What you need to bring when you visit us
•	Insurance card
•	Co-payment (due at time of service)
•	Referral forms (if applicable)
•	Previous health records
•	Patient Demographic Sheet ( download form )
•	POS Waiver ( download form )
•	Medical Records Release ( download form )

Financial Policy

Before starting medical services and treatment or at your first visit, we will require all of your insurance information, including a current insurance identification card and any referral or authorization that may be required. If you have any questions regarding your insurance coverage prior to your visit, please call your insurance company and/or our office at (323) 725-0167.

South Atlantic Medical Group is a participating provider with Medicare and Medi-Cal, and we accept assignment. SAMG is also a participating provider with HMOs and managed care organizations. Required co-payments under arrangements patients have with your HMO or managed care organization are the responsibility of the patient and payable by the patient or the patient's secondary insurance carrier (if such exists and prior arrangements are made with us). As a courtesy to our patients, we file all necessary and appropriate insurance claims. If you are covered by Medicare, Medi-Cal or HMO/Managed-Care program, you must contact our office prior to your first visit.

You are requested to pay any co-payment amount at the time of service. Additionally, you are responsible for the timely payment of your account. All patient balances are due within 30 days of our statement date.

If your visit requires tests, procedures or any other services done outside of our offices, these services will be billed to you directly by the provider. We will give these providers all your insurance information.

Our office staff is always willing and available to discuss billing matters with you at any time. We know that you will agree that your clear understanding of our financial policy is important to our professional relationship.