Forms

First-time Patient? No problem, we’ve got you covered. Just download the forms and print them out. Return them before your first visit and avoid the dreaded wait time.

Welcome Packet

Prenatal Packet

Prescriptions and Renewals

Clinton Women’s Health Care is committed to cost-effective healthcare. To assist patients that have high deductibles and copays with medications, if your treatment plan includes medication, the Physicians will always offer a generic brand of the drug first. This policy has been mandated by Healthcare organizations everywhere and physicians are being tracked on how many generic drugs are prescribed.

It is our policy to manage any new condition with a patient that is requesting a prescription to be seen in the office. It is required the physician have the opportunity to review your medical condition face to face and discuss the best plan of care for you. Refilling of prescriptions can be requested in several ways, including calling the triage receptionist to have your request sent to the physician or by logging into your Health Record Account through the secure patient portal to send a request electronically.

Prescription refill requests require up to 48 hours for processing. Your physician may be on call at the hospital or performing surgery on days they cannot access your requests. Allow plenty of time when calling or sending your requests.

Insurance

WE PARTICIPATE WITH MOST PLANS

Our staff will gladly submit all claims for you if we participate in your plan. Please bring your insurance card and forms with you to your appointments, and notify us if your insurance coverage changes.

Insurance plans vary greatly. Therefore, we ask you to be aware of what your insurance plan covers, particularly deductibles and co-payments.

We require copay and balances at the time of service. If you are not covered, or if we do not participate with your insurance plan, we appreciate payment at the time of your visit. For your convenience, you may pay by cash, check, and card.

Currently accepted insurance plans:

  • Aetna U.S. Healthcare
  • Alliance Health and Life
  • Beaumont Employee Health Plan
  • Beaumont Services Company
  • Blue Choice
  • Blue Cross/Blue Shield (Blue Preferred, Blue Preferred Plus, Community Blue
  • Cigna HAP Preferred
  • Cigna Healthcare
  • Cofinity
  • First Health/CCN
  • Great West
  • Health Alliance Plan (HAP)
  • HAP Preferred Health Plan (PHP)
  • Humana
  • McLaren
  • Medicare
  • Medicare Aetna Open Plan
  • Medicare Alliance
  • Medicare Health Plus Senior
  • Medicare Plus Blue
  • Messa
  • NPPN (National Preferred Provider Network)
  • Priority Health
  • Private Healthcare System (PHCS)
  • Tricare Standard (formerly Champus)
  • United Health Care
  • United Physicians Health Insurance Plan