Patient Information - Upper Chesapeake Surgical Associates
Bel Air Office
520 Upper Chesapeake Drive, Suite 412
Bel Air, MD 21014
Phone: (443) 643-4400
Fax: (443) 643-4404
Havre de Grace Office
2027 Pulaski Highway, Suite 205
Havre de Grace, MD 21078
Phone: (443) 843-6363
Fax: (443) 843-6653
Hours: Monday – Friday, 8 a.m. to 4 p.m.
In compliance with a federal regulation known as the "HIPAA Privacy Rule," the physicians and staff of Upper Chesapeake Surgical Associates are providing you with a summary of the Privacy Rule. This notice describes how medical information about you may be used and disclosed and how you may access this information. You may request a copy by calling our office.
If you are coming to our office for a consultation and you or your primary care physician suspect you may need a surgical procedure, this first meeting will be to confirm that surgery is necessary. We will ask you to return to see us for the procedure. This allows us to schedule the amount of time needed to do the procedure and it allows us to contact your insurance if authorization is needed.
Many insurance plans require referrals including HMOs. We will not be able to see you without the referral. We ask you to have your referral sent to us prior to your appointment or that you bring a copy of the referral with you to your appointment. We appreciate your attention to this matter.
Registration and History Information
We require all new patients to complete Patient Registration and Patient History Forms. You should plan to arrive at our office 30 minutes before your first appointment to allow us to make sure all information is complete for when you see the doctor.
If you require surgery, we will contact you to schedule the surgery time and date. The following information link may be helpful in getting some background on your procedure.
Many insurance plans ask that you go to a particular facility for tests. This includes laboratories, x-ray facilities and hospitals. We make every effort to send you to the appropriate facility, however, insurance plans may change preferred providers at times and we do not always receive timely notification of the change. We appreciate your help in ensuring that you are going to a facility that your plan approves.
Prescription refills for medications prescribed by our physicians are to be obtained during our office hours of Monday through Friday between 8:00 a.m. and 4:00 p.m. This allows us to have your medical record available for the physician to review.
We see patients from many insurance plans. Please bring your insurance card with you, as we will make a copy of it for our records. We know it is not always easy for you to know everything about your insurance. We will work with you to ensure we are following the right process for your insurance company. We also ask that you notify us if your insurance changes at any point during your visits with us. We also ask to copy your valid driver's license as proof of identification.
We collect co-payments at the time of your visit as required by your insurance plan. Please be prepared to pay your co-payment when you come to see us. If you are paying for your own health care, we request that you pay for your office visit on the day of service. We will establish a payment plan for surgery, if required.
We will complete disability forms for a minimal fee.