1401 Foulk Road, Suite 202 • Foulkstone Plaza, Wilmington, DE 19803
Phone: (302) 478-5650 • Fax: (302) 477-0455
Patient Info
What Do I Bring?
Prepare for Your Visit
We ask that you present your current insurance card at each office visit and be prepared to pay your co-pay at each visit. If you have wellness forms please bring these at the time of your visit.
Medical Records, immunization records, insurance card, photo id, co-payment, family health history, list of prescription drugs and over the counter drugs, vitamins and supplements that you currently take, how often and why.
Payment Options/Financial Policy
How may I pay? Payments can be made by cash, money order, check, debit or credit card. A returned check fee in the amount of $25 may be assessed to your account for every check returned for insufficient funds, stopped payment or closed account.
If you have an outstanding balance for an extended period you may be asked to agree to a payment plan.
Patient Insurance plan requirements. We will do our best to assist you with your insurance company’s requirements, however it is the patient’s responsibility to ensure that all required permissions are obtained, including referral, pre-certification, and pre-authorization and using in-network facilities. You will be responsible for the entire bill if the payment is denied by your insurance company for failure to meet requirements. We make every effort to find a payment solution, but please understand that payment of your bill is part of your care.
Insurance and Personal Information
It is the patient’s responsibility to ensure that we have the most current and up to date information. You must bring your current insurance card to each office visit, and notify us of any changes in address or phone number.
Co-Payments: Please be prepared to pay the co-pay at each visit.
SELF PAY (Cash/Credit Card) Patients: If you do not have health insurance, payment in full is expected at the date of service.
Form Completion: We will complete forms submitted to our practice, there is a charge for some forms, and you can obtain fees associated with these requests from our office.
Missed Appointments: we request at least 24 hours’ notice for cancellation of appointments, you may be assessed a fee if not given 24 hours notice or your cancellation.
MEDICARE: Our office accepts Medicare, accepting this plan means that we must accept Medicare’s approved amounts. Generally Medicare pays a portion (usually 80%) of the approved amount above your deductible. In addition to your deductible, you are responsible for the other portion (usually 20%) of the approved amount unless you have a supplemental plan that covers these fees. You will be billed for any allowable balance not covered by Medicare and/or your supplemental insurance plan.
RX Refill
Please leave your name, date of birth, name of medication, dosage, frequency and provider’s name along with your pharmacy name. We ask for 24-48 hours’ notice to fill prescription refills.
INSURANCE INFORMATION
We accept the following:
Aetna
AmeriHealth
Blue Cross Blue Shield
Cigna
Coventry
(existing patients only)
Christiana Care
Quality Partners
Independence Blue Cross
Keystone
Medicare
Optimum Choice
Personal Choice
Tricare Prime
(out of network provider)
Tricare Standard
(out of network provider)
United Healthcare
(existing patients only)
Currently not accepting
Bravo
Devon
Delaware Physicians Care
State Medicaid
United Healthcare Community Plan/Unison
Please contact our office if your insurance plan is not listed.
Matthew M. O'Brien, M.D.
1401 Foulk Road, Suite 202 • Foulkstone Plaza, Wilmington, DE 19803
Phone: (302) 478-5650 • Fax: (302) 477-0455