Submit your direct billing info
Fill in the form below to submit all of your direct insurance billing information to us.
During reception hours, receptionist will accept and process direct billing requests.
We do not accept direct billing requests outside reception hours. You are required to pay the full fee for your appointment.
NOTE: For us to serve you better, we require 24 hours prior to your appointment to process your coverage.
NOTE: Ability to do direct billing is dependent on your coverage plan, and you are responsible to pay the difference not covered by your plan.