office hours when your records are available.

If you find it necessary to contact our providers after hours, please call our office at (309) 662-2273 and follow the phone instructions.

Office Policies

Welcome to OBGYN Care we look forward to providing you with the highest quality care and trust. We hope you will find us friendly and helpful. We are a participating provider with many insurance companies and plans. Due to the complexities and constant changes of individual insurance plans, it is impossible for us to know about your specific benefits. It is important for you to know your individual plan.

Updated Personal Information:
Please provide our office with accurate, up-to-date contact information; especially phone number (cell and work), address, insurance, employer, and emergency contacts.

Office Payments:
We accept cash, personal checks, and the following credit cards: Visa, MasterCard, American Express and Discover.

Insurance Information:
For each visit to our office, please be prepared to provide the information needed to verify your insurance coverage and file your insurance claim. A current insurance card will provide this information. If you are unable to provide adequate insurance information, we will require that you pay in full for services rendered at the time of the visit. Deductibles, co-insurance, and co-payments are due at the time that medical services are rendered.

Our office will file for payment with your primary insurance carrier providing that we participate in your plan. Because your insurance policy is a contract between you and your insurance company, it is your responsibility to know and understand your plan's requirements and policies regarding co-payments, co-insurance, deductibles, and benefits. Should your insurance carrier deny a claim, we will make a reasonable attempt to help you resolve the disputed issues. If, however, we have provided your carrier with adequate information to process your claim and they persist in refusing to reimburse for that claim, the responsibility for resolving the dispute will become yours.

Should you make an overpayment, your account will be credited with the overage and you may either leave that amount in your account as a credit or request a refund providing there is no outstanding balance owed on your account. Please allow 10-14 business days for refunds to be processed and mailed to you.

Missed Appointments:
If you are unable to keep an appointment, please provide at least 24 hours’ notice. This courtesy on your part will make it possible to give your appointment to another patient who needs to see a provider. If you must cancel an appointment, we will do our best to reschedule your visit as soon as possible.

"No Show" Policy:
If you do not call to cancel an appointment, it is documented as a “no Show” in your chart and we will notify you by letter. If you have three (3) “no shows” within a twelve-month period, you will be unable to schedule further appointments and will be discharged from our practice.

  • "No Show" Fee Policy:
    Your first “no show” will result in a $30 fee. Your second “no show” will result in a $50 fee. These fees are patient responsibility only and will not be submitted to insurance.

Late Policy:
If you are more than 15 minutes late to an appointment without calling, we may need to reschedule your appointment.

New Patients:
New patients must arrive 15 minutes early for the first appointment. This allows time for paperwork and entering information into the chart.

Personal Health Information:
We fulfill our obligation in keeping your personal health information confidential and comply with HIPAA regulations. As health care providers, we rely on you to provide us with complete and accurate information about your condition, symptoms and health history, which helps us make a diagnosis and provide you the best care and treatment. Your medical records will not be released without your written consent, unless compelled by law. Privacy issues may be addressed to our Privacy Officer.

Prescription Refills/Request:
All prescriptions and authorizations for renewals should be requested during normal office hours. Prescriptions will not be phoned in after office hours or on weekends, except for emergencies. We recommend that you notify us of any refills at least 2 to 4 days before your prescription is due to run out (to assure there are no interruptions in your medication schedule). Please remind your practitioner of any refill needed during an office visit. Please advise us if this prescription is for a mail-in program. When your provider feels it is necessary, you will be asked to make an appointment with them to reassess your need for the medication prior to getting a refill.

Disclosure:

Our website is for convenience and for informational purposes only. Please contact our office to schedule an appointment and for additional advice. OBGYN Care is not responsible for the content of linked sited or resources provided.

This is not a secure website please do not enter any personal health information.

1414 Woodbine Road
Bloomington, IL 61704
Phone: (309) 662-2273
Fax: (309) 662-2014

Monday - Thursday
7:30 am - 4:30 pm

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