New Patient Forms

NEW Patients:

We no longer accept HMO forms of insurance plans requiring a paper referral or accept new patients with United Health Care.

1.  We currently participate with: PPO, POS, Open Access types of insurance coverage from Aetna, Anthem, BCBS, Cigna, Federal BCBS and HMO forms of Aetna which have electronic referrals (these need to be sent to Aetna by your primary care physicians prior to your visit). If we do not participate with your insurance and have an out of network option, payment is due at the time of service.  We will provide you with the information necessary for you to file for reimbursement with your insurance. Our medical biller can also help as a courtesy with your claim form, however we cannot guarantee your insurance reimbursement, most reimburse 80% of costs paid by the patient.

If you or your physician would like for a consultation letter to be sent back to your primary physician: You must obtain a written request from your primary physician for a consultation visit which includes evaluation and testing as needed* for allergy, asthma, or immune disorder. This can be a simple note on a prescription pad or on letterhead (which includes the physician’s name, address, & phone/fax number printed on the paper) and may be faxed to our office or brought by the patient at the time of visit. When calling to make your appointment please have your insurance card in front of you to provide information regarding your insurance.

2. Please print, complete and bring in with you on the day of your appointment the forms below:

3. Please plan to arrive 15 minutes prior to your appointment to sign in, pay co-pays and be triaged prior to seeing the physician. If you are unable to ACCESS THE PATIENT PORTAL ahead of time, please arrive 30 minutes prior to your appt time and complete them in our office. We are closed from 12-1pm for lunch.

Don’t forget to bring along your insurance card, photo ID, your new patient questionnaire, registration form and method of payment for your co-pay (cash, credt card-VISA or MC).

Please check your benefits regarding visit and testing coverage prior to making your appointment. Every insurance policy is different and only your insurance company can tell you about your coverage.

All co-pays, out-standing balance and deductibles are due at the time of the visit.

Instruction: For accurate allergy testing, we recommend patients be off of their antihistamine medications for 1 week prior to their appointment. Patients may continue to take their nasal steroid sprays. Commonly used antihistamines include: Benadryl (Diphenhydramine), Chlorpheniramine, Atarax (Hydroxyzine), Claritin (Loratadine), Clarinex (Desloratadine), Allergra (Fexofenadine), Zyrtec (Cetirizine), Xyzal (Levocetirizine). Astelin nasal spray; Astapro; Patanase are antihistamine nasal sprays (other nasal sprays such as steroid sprays are usually fine) and many allergy eye drops such as Pataday, Patanol, Optivar, and Zaditor also contain antihistamine and should be avoided for 5 days prior to the visit. Please contact us if you are unsure if your medication is an antihistamine.

For asthma patients, daily maintenance asthma medications may be continued, however if possible do NOT use your rescue medication/bronchodilators (short acting beta agonist) Albuterol/Proventil/Xopenex/Maxair/ Ventolin or long acting beta 2 agonist such as Serevent 24 hrs prior to appointment. If unable to remain off your rescue medication due to symptoms of shortness of breath, wheezing or cough, please notify the nurse at the time of the appointment. If you have any questions, please contact us at (703) 558-6040.

Appointments: If you will not be able to make your appointment, please kindly call 48 prior to your appt time and reschedule so that another patient from the waiting list may use that appt slot. If you will be more than 15 minutes late for your appointment, please call and reschedule your appointment as you have missed your appointment and a $50 no show fee may apply.

There is a $30 no-show or late cancellation fee (less than 2 full business days, 48 hours). Please have your credit card in front of you to provide in order to hold your appointment. Your credit card will not be charged unless there is a no-show or late cancellation (less than 48 business hours prior to the appointment).

Please expect to spend between 1-2 hours on your initial consultation visit (usually includes skin testing and/or spirometry testing). Most follow-up appointments without testing are about 20-30minutes, depending on the patient’s medical diagnosis.

***If you are having acute medical problems and we are not able to see you immediately or it is after hours, please contact your primary care provider, go to an urgent care center or the nearest emergency room.***

Patients receiving immunotherapy vaccine shots should expect to remain under supervision in our office for 20-30 minutes immediatey after receiving your injections. For those patients receiving Modified RUSH immunotherapy or Xolair, please plan to wait 2-21/2 hrs in the office after your injection (be sure to bring your epinephrine autoinjector with you). AVOID vigorous activity for 2 hours after you receive your shot. Please inform the allergy nurse or MD if you are pregnant or started on a new blood pressure medications such as a beta blocker.

Payment methods: currently accepting cash and credit card: Visa and Mastercard. No personal checks, except from established patients.