Click on the blue button below and fill out the following forms:
Patient Registration Form
HIPAA and Billing Policies
Suboxone Consent for Treatment
Suboxone Consent to Release of Information
Suboxone Intake Questionnaire
If your narcotic dependence is related to a pain condition, you may also fill out form #5, the Pain Assessment Form.
Once all of the above forms have been completed, a member of our staff will contact you within one business day.
However, they do usually cover the medication.
all open Workers' Compensation and auto (personal injury) insurance claims - even from NY, NJ, or other states.
We can see you if you have out-of-network benefits. Sadly, Obamacare makes it impossible to deliver quality medicine at the in-network rates for a specialist, and most pain care is subject to a huge deductible. We can often arrive at fees that fall under the deductible. Please register online and our biller can explain.
We do not participate in any HMO plans
We do not accept any Medicaid plans (which includes PA Access, Geisinger, Highmark, AmeriHealth Products).
However, under federal law these Medicaid plans must find you a specialist in 15 days or else they should provide an out of network referral, which they can fax to us. Please contact your insurance directly and ask them to provide you with an in-network specialist who has less than a 15 day wait and is not more than a 60 minute drive.
Please see pages 23 and 24 of STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE.