Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.
Attention: Self-Pay Patients
(Patients who do not have any insurance coverage)
Payment is due at the time in which services are rendered. This includes co-pays, deductibles, co-insurance, and self-pay fees.
There is a minimum of $80.00 for an office visit.
Additional fees may be incurred due to tests or procedures performed at the visit.
Please let us know if you do not have insurance coverage and have questions regarding our policy.
Insurances We DO NOT File
Mahoney Family Medicine participates with most all major insurance plans. We encourage patients to check with their individual policy for network participation.
We do NOT file any type of third party insurance. (EX: auto insurance, workers compensation, accident policy, etc)
Returned Check Fee: $25.00
There is a $15.00 CHARGE for ALL FMLA FORMS & DISABILITY FORMS
To become a new patient, you will need to either contact the office OR fill out the form (attached) and return it to the office by mail, dropping it off, or email to S.Brinegar@mahoneymedicine.com. If you wish to fax it, please send to 276-403-5484