- Preparing for your first appointment (see below)
- Prerequisites for surgeries and procedures
- Transferring care
Preparing for your first women’s healthcare appointment
1. Complete new patient forms
If you are a new to Four Corners OB-GYN, please download our new patient forms. (download New Patient Forms Package) In advance of your women’s healthcare appointment, fax to 382-0122 or mail completed copies to our office at 1 Mercado Street, Suite 105, Durango, CO 81301. Please bring the originals to your appointment. If you have questions about the forms, we will be happy to help you when you arrive.
2. Contact your insurance company
Please feel free to confirm your insurance coverage prior to your appointment. Our Tax ID # is 84-1451020.
3. Arrive 20 minutes early
To assure that you have enough time to get answers to any insurance questions and other matters, we ask that you please arrive 20 minutes prior to your women’s healthcare appointment time with your paperwork completed. Your insurance card and a photo ID must be presented at this time. Late arrivals may need to reschedule for a future date.
4. Provide co-payment and proof of insurance
Your insurance may require a co-payment for an office visit. This is collected at the time of check in.
If you are insured but have not yet received an insurance card, it is your responsibility to get the necessary billing information from your insurance company in advance. If you are not able to provide proof of coverage and all of the necessary billing information, we will consider you self-pay. (link to Payments in this section) We offer a “prompt pay” discount for uninsured self-pay patients who pay in full on the day of service.
Please inform our office as soon as possible if you are unable to attend your appointment. Failure to contact us will result in a $30.00 “no show” fee.
New patient forms (Download New Patient Forms Package)
New patients should download, print and complete our new patient forms, and have them ready on the first visit. If you have any questions about the forms, we will be happy to help when you arrive.
Records release form (Download Records Release Form)
The records release form enables us to release your medical records or to request them from another office. Please complete the form and fax, mail, or bring it to our office.
Authorization to release information form (Download Authorization to Release Information form)
The authorization to release information form allows us to discuss your medical information with another person or organization. This form is most commonly used by patients who would like their family members or friends to have the ability to discuss their care with our staff. Complete the form and either fax, mail, or bring it to our office.
Pay your bill (link to payment service)
Insurance co-pays are collected at the time of check in. We accept cash, checks, debit cards, Visa, Mastercard, Discover and American Express payments. We bill your insurance as a courtesy, but it is your responsibility as the policyholder to verify your benefits with your insurance company.
If you are uninsured or are unable to provide proof of coverage at the time of your visit, you are considered self-pay. If you are able to pay in full at the time of service, we can offer you a 20% discount on your total bill. If you are not able to pay in full, we must collect at least 25% of your total bill at the time of service, and can set you up on a payment plan for the remainder. The 20% discount is not available in this case.
Uninsured patients who are being seen for their first prenatal visit and ultrasound, and are unable to pay for their visit in full at the time of service, are expected to pay at least $100.
If you have applied for Medicaid but have not yet received your approval letter, you may be considered self-pay. The above options will apply.
Colorado Indigent Care Program (CICP)
We do not participate with CICP. However, if you are able to provide proof of coverage and are able to pay in full at the time of service, we can offer you a discount on your total bill. If you are not able to pay in full, we must collect at least 25% of your total bill at the time of service, and can set you up on a payment plan for the remainder. The discount is not available in this case.
We welcome new patients referred by another care provider, or who choose to transfer their care to our office. If you are experiencing a specific problem or issue and have been diagnosed or treated for it by another office, we must obtain your medical records. The easiest way to do this is usually to have your health care provider fax or mail your records to us directly.
Another option is to have our office request your records. You must fill out a records release form. (Download Records Release Form) Return your completed form to our office and we will request your records.
Surgeries or Procedures
Before we can schedule any kind of surgery or procedure, you must establish care with our office by meeting with one of our providers for an evaluation and consultation. Any previous health records pertaining to the surgery must be transferred to our office. (Download Records Release Form) It is important that we receive these past records prior to your appointment.
Transferring Prenatal Care
If you have been receiving prenatal care from another healthcare provider and would like to transfer your care to our office, we must obtain your prenatal medical records. Please request this record transfer (Download Records Release Form) from your previous provider before coming to your appointment.