For your convenience and to decrease the time you spend waiting for your consultation, please complete the following forms in advance and provide to our staff at the time of your appointment. Each form can be completed and printed right from your computer’s browser or saved directly to your computer for your permanent record.
We accept most traditional PPO plans, including but not limited to Blue Cross/Blue Shield, United Healthcare, Cigna, Aetna, Golden Rule, Beech Street, AvMed, Medicare and many others. Please call us for a complete listing of covered plans.
Co-pays are due at the time of your visit and can be paid by credit card, debit card, check or cash. We accept American Express, Visa, and Mastercard.
Balances due after your insurance company has paid their percentage of the allowed reimbursement is forwarded to you in your patient statement.
Note: Some cosmetic procedures may not be covered under traditional health care plans, and we make every effort to convey this information to our patients prior to any surgery scheduling.
There are times when patients without insurance need an operation. For these patients, Dr. Koller offers special discounts and payment options to help patients get the surgery they need with the same quality and convenience provided to patients who have insurance coverage. Most patients who lack insurance coverage or who have high out-of-pocket deductibles can be seen and cared for as any other patient.
Surgery is always performed in an approved hospital operating room or outpatient surgery center. Usually, all pre- and post-operative care is included in the cost of an operation. There are no hidden fees or unnecessary expenses. All costs are explained up front and all questions are thoughtfully answered. There is no reason to put off that necessary operation any longer. Quality surgical care by a Board certified surgeon is now just a phone call away. Call us today to find out if you qualify for no-insurance surgery.