RSI
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FORMS

Forms to bring

& insurances

Demographic Forms

Please complete the Patient Demographics forms prior to coming to your first appointment.  Please bring completed forms with you on your first visit.  We request that you arrive 30 minutes prior to your appointment time on your first day to ensure that we have all paperwork necessary for your appointment.  Be sure to bring your driver's license and insurance card with you, along with any referral, authorization, hospital discharge paperwork, or post-surgical paperwork.  Please bring any surgical reports or other documents you have from your doctor.


Patient Information

Please see our Patient Information form.  This contains important information about our office and our policies.

 


Patient Privacy Forms

Please see our Patient Privacy Practices.  We ensure that you and your loved one will get the care you need and the privacy you deserve.  We take your privacy very importantly, and uphold all HIPAA practices in our office.

 


INSURANCE

We make dealing with insurance as-easy-as possible. Below is a partial list of the insurance providers we accept. Call today to see if we participate with your insurance carrier.

  • Aetna (HMO & PPO / POS) 
  • Alliance 
  • BC/BS Federal 
  • BC/BS Maryland 
  • BC/BS National Capital Area 
  • Capital Care 
  • CareFirst Blue Cross/BlueShield 
  • Cigna
  • Evergreen 
  • GEHA 
  • GHMSI 
  • Great West 
  • Health Keepers 
  • Humana 
  • Kaiser Permanente
  • Johns Hopkins
  • MAMSI 
  • MD-IPA 
  • Medicaid/Medical Assistance
    (up to 20 yrs) 
  • Medicare 
  • One Health Plan 
  • Optimum Choice 
  • Optum Health 
  • Personal Injury Protection (Auto/PIP)
  • Priority Partners 
  • PHCS 
  • Potomac Physicians 
  • Tricare / Tricare Prime 
  • United Healthcare 
  • Worker’s Compensation 

Memberships, Resources & Recognition

  • We hold membership in the following either collectively as an organization or individually among our staff:
    • APTA, AOTA, ASHA,
  • Over the years, we have worked with many wonderful organizations, and we would love to share information about them with you.
  • We are honored to be recognized as a "Favorite Doctor" by Chesapeake Family Life