4131 Spicewood Springs, Suite K6,  Austin, TX 78759 Phone:  512.345.6781 x5 FAX: 512.345.8083

E-mail: drberyl@berylrushefsky.com

If You Plan to Use Your Insurance

In order to make the most efficient use of our time during the first session, please complete the forms (see below) called New Client and Insurance Authorization Form and get them to me at least two business days before your first appointment. Otherwise, we will lose valuable session time getting the forms filled out and obtaining authorization during the time allotted for your session. Alternatively, you may choose to pay for the initial session out of pocket and we can bill the insurance company for subsequent sessions once we have the needed information and insurance authorization.

The forms are editable pdf files which will allow you to type in the information, which my billing service greatly appreciates. This results in fewer errors and hence rejected claims for which you will be billed. If you have a pdf editor such as Adobe Acrobat or Nuance PDF Creator, you can save the forms to your computer and send them to me as an email attachment. Otherwise, you may print them out and either mail them to me at the address above; fax them to me at the number above; or print them, scan them to a pdf file (if you have a scanner) and then email them to me as an attachment. Of course, you can always simply drop them by my office. You can obtain directions to my office by following the link at left to Driving Directions.

Thank you very much for taking the time to get the paperwork done in advance so that we can concentrate on the issues that led you to make an appointment in the first place.

 

 

Please click on the links below to download/print in an editable PDF format

 

 

 

New Client [132.74K]