Patient RegistrationClick Here to complete and submit our
Secure Online Registration Forms Click Here to Update your medical history (for previous patients) Or you can download, print and complete the forms below then bring them with you to your appointment: 
SchedulingSouthern Colorado Oral & Facial Surgery is open Monday - Friday
8:00 am until 4:30 pm We will schedule your appointment as promptly as possible. If you have pain or an emergency situation, every attempt will be made to see you that day. We try our best to stay on schedule to minimize your waiting. Due to the fact that our practice provides surgical services, various circumstances may lengthen the time allocated for a procedure. Emergency cases that we take can also cause delays. We appreciate your understanding and patience. Please call 719-542-4546 with any questions or to schedule an appointment. Privacy PolicyWith your consent, the practice is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment, and health care operations. Protected health information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination and test results, diagnoses, treatment, and applying for future care or treatment. It also includes billing documents for those services.
The American Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a set of rules to be followed by health plans, doctors, hospitals and other health care providers. HIPAA took effect on April 14, 2003. In the health care and medical profession, the great challenge that HIPAA has created is the assurance that all patient account handling, billing, and medical records are HIPAA compliant. For example, patients must be able access their records and correct errors and must be informed of how their personal information will be used. Other provisions involve confidentiality of patient information and documentation of privacy procedures. This summary of our privacy practices contains a condensed version of our Notice of Privacy Practices. Our full-length is available upon request and is also available in the waiting room. |
First ConsultationWe consider your first appointment with our practice an important educational visit for both the patient and the practice. We use this time to truly listen to your concerns and expectations. We take the necessary time to educate you with accurate information about your condition and effective treatment plans.
Dr. Payne will personally discuss the surgical and anesthetic procedures involved in your upcoming procedure and will provide you with a custom treatment plan. Many of our patients have found that this personal touch and attention to detail provides the necessary comfort to accomplish your required treatment. Occasionally, surgery can be performed the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day. Please assist us by providing the following information at the time of your consultation:
Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e., diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are currently taking any medication (i.e., heart medications, aspirin, anticoagulant therapy, etc.). Financial InformationFor your convenience, we accept Visa, MasterCard, American Express, Discover, Debit and Cash.
Many patients put off treatments and procedures because they cannot afford to pay. Therefore, Dr. Payne offers CareCredit payment options as an alternative to consumer credit cards, cash or checks. This allows you to pay over time instead of a lump sum prior to treatment. Use your card to get flexible payment plans for the health care treatments your family needs. Payment is due at the time service is rendered unless other arrangements have been made. Some procedures may require payment in advance. Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage. If you have questions regarding your account, please contact us at 719-542-4546. InsuranceBecause some of our procedures are covered by medical insurance and some by dental insurance, we work with you to maximize your insurance reimbursement for covered procedures. In order to help you get the maximum benefit from your coverage, we ask you to take a few moments to understand our policy.
As a courtesy to all of our patients, we will file your insurance claim or assist you in completing the proper forms. On the day of your consultation, please bring your medical and dental insurance cards, as well as your driver's license. We can provide you with an estimate of your coverage and co-payment. It is important to remember that the information we receive from your insurance carrier is an estimate only and the actual payment made by your insurance company may differ. If your insurance carrier pays less than expected, a small balance may be due. You will receive a monthly statement reflecting the status of your account. It may take several weeks or months to finalize your insurance claim. We will make every reasonable attempt to maximize your insurance benefits. Please be aware, however, that any insurance coverage you have is a contract between you and the insurance company. Dr. Payne is not a party to that contract. You are fully responsible for any balance due on services you have received. Not all services are covered by all policies. Some insurance companies may arbitrarily deny certain services. If at any time you have questions, please call (719) 542-4546. We are always here to help answer your insurance questions. | ||||