Registration
Patient registration is easy, but requires you to do the following things:
1. Download and print the Kidney Associates Registration Form and Kidney Associates Patient Information Form.
2. Download and print one of the following forms,
- I have indemnity health insurance.: Here is an insurance form. If you have indemnity insurance, please read and sign.
- I have Medicare.: Here is the Medicare Form - Please read, review and sign if you have Medicare.
- I am enrolled in a managed care.: If you are in a managed care plan, please read and sign this form.
- I am paying cash.: If you are paying cash for your care, please read, review and sign this form.
3. Download and read the Notice of Privacy Practices Agreement. It is part of the Patient Information Packet. Once you have done so, please download and sign the
Each patient consent section should be carefully read and signed to give authorization for medical services rendered and to comply with HIPAA regulation. Please download, read and complete. Then fax to (713)795-4627 This form acknowledges that you read the HIPAA agreement and consent to treatment
4. Fax the registration form, your financial agreement form and your consent form back to us at (713) 795-4627.
That's it. Please be sure to call to schedule and confirm appointments at (713) 795-5511.
Patient Information Packet - General information about Kidney Associates, the Privacy Policy, and what you can expect when receiving services from our providers.
Scheduling Requirements - Patients should allow a minimum of three days for account set-up, insurance verification and to obtain paperwork from their primary care physician (i.e. clinical notes, lab results, medication list and any test results). It is the resonsibility of the patient to obtain referrals and notify the office of any change in insurance, address and phone. failure to provde current information may result in unexpected out-of-pocket expenses for the patient
Parking/Appointment Arrival - Please allow an extra twenty minutes travel time due to medical center traffic and garage parking. Please note: there is a fee to park in the parking garage, which is the responsibility of the patient. Kidney Associates requests each patient arrive ten minutes prior to scheduled appointment time and new patients arrive twenty minutes prior to complete any remaining new patient paperwork. Patients arriving thirty mintues later than their scheduled appointment will be rescheduled.
Required Documents - Requred information/documents may be provided by phone or returned by mail (Kidney Associates, PLLC 6655 Travis, Suite 720, Houston, TX 77030), fax (713-795-46270, or e-mail (info@kidneyassociates.com). in an effort to meet our core values and provide you the highest level of service, we requre this information for all scheduled appointments.
Kidney Associates is proud to be able to serve you. If you have feedback, questions or concerns please contact the administrator at your earliest conventience (Tomorrow Orsak, 713-795-5511 torsak@kidneyassociates.com).
