Patient Info/ Forms


 

Insurance

In my desire to put your care and wellness ahead of the Insurance companies paperwork and contractual constraints, our office does not bill any Insurance. I care only to be your doctor not theirs.

We are considered out of network providers which allows me to spend more time with patients and less time with paperwork.

This works well with EPO and PPO plans yet not so great with HMO or Medi-Cal and Medicare.  Each plan is different. So, please call the customer service number on the back of your card to verify your out-of-network benefits and deductible. Labs are covered if you have EPO or PPO plans. We have the option of cash labs that are extremely affordable.

We accept all forms of payment. Our office will provide you with the three things you need for reimbursement from your Insurance:

  • Copy of your Invoice
  • Superbill
  • Reimbursement form from your Insurance plan

Your Insurance company will mail your reimbursement check directly to you.

Please call the office for your Complete cost of care 714-794-1818

Payment Options & Financing

For your convenience, we accept Cash, Certified Check, Visa, MasterCard, and Discover, American Express, FSA and HSA cards.

Payment plans are always considered.

Patient Forms

Fillable Female Intake Form

Fillable Male Intake Form

 

Location
Terese Harris, MD, FACOG
1501 Westcliff Drive, Suite 302
Fashion Island

Newport Beach, CA 92660
Phone: 714-794-1818
Fax: 714-829-1415
Office Hours

Get in touch

714-794-1818