Easily register with our convenient patient forms
Our New Patient Forms are available in PDF format and will help to make your registration process faster and eliminate some of the paperwork you would normally fill out in the office before seeing the doctor. Patients are requested to download these patient forms and email or fax them to 713-715-6367 within 2 days of when they schedule their in office new patient appointment. To be in our practice, all patients have to maintain an email address that they check regularly, therefore we no longer mail our New Patient Forms to patients.
If you do not already have a PDF software, we recommend you download Adobe Acrobat Reader. Download Adobe Acrobat for free. It will allow you to fill out our form and even sign it.
Avoid frustration with some helpful hints when completing your registeration.
- If you do not know your operating system, visit this website to find out.
- Save your work often in case you have a computer issue so you don't loose anything you filled out. Our form is several pages.
- You can wait and sign your form once you arrive at the office. That is one of the reasons we ask you to come 15-20 minutes before your scheduled appointment time.
- If you decide to sign the form electronically in Acrobat, save a copy unsigned. To do this "Save" the filled out form then do a "Save As" and save it with a new file name before you start signing it.
- If you keep getting a "File is Read Only" error when you try to save your file you probably have the file name selected in Windows Folder Explorer or Mac Finder. You need to select a different file in Windows Folder Explorer or Mac Finder other than the one you currently have open then you will be able to save it just fine.
Insurance
Insurance has made life much more complicated than it used to be. When a patient sees a physician, the physician can either be in network or out of network. Some insurance plans have office co-pays for visits and some have deductibles with a coinsurance portion. Once we have your insurance information and can verify your benefits, we will be able to tell you what we expect your insurance will reimburse for our visit.
Charges that we do not expect insurance to cover are to be paid at the time of the visit. Cash, Check, Visa, Mastercard, American Express and Discover are accepted.
Bellaire Neurology offers patients a 20% discount on charges paid the same day as their appointment.
- Out-of Network and Self-Patients can expect an initial In-Office visit to cost approximately $320 after the discount.
- Out-of Network and Self-Patients can expect an initial Virtual Visit to cost approximately $360 after the discount. (Televisits are not appropriate for all new patients - if you would like to have a Virtual Visit then we need to make sure it is appropriate for your condition and medical history)
- Follow-up visits (both in-office and virtual) are typically $175 after the discount.
Dr. Loftus is out of network with all insurances. Here is our current fee schedule.
Not in Network?
Just because Dr. Loftus is out of network does’t mean he can’t be your doctor. You may have out of network benefits that will cover a portion of your visit. Also, to ease the financial burden of being an out of network patient, we give a 20% same day payment discount for the portion of your anticipated bill. Only Dr. Loftus’ physician visit is out of network. The following is typically referred to an in-network provider:
- Imaging such as MRI or CT
- EEG
- Labs and Bloodwork *
If you have out of network benefits, then our courtesy filing of your charges with your insurance will instruct your insurance to send you the money that you are owed. Here is a fee schedule to guide you regarding our most frequent charges.
*As a convenience we can draw your bloodwork in our office and send it to your in-network laboratory for a fee or you may go to an in-network draw station.
Why isn’t Dr. Loftus in my insurance network?
Patients ask all the time why Dr. Loftus does’t join their particular insurance network. The reason is simple. Dr. Loftus spends a minimum of 40 minutes with a new patient and 20 minutes with a patient for a follow-up appointment. Dr. Loftus answers portal messages from patients each day and even on the weekends. He likes to spend time with patients and believes medicine is a “team sport” where both the patient and physician must work together to create the treatment plan.
Plans that are currently out of network reimburse physicians very low (sometimes even less than Medicare). If Dr. Loftus were contracted with them, he would not be able to devote as much time to individual patients and he would not be able to provide the personalized care that so many of his patients highly value.
Medicare
Dr. Loftus has opted out of Medicare. This means that we cannot bill Medicare and you cannot seek reimbursement from them. We can still order testing (lab work, MRIs, etc) and Medicare will pay for this testing.