Thank you for choosing K. Anthony Shanbour MD, as your healthcare provider. The following is a statement of our payment policy. This payment policy applies to all services provided by K. Anthony Shanbour MD, Inc. All patients are expected to arrive with Photo ID, Insurance Card and complete a patient demographic sheet, patient history form, consent to treat form, and HIPPA. Failure to provide correct information at the time of your visit may result in delay in care and responsibility for the cost of the entire visit.
Our business office will submit a claim for any services rendered to a patient. If you have a secondary insurance payer we will automatically file a claim with them also. It is the patient's responsibility to provide our office with all insurance information.
Payment of co-payment, deductibles and co-insurance are due at the time of your visit. We cannot bill or waive co-payments, deductibles or non-covered service amounts defined as patient responsibility under the terms of our contract with the various health plans. Any remaining balance on your account after the insurance company has processed your claim is due at the time upon receipt of a statement from our office. If a patient is a member of an insurance plan with which we do not participate in our office will also file a claim on the patient’s behalf, however, the patient is expected to make payment in full at the time of service. For our patients with no medical insurance, payment will be due to at time of service and with be subjected to our self pay discount.
Cash, Check, Visa, MasterCard, American Express and Discover are accepted methods of payment. You will be charged a $35.00 bank fee for any returned checks for any reason.
Completion of health forms including those related to Family Medical Leave (FMLA), insurance and disability will be done, however, because of the time involved in completing these documents, there is a service charge. This fee is due prior to completion of forms and every time it is requested. This charge cannot be billed to the insurance company and will be your responsibility. Please allow us 2 weeks to complete these documents.
Thank you for understanding our financial policy. If you have any questions regarding your bill or the status of your account please call K. Anthony Shanbour Office at (405) 237-9878.
Download, print and complete the forms that pretain to your visit. Please arrive 30 minutes before your appointment if you are a New Patient.
Consent to Treat Form
HIPAA Privacy
Welcome to Patient Portal, your medical home on the Web. With Patient Portal, you can connect with your doctor through a convenient, safe, and secure environment.
We accept many insurances, listed below are just a few insurances we accept. Please feel free to call our office for more information.
