Commonly Used Uninsured Services

  • Prescription renewals by phone or fax (often require review of the chart): $25.00 per medication per renewal
  • Notes for work / school absence: $30.00
  • Insurance letters for allied health care professionals: $30.00
  • Physician referral request without office visit: $35.00
  • Fax/E-mail requisition without office visit: $25.00
  • Telephone consultations with patients: hourly rate
  • Minor 3rd Party Forms: $40.00
  • Intermediate 3rd Party Forms: $60.00
  • Major 3rd Party Forms: $80.00