Appointments: (630) 656-3171

HMI Foot and Ankle Group S.C.
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    • Home
    • About Us
    • Services
    • Office Tour
    • Contact
    • Policies/Forms
    • Blog
    • Pay My Bill/Shop

Appointments: (630) 656-3171

HMI Foot and Ankle Group S.C.
  • Home
  • About Us
  • Services
  • Office Tour
  • Contact
  • Policies/Forms
  • Blog
  • Pay My Bill/Shop

New Patient Forms

Short on time? Print and bring your forms already completed to your visit to streamline the check-in process and jump right into your visit! 

Health History Form (pdf)

Download

Office Policies and Consents (pdf)

Download

Payment Plan (pdf)

Download

Educational Materials

Plantar Fasciitis Stretches (pdf)

Download

Achilles Tendon Stretches (pdf)

Download

Postop Nail Removal (pdf)

Download

Office Policies

  • Same day visits: 

Walk-in appointments made for the date of service are welcomed based on provider availability. No additional fee is incurred for same day or emergency visits.


  • Late arrivals: 

Your appointment time is reserved only for you. In the event that you are late to your visit, we are happy to accommodate you at the physician's discretion. However, please be aware that the length of your appointment will not be extended as it would potentially encroach upon another patient's visit.


  • Cancellations: 

We understand that unforeseen events and emergencies may arise. Kindly give 24 hours' notice if you are not able to keep your appointment. Recurrent cancellations within 24 hours of the scheduled appointment date and time can be subject to a cancellation fee or termination from the practice.


  •  Accepted Insurance Plans: 

Blue Cross Blue Shield (BCBS), Aetna, Cigna, United Healthcare, Humana, Medicare, Medicare Advantage, Blue Cross Community, Humana HMO (Gold Plus), Tricare. If your plan is not listed above, please call and our staff can help verify whether it is accepted.


  • ​Financial Policies:

​​We are happy to bill your insurance on your behalf; please be sure to bring a valid insurance card to your visit. Necessary copays (when applicable) are expected to be paid at check-in or check-out of each visit.  It is each patient's responsibility to independently verify deductibles and out-of-pocket maximums prior to the initial visit with our provider. If insurance benefits cannot be verified by the time of your visit, full payment is due at the time of service unless arrangements have already been made.


If covered by an HMO plan, it is your responsibility to obtain a referral from your primary care physician prior to being seen by the doctor. If you do not have your referral at the time of your visit, we would kindly ask that you reschedule or pay for the visit at the self pay cost.


It is also the responsibility of all returning patients to provide updated insurance coverage information. Failure to do so may result in the rejection of claims and the need for the patient to be billed for the full amount then directly reimbursed by their insurance carrier.


  • Self-Pay Options:

Uninsured or underinsured? We do offer cash-pay options for the following visit types:

          New patient consultation (includes digital x-rays)

          Return patient visit

          Return visit for digital x-rays only

          Steroid injections

          Ingrown toenail removal

          Wart destruction

          Callus removal

          Nail trimming

          Biopsies


Durable medical equipment (i.e. surgical shoes, walking boots, ankle braces, over the counter orthotics) are also available for purchase.


Questions about what deductibles and out-of-pocket maximums are and how they play into your financial responsibility?

 Deductible vs. Out-of-Pocket Maximum – Forbes Advisor 


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