Patient Information
Online Forms
The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save a significant amount of time during your visit. Please be prepared to provide this information to our office along with your current insurance information.
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Patient Registration Form |
If you do not have a copy of Acrobat Reader you can get one for free by clicking on the icon 'Get Acrobat® Reader'.
Payment Options
At the time of your initial visit, your treatment plan will be established along with an estimate of fees. We will file your insurance paperwork to help you receive all entitled reimbursements. Please bring your insurance forms with you and have your portion filled out and signed to expedite the filing of your claim.
Filing your claim: Our financial secretary will be happy to discuss payment arrangements that will suit your needs. We accept cash, check, VISA, Mastercard and Discover. In order to contain billing costs, we ask that all accounts be paid within 60 days from the date of service. If an account goes over 60 days, a finance charge of 1.5% per month (18% per year) is added to the unpaid balance.
Insurance
Our insurance coordinators deal with many insurance companies. Some companies offer up to six medical plans. Because many companies frequently change policies, it is sometimes difficult to accurately estimate our patient's insurance co-payment. Many insurance companies will not give out fees until after the treatment is completed. As a courtesy, we ask that you keep us informed of any changes to your insurance. It is important that all information about you is current.
Co-Payment: All co-payments are payable when you check in at the front desk.
HMO Patients: If a patient comes to us with a problem that they expect to be covered by medical insurance, (biopsies, tumors, infections, deformities), they must have a referral from their primary care physician. A referral from a dentist is not adequate for medical insurance coverage. Obtaining a medical referral is the patient's responsibility. We cannot obtain the referral for you, and the referral cannot be obtained retroactively. If you do not have a referral, we will be happy to see you on a cash basis, but your medical insurance company will not pay for your treatment.
Medicare Patients: Medicare pays us directly for your care. You are responsible for any deductible and co-insurance. If Medicare denies your procedure, you are responsible for the charges.
Private and Group Insurance: As a courtesy, we will file your insurance claims for you. Upon receipt of an insurance payment, any balance due will be billed to you. If you have deposited an excessive co-payment, it will be refunded to you.
If you have any problems or questions, please ask our staff. They are well informed and up-to-date. Please call if you have any questions or concerns regarding your initial visit.
Financing Available!
- Chase Healthcare - our Provider ID is 30557
- Care Credit
Apply with any one of these finance companies that can design an affordable repayment plan that works for you. Your application can be reviewed and approved online in just a few minutes. Simply click on one of the links above or ask about our finance options during your visit.
Gift Cards
Are you looking for the perfect gift? Spa Serene MD surely has something your loved one would enjoy. Whether it's a Deluxe Manicure or Facial for her or a Hot Stone Massage for him, give your loved one the gift of relaxation. Gift cards are available for you to simply put a specific dollar amount on a gift card and let your loved one decide what service is right for him or her. We invite you to let your loved one Relax, Recharge, & Rejuvenate with Spa Serene MD.
Careers
Ritacca Laser Center and Spa Serene MD are always looking for experienced and qualified candidates to join our team. Please email info@ritaccalasercenter.com with your resume and salary expectations for any of the following positions:
- Front Desk / Reception
- Aesthetician
- Administrative Assistant
- Experienced Nail Technician
- Experienced Massage Therapist
Special Events
To Be Announced
