The patient download forms are listed below, but first, we request you read this brief note regarding our payment policy (because Dr. Allen is NOT participating in any insurance plans).

ACO Payment Policy

As a patient who may own a health insurance policy, you are ultimately responsible to understand the parameters of your policy. We have learned that what they tell us is not always correct, nor it is what they may tell you, the policy holder. Thus, you must stay on top of your policy and its coverage. Dr. Allen is NOT in any insurance plans, he does NOT accept your insurance. Thus, it is going to be important that you understand the following components of your policy, to mention a few, in case you may wish to try to get reimbursed on your own.  Here are some items we suggest you understand:

- The difference between in-network and out-of-network coverage
- if written referral from your Primary Care Physician is required
- services that are covered, and not covered
- deductible and co-pay amount etc.

In order to assist you with this we have provided the Patient Guide to Insurance Verification on our website

* IMPORTANT:   Our office will no longer inquire about your insurance benefits for chiropractic/physical medicine/physical therapy. Dr. Allen's practice is a cash only practice and does not accept insurance assignment. We will provide you with a detailed billing receipt with diagnosis codes and all that you will need to submit your insurance claims to your provider. There is never any guarantee that your insurance will provide coverage for your care. Please note that your submissions will be considered "out of network", since Dr. Allen is no longer participating with any insurance providers.  He still is however still involved as a Medicare provider. It is up to you to take up any insurance coverage issues with your insurance carrier. Questions regarding your coverage should be addressed to your insurance carrier and not ACO.




2. Patient Guide to Insurance Verification Form

3. Medicare Form /Note

4. Notice of privacy form