Forms

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IF YOU ARE UNABLE TO BRING YOUR COMPLETED FORMS, PLEASE ARRIVE 30 MINUTES PRIOR TO YOUR APPOINTMENT TO COMPLETE THEM

ADULT

Doctor | ARNP | Counselor

MINOR

Doctor | ARNP

 

Both parents MUST complete a Treatment Consent form for a MINOR applicant. Mother/Father pages are included in the packet.

 

MINOR

Counselor

 

Both parents MUST complete a Treatment Consent form for a MINOR applicant. Mother/Father pages are included in the packet.

Time For A Change

New Patient Appointment

This section is for people interested in becoming new patients at APG Health. Complete the form and we will contact you within 48 hours to schedule an appointment.

After you complete your form, submit it using the contact form or e-mail it directly to newpatient@apghealth.com

Existing patients should not be using this section

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Staying Up To Date

Update Insurance

Complete the form to ensure we have your most current insurance information on file, and you may also upload your most current insurance card.

After you complete your form, submit it and your insurance card using the contact form or e-mail it directly to info@apghealth.com

New patients should not be using this section

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Frequently Asked Questions

  • We accept most private insurances. Please call the office to ensure that we are accepting your plan.
  • Please check with your insurance carrier to see if pre-authorization is required for any mental health services.
  • We are NOT a provider for Medicaid/Healthy Kids, Aetna/HMO, and BC&BS Health Options or any other HMO contract.
  • We are providers for Cigna HMO
  • If you are unable to keep an appointment, kindly give 48 hours notice

What do I do if my medication is not covered by my insurance company?

Ask your pharmacy if you need a Prior Authorization. If they say yes, please call your insurance company and have them fax us the Prior Authorization form to 407-422-0470. Once your provider completes the form we fax it back to your insurance company then we wait to see if they approve or deny the medication.

What if my pharmacy states that my medication needs prior authorization?

Please call your insurance company and have them fax us the Prior Authorization form to 407-422-0470. Once your provider completes the form we fax it back to your insurance company then we wait to see if  they approve or deny the medication.

My pharmacy states they sent prior authorization to my doctor

Your pharmacy only sends the doctor’s office notification that the medication needs Prior Authorization. The pharmacy does not send the forms to our office. Please call your insurance company and have them fax us the Prior Authorization form to 407-422-0470. Once your provider completes the form we fax it back to your insurance company then we wait to see if  they approve or deny the medication.

How long does this process take?

This process can normally take 3-5 business days. Your insurance company may tell you 7-10 days.

What if my authorization is expiring and I need a new one (re-authorization)?

Please let your provider’s assistant know at least a week or more in advance (as soon as possible is best). This way she can help you begin this process.

What is considered an urgent request?

Urgent requests are reserved for antipsychotics, antidepressants, mood stabilizers and anti anxiety medications. If you have any questions about these classes of medications please do not hesitate to ask your provider’s assistant.

My insurance is stating that my doctor's office needs to call my insurance company for prior authorization and they have given me an 800-xxx-xxxx phone number

We do not do Prior Authorizations for medications over the phone. Please have your insurance company fax the form to our office at 407-422-0470 for your provider to complete.

What does it mean if the medication prescribed is not on my insurance formulary?

First, call your insurance company or visit their website and ask what medications in that “class” are covered by your plan. Obtain a list of covered medicines and fax it to our office at 407-422-0470. Call the office and speak directly to your provider’s assistant to inquire on how to proceed.

My medication is covered by my insurance but is still too expensive

First, call your insurance company or visit their website and ask what medications in that “class” are covered by your plan. Obtain a list of covered medicines and fax it to our office at 407-422-0470. Call the office and speak directly to your provider’s assistant to inquire on how to proceed.

How will I know if my Prior Authorization is approved or denied?

Your insurance company will notify your pharmacy, provider’s office, and will send you a letter with their determination. You may also contact your insurance company directly.

What if I need an appeal?

The providers do not complete appeals over the telephone. However, for certain medications they may complete a written appeal or complete a form required by your insurance. Please contact your provider’s assistant for further information.