Patient Information

• New Patient forms

  • New patient welcome letter
  • Allied New Patient demographic form
  • Patient Financial Summary
  • Patient Provider Agreement

• Other Forms

  • Medical Record Release Authorization Form
  • MediCopy – Form Completion & Medical Record Copies
  • Facility Ownership Disclosure – Dr. Thomas Akre
  • Consent to Treat Minor Children Policy
  • Patient Portal – Healow app

• Pay Your Bill

• NOTICE OF NON-DISCRIMINATION

 

Frequently Asked Questions

How do I schedule an appointment?

To schedule an appointment, please call our office in South Bend at (574) 247-4667. Allied Bone and Joint has an automated appointment confirmation system that will contact you 2 business days ahead reminding you of your appointment date and time. If you are unable to keep your scheduled appointment, please notify our office as soon as possible so that we can offer that time slot to another patient in need of care. If you arrive late, we may need to reschedule your appointment in order to accommodate the patients who are here for their scheduled appointment time. We make a sincere effort to adhere to an “on time” schedule and appreciate your patience if we are late due to emergencies or unforeseen details that may occur.

If you are a new patient, please arrive 15 minutes prior to your scheduled appointment time to complete our registration process. In addition, please bring the following items with you:

• Picture ID
• Insurance ID card/information
• Copies of x-rays, MRIs, CT Scans and other pertinent medical records
• List of current medications and known allergies
• Copayments

 

Do I need to pay at the time of service?

Allied Bone and Joint requires payment at the time of service unless prior arrangements have been made. We accept cash, checks, MasterCard, Visa, and Discover Card for your convenience. If we are a participating provider for your insurance company, we will help in any way we can to assist you in handling claims. However, any insurance co-pays and deductibles are the patient’s responsibility. We offer discounted cash rates for private pay patients as well.

 

Can I call the office if I need a prescription refill?

If you need a prescription refill, please contact our office with the name & strength of the medication needing refilled. Refills are usually processed within 48 hours of the initial request with our office.

Refill requests must be made during regular office hours. Call (574) 247-4667 Monday – Thursday between 8:00 AM and 5:00 PM and Friday 8:00 AM – 12:00 PM.

Refills will not be accommodated outside regular business hours.

Prescriptions refills requests will not be approved for lost, stolen, misplaced, damaged or misused prescriptions.

 

How do I get FMLA forms or disability forms completed?

If you need forms completed please bring or fax the form to our office.  There is a fee required for completion and this fee must be paid prior to the form being completed.  Once payment is received forms will be completed within 7-10 business days.

 

How do I request a copy of my medical records?

You will need to complete a medical release form with our office to obtain a copy of your medical records.  Medical record requests are sent to a third party vendor to complete.  It may take 5-7 days for the records to be sent to the requesting party.