Patient Information

Late Policy | First Appointment | Patient Forms | Cancellation Policy
Privacy Practices | Insurance Filing | Payment Plans
Motor Vehicle Accidents/Litigation | Authorizations

We feel it is important that you understand what to expect as a patient of Guilford Neurologic Associates (GNA). Please note the policies listed below. If you have any questions, do not hesitate to call our office regarding any of this information.

Late policy

  • For 30 minute appointments if you are more than 10 minutes late you will be rescheduled.
  • For 15 minute appointments if you are more than 5 minutes late you will be rescheduled.

Your First Appointment

Please arrive early to your first appointment so that we may complete your paperwork. Also, please bring the following with you:

  • Your insurance card
  • Photo identification
  • Physician referral forms if required by insurance
  • A list of current prescription or over-the-counter medications you are taking, including dose and frequency
  • Pertinent information about your medical and surgical history
  • Any recent x-rays or appropriate records you may have
  • Copay or co-insurance amount
  • Completed new patient forms, if received or downloaded in advance

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New Patient Forms

For your convenience, you can print out the patient information form prior to your next appointment. Please bring the completed form with you to your visit.

[PDF help]

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Cancellation Policy

Failure to keep your scheduled appointments at Guilford Neurologic Associates hinders our ability to provide the best care to our patients. So, to limit missed appointments, we have implemented a cancellation policy effective January 15, 2010

We ask that you show our physicians and our other patients consideration by calling at least 24 hours prior to your appointment, if you are unable to keep it.

Due to an increase in missed appointments for both new and return patients, a $35.00 rescheduling fee will be charged for appointments that have not been cancelled within 24 hours of scheduled time. In order to reschedule the appointment the fee must be paid. If you are unable to keep your scheduled appointment for any reason, please contact us at (336) 273-2511 so tht we may make that appointment time available to another patient.

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Privacy Practices

The privacy of our patients' personal information is important us. Please review a copy of our privacy practices. [PDF help]

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Insurance Filing

As a courtesy to you, we will generally file your charges with your primary health insurance carrier. Regardless of your insurance coverage, you are responsible for the charges for your treatment in our office. Please come prepared to pay your unmet deductibles and co-pays at the time of service. If you are covered by Medicaid or by an HMO with which we participate and do not bring your co-pay, your appointment may be rescheduled.

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Payment Plans

When necessary, our staff will work closely with patients who require a payment plan. Financial arrangements should be made by calling our office before your appointment. If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company.

GNA accepts MasterCard, Visa, American Express, Discover, and most HSA Debit Cards. We participate with the following insurance plans:

All HMO Medicare Plans
Blue Cross Blue Shield
United HealthCare (UHC)

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Motor Vehicle Accidents/Litigation

We do not file with automobile insurance carriers, nor do we hold bills at the request of attorneys who handle motor vehicle accidents or other litigation. Payment for services rendered under these circumstances is due in full at the time of service. We will be glad to provide you with a statement of your charges so that you can receive reimbursement for your payment.

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Many managed care companies and Medicaid Carolina Access require that your visit here be pre-authorized, usually by your primary care physician. It is the patient's responsibility to have referrals authorized. Please check with your insurance carrier if you have questions about the authorization requirements.

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