Change of Insurance

Change of Insurance General Information​

You must supply the office a copy (front and back) 0f your active insurance card before the date of your appointment by one of the following options:

Change of Insurance Submitter Form
  • Patient Contact Information

  • New Insurance Information

  • Date Format: MM slash DD slash YYYY

Please understand that it is your responsibility to provide your doctor’s office proof of and time to verify the active status of your health insurance policy prior to your office visit. If you are unable to do so, please understand that you will be expected to pay the full cash price for your visit at the window prior to your visit. Following any office visit we will be happy to submit a claim on your behalf to your insurance carrier, with exception of Medicare. Of course any funds recovered from your insurance claim will be applied to your account and you will receive any fee adjustments per your health insurance contract. Cash prices are as follows: What happens if I do not supply proof of insurance before the date of my visit?* Be prepared to pay full cash price for your visit:
New Patient: $270.00
Follow-up w/ Dr. Jawad Riaz: $175.00
Follow-up w/ NP or PA: $120.00

If you have any questions please call our office before the date of your appointment: (972) 985-7499