For Patients
Below are our new patient forms and specialty forms to submit prior to your next visit and expedite your check-in process. We look forward to participating in your care.
New Patient Process
Once your appointment is booked, we create a record for you in our medical system. Complete the New Patient Information Form and Health History Forms below — click to download and print, or fill them out in the office prior to your next appointment.
Insurance
Most of the procedures we specialize in are covered by insurance, and we’ll work with your insurance provider so there are never any surprises. You’ll always know exactly what’s covered before you begin any consultation or treatment.
We accept nearly all insurance plans, including Medicare and Medicaid, and will confirm in-network or out-of-network status upon booking your appointment. We also offer cash pay options with payment plans as needed — call to find out what payment plans we offer.
We Are In-Network With The Following:
Commercial Plans
- Blue Cross Blue Shield (Anthem, Preferred Care Blue, Horizon)
- Humana (Humana Choice Plus)
- Aetna
- Cigna
- United Health Care (AARP, Optum)
- Oscar
- Quicktrip
Medicare Plans
- Missouri & Kansas Medicare
- Medicare Supplemental Plans
- Tricare
- GEHA
- Prime Health
Medicaid Plans
- Missouri & Kansas Medicaid
- Ambetter
- Home State Health
- MO HealthNet
- Healthy Blue
- United Healthcare Medicaid
MIVA During COVID-19
Our employees are expected to limit risk of COVID exposure for each other and our patients. If any patients or employees exhibit CDC-listed symptoms of COVID, they will be required to stay home and self-quarantine until they can provide a negative test result or receive treatment and be symptom-free before being allowed inside the MIVA clinic.