New Patient Forms
Please bring those forms with you or fax to 312 944 0007

Patient Health History

Patient Registration  

Patient Rights and Responsibilities 

Orthotic Information

We understand how important your time is, and do our best not to keep you waiting.  Unfortunately, we cannot predict emergencies or the seriousness of each appointment, our office staff will ask you what is the nature of your appointment, please understand that this is in effort to provide the appropriate time for your appointment..  At times, emergencies  can cause us to run late.  We appreciate your patience and strive to make your appointment as pleasant as possible.
 
Billing
We encourage all patients to read their insurance policy handbook and to become familiar with their coverage, deductable and co-pay amounts, policy limitations, exclusions and pre-certification requirements. As insurance plans and coverage benefits change on an ongoing basis, it is the responsibility of the patient to check with their insurance company and plan to ensure that we are a participating provider in their particular plan and that they have benefits for podiatric services. We participate with many medical insurance plans, including Medicare. We do not participate in any HMO plans, Unicare, or in the IDPA (public aid) program. If we are a participating provider on your plan, we will accept your valid insurance card for the services we provide you. Your co-payment will be required at the time of service. Any deductible applied to our fee or non-covered charges will be your responsibility. We will file a claim on your behalf to your insurance company. We do require a current copy of your insurance card and should your insurance change or be canceled please make us aware when scheduling your next appointment.  If we render services and your insurance information in invalid, you will be responsible for the expenses incurred at the visit.

Self-Pay Patients
If you do not have medical health insurance or are receiving medical care  or elective services or "cosmetic or aesthetic services" that are not covered under your benefits payment, you will be considered a self-pay patient in that capacity or for that procedure or visit. Self-pay patients are expected to pay for their visit in full at the time services are rendered. We accept cash, personal check, VISA, MasterCard, and American Express. Our billing service can work with you to establish a payment plan if necessary.
 
Office Hours and Answering Service
Our office phones are answered 24 hours a day. They are answered by our staff during business hours on Monday, Wednesday and Thursday all day. Fridays afternoons are available on an emergency basis. We have an answering service,  for the hours the office is closed (weekends, evenings, and lunchtime 12-1pm) our service can make appointments so you do not have to speak with the office directly to schedule an appointment.  Please call (312) 944-0000 to reach us at anytime. For emergency situations, either call 911, go to the closest ER or have Dr. McCombs paged and she will evaluate and provide instructions.

Cancellation Policy
Please notify us by 4:30 the business day prior to your appointment if you are unable to keep the appointment.  Failure to do so will result in a $25.00 fee.