818-843-5864Patient Forms
Forms Packet
Please print and complete these forms before your appointment, and bring them with you to your appointment.
- Patient Forms Packet (8 pages)
Individual Forms
If you need a form from the packet above, please choose from the list below.
Insurance Information
California Chest and Medical Center accepts the insurance plans shown below. If your plan is not shown, please call us at 818-843-5868 or your insurance provider to confirm your coverage and our participation.
- Aetna
- Beechstreet
- Blue Cross Blue Shield
- Champus/Tricare
- Choice Care
- Cigna
- First Health
- First Medical Network
- Great West
- Humana
- Healthnet
- Health care Partner- HMO
- Medicare
- Oscar insurance
- PHCS/ Multiplan
- Preferred Plan
- State Health Plan- Covered California
- United Healthcare
- Wellcare
California Chest and Medical Center provides self-pay discount for patients who are uninsured. Please contact our office for more information.
Office Policies
Appointments
You may request an appointment online or by calling our office at 818-843-5864. We choose to use personal scheduling, as opposed to a voice mail system. Same day appointments are available, when necessary. We call to confirm appointments approximately one week in advance.
Appointment Cancellation
The office requests a minimum of 24-hour notification. There may be a charge for appointments which are not cancelled.
Telephone & Online Consultation
Communication is an important part of a successful doctor-patient relationship. Patients are encouraged to call or use email for clarification of instructions that are not well understood.
As a convenience, the doctor offers telephone and online consultations when appropriate. Some patients due to illness, disability, distance, or time restraints find this more convenient than an office visit. Many problems can be safely and efficiently handled by telephone or online. This service will start after 1/2018.
Charges for consultation are based on time and are the same whether in the office or on the telephone. Some insurance carriers cover telephone and online consultation. Some do not. Medicare will not.
Medication Refills
Most refills are processed electronically. If one of your medications needs to be refilled, simply ask your pharmacy to fax our office at 818-843-5860 for authorization.
If you do not have access to, or are not comfortable with a computer, please call our office for assistance at 818-843-5864.
Fees
Consultation fees are determined by the amount of time required. Testing is additional. We are happy to discuss our fees with you. We will bill your insurance for the service. If there is a co-payment please pay at the time of service and left over bill after the insurance has paid their portion will be billed to the patient. Please remit payment as soon as possible to avoid collection efforts.
Insurance
Dr. Mayur Patel is in network provider for all private insurance plans. We do bill your insurance directly.
Medicare
Dr. Patel is enrolled as a Medicare Provider. Reminder Medicare pays only 80% of the bill , rest is pid by secondary insurance or patients.