Patient Information

RICHMOND SPINE
INTERVENTONS
AND PAIN CENTER

14404 Sommerville Court
Midlothian, VA, 23113
Ph: (804) 378-1800
Fax: (804) 378-5400
  Patient_Info_PicPatient forms -
Click a link to download form

Bullit24-Hour Cancellation Notice (PDF)
BullitPatients Insurance Coverage (PDF)
BullitMedical Release-Payment (PDF)
BullitHIPAA Consent (PDF)

Insurance
We accept the following insurance programs and their subsidiaries. 

BullitBC/BS—Anthem
BullitCigna
BullitSouthern Health
BullitMedicare
BullitTricare For Life
BullitUnited Healthcare
BullitAetna
BullitMAMSI: Optimum Choice, MDIPA, Alliance
BullitOptima Health

Co—Payment
BullitInsurance co-payments are expected at the time of arrival.  If you are unable to provide this, please see the receptionist upon arrival for rescheduling of your appointment.
BullitPlease note: There will be a $25 fee for any returned checks.

Initial Consultations
BullitWe request that your referring physician contact our office to set up your initial consultation visit.  The referring physician’s office must also fax to our office any notes regarding your previous care 48 hours prior to your appointment; if they do not, we may have to reschedule your appointment.
Please be certain to bring your insurance cards and a photo identification to your visit.

BullitYou should also bring a complete list of your medications, including the strength and dosing instructions.

Referrals & Authorizations
BullitYou must obtain a referral from your physician (primary care or other referring physician) prior to your appointment.

BullitIf your insurance requires authorization for a visit to a specialist you must also obtain this authorization number prior to your visit.

Message Service
BullitDue to the high volume of telephone calls, we request that if you get our answering service, please leave a complete message including your full name, a telephone number where you can be reached, and your reason for calling.  All messages will be answered after 4pm.

Medications & Refill Requests
BullitYou must discuss your medication needs, including refill requests, with the practitioner at the time of your appointment.

BullitMedications should be taken only as prescribed; please do not request early refills of your medications.


Copyright © 2006-2008, Richmond Spine Interventions and Pain Center
Site Design by Swarm Interactive