PATIENT INFORMATION

PATIENT INFORMATION

Blue checklistMedication Refills
Please ask your pharmacist to submit the refill request to our office.

What to Bring to your Appointment
Please be sure to bring the following to your appointment:

  • Insurance card
  • Co-Payment is required upon check-in
  • Insurance referral if necessary
  • Picture identification card such as your drivers license
  • Test results or images related to your current problem
  • A list of your current medications

Patient Paperwork – A Necessary Requirement
Please arrive twenty minutes prior to your first appointment time to allow sufficient time to complete our patient information and medical history forms and to obtain our practice policy guidelines. For your convenience, you can download these forms below, and complete them before coming into the office. Then, you can simply present the completed and signed forms to our receptionist when you arrive.

Patient Information Document
Below is our Patient Information document & Patient Demographic Form which you can download and complete at your home or office. By completing the forms in advance, you can speed up the check-in process when you come to our office for your appointment. It includes the following sections:

  • Patient Demographic and Medical History Form
  • HIPAA Notice of Patient Privacy
  • HIPAA Notice of Patient Privacy Acknowledgement and Designation Disclosure
  • Financial Policy and Obligations of Patients

We require newly completed information for each patient every twelve months. While we understand that this paperwork can be an inconvenience to complete, today’s healthcare system and structure for the payment of services requires updated and verified information annually. We thank you for your understanding and anticipated cooperation.

Click here to download the Patient Information Document
and Patient Demographic Form

 

Insurance Information

Brandywine Urology Consultants will attempt to receive authorization for your care. Please contact your insurance provider to confirm your benefits and any necessary steps to obtain care, such as required referrals and in or out of network benefits. You will also want to check with your Primary Care Physician regarding your benefits and to obtain referrals for your care at Brandywine Urology and other facilities. This applies to private insurance providers as well as community plans and Medicare/Medicaid.
Due to the always changing nature of plans and benefits, we strongly suggest you check with your provider prior to scheduling and receiving care. 

We accept the following insurance plans:

  • Aetna US Healthcare
  • AmeriHealth – Independence Blue Cross Blue Shield
  • Blue Cross Blue Shield of Delaware
  • Christiana Care Quality Partners
  • Cigna Healthcare (Anthem Inc.)
  • Coventry Health
  • Health Options (administered by Highmark BC/BS)
  • Highmark Blue Cross Blue Shield
  • Medicare
  • Medicaid – EDS
  • United Health Care (WE ARE AN OUT OF NETWORK PROVIDER)*

*Brandywine Urology does not participate in United Healthcare Community Plan. We do, however, provide post hospital continuity of care for these patients and can obtain authorization with some diagnoses. Please contact United Healthcare Community Plan for the most accurate, up-to-date information.

IMPORTANT: if your insurance policy requires a referral, you must have that referral information in hand for our receptionist at the time of check-in or already submitted electronically by your Primary Care Physician. If you do not have this arranged in advance, your appointment may have to be rescheduled.
As always, please contact your insurance company directly if there are questions as to whether we are a participating provider and to clarify their requirements for appointments & procedures.

 

Hospital Affiliations
For our patients’ convenience, our practice is affiliated with:

  • Christiana Care Health System – Christiana Hospital
  • Christiana Care Health System – Wilmington Hospital
  • Christiana SurgiCenter
  • Delaware Outpatient Center for Surgery
  • Saint Francis Hospital