Women's Health - Forms and Policies

Forms are not submittable online. Please print the forms and complete them, then bring them with you to your appointment.

Forms For New Patients

Forms For Existing Patients

Phone Calls Policy

When you have a question or concern about an illness or medication, our reception staff will be happy to take a message and forward to the medical assistant. We strive to return calls in a timely manner and you can expect our staff to return your call within the same day.

Please provide the reception staff with your phone number, date of birth and pharmacy of choice. Triage phone calls after 4:30 p.m. will be handled the following day, unless it is an emergency. Please call for all refills several days before running out of medication.

Medications cannot be refilled on the weekends.

After Hours & Emergency Care

If you are experiencing a serious or life-threatening emergency, dial 911.

For our patients who are experiencing urgent medical problems, same-day appointments are usually available. For medical emergencies outside of office hours, a healthcare provider is on call at all times and can be reached by calling the hospital switchboard at 828-580-5000.

Your Women’s Health personal electronic medical records are only accessible to health providers of Women’s Health , to medical providers at UNC Health Blue Ridge Emergency Room, and to the staff in The Family Center. Please do not call the emergency line if you are not having an urgent medical problem and can wait until normal business hours.

We do not refill any prescriptions via the emergency line.

Prescription Renewals

Prescription renewals are processed only during our normal office hours. In some instances, we may require the patient to be seen in our office prior to medication renewal.

Financial Policy

Thank you for choosing Women’s Health at UNC Health Blue Ridge as your healthcare provider. We are committed to providing the best possible healthcare to every patient we serve.

Please review the following information about our financial policies:

  • Our office takes a variety of insurance plans. It is your responsibility to bring your insurance card to every visit
  • Be prepared to pay your co‐pay at the time of service or pay in full if you do not have coverage for your visit
  • If you’ve received a statement, please be prepared to pay any outstanding balance

Please understand that medical insurance is a contract between you and your insurance company. It is your responsibility to know limitations, exclusions, deductibles and co‐pays of your insurance plans.

We accept cash, checks, Visa/MasterCard and debit cards for your convenience.

If a patient is a minor (18 years and younger) and is using a parent’s insurance benefit, the parent or guardian must sign the minor consent form. The parent or guardian is responsible for any payment due at the time of service.

If you are unable to pay for necessary medical care, you may be eligible for financial assistance or a payment plan. It is your responsibility to inform us of your financial need prior to the visit. Please speak with our billing department to discuss arrangements.

Surgical Services and Office Procedures

Insurance benefits will be verified prior to all elective and non‐elective scheduled procedures. Although we may have been informed by your insurance company that you have coverage, this does not mean the procedure will be paid. There is never a guarantee of payment until the claim is processed. If you do not have coverage for the benefit at all, full payment is required prior to the procedure.

Compliant Coding

Please be aware that some, and perhaps all, services rendered may not be considered payable under some insurance policies. You will be responsible for these balances. Some insurance companies do not cover preventative care, such as annual exams.

Medicare does pay for a breast and pelvic exam every 24 months or routine physicals. You may choose to pay for routine physicals and tests out-of-pocket.

Routine and preventative services cause confusion for many patients. It is not uncommon for patients in the course of a visit to receive both treatment for a problem and preventative services. When this occurs, proper coding will be used which may result in a charge for both services. Your individual contract with your insurance carrier will determine how your insurance will pay. We make every effort to bill each visit with the proper diagnosis and procedure codes according to national coding guidelines. Please understand that we cannot make exceptions to our coding practices due to federal and state legal compliance concerns, and we are unable to bill for services other than those documented in your medical record.

Laboratory Fees

Most laboratory charges, such as blood work, PAP and pathology tests, ordered through our office are billed directly to your insurance by LabCorp. If you receive a statement from one of these laboratories, we request that you contact them directly to resolve any billing questions.

Billing Fees

There will be a $25.00 fee for any returned checks. Finance charges will be applied to balances older than 60 days.

Billing Questions?

For questions about insurance payments, call 828-580-4307.
For general questions about your bill, call 828-580-4302.

Financial Policy for Obstetric Care

Please be advised of Women’s Health Group’s office policy concerning your pregnancy and insurance coverage. Unlike other types of services, prenatal care is billed globally and will be billed at the end of your pregnancy, after delivery. Prenatal care includes your routine office visits and delivery charges.

During your pregnancy, physicians may order additional studies, such as ultrasounds or non‐stress tests. These services will be billed to your insurance at the time of the service and are not included in the global prenatal care fee. Additionally, if you are seen for any problem or condition unrelated to your pregnancy, we are required to bill for the office visit. You may be responsible for co‐pays and/or additional fees for these services, which will be determined by your contract with your insurance company.

Please be aware of the cost of delivery. Some insurance companies apply part of the delivery charges as a co‐insurance and/or deductible. This balance is considered part of the total reimbursement to the doctor and will be your responsibility. After your initial obstetric visit, our office will verify your benefits and make you aware of your total responsibility. We require payment in full by the end of the 32nd week of pregnancy. We will be happy to arrange a payment plan to pre‐collect your balance prior to delivery. It is your responsibility to inform our office of any changes in your insurance.


Call to schedule your appointment at any of our Women’s Health locations today: 828-580-4661

First visit? Find and print all of the forms you need to complete before your first visit to our offices.

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