Patient Forms, Insurance and Financing

Insurance and Billing

Orange County Physicians’ Hearing Services participates in most insurance plans available. See below for a list of many of the insurance plans we have dealt with in the past. Please contact our office if you have any questions regarding your insurance plan.

We bill all primary and secondary insurances. As a courtesy, we are happy to help you obtain the maximum benefits from your health insurance plan.

We accept cash, check, and credit cards, including: Visa, Mastercard, American Express, and Discover.

Thank you for choosing Orange County Physicians’ Hearing Services as your hearing healthcare professionals!

To expedite your waiting time, please complete to appropriate forms prior to your appointment.

New Patient information

New Patient (Adult):
Patient Information Facesheet, Medical History, Receipt of Notice of Privacy Practices, and Financial Policies

New Patient with Medicare:
Patient Information Facesheet, Medical History, Receipt of Notice of Privacy Practices, and Assignment of Benefits & Release to Medicare

New Patient (Pediatric):
Pediatric Facesheet, Medical History, Receipt of Notice of Privacy Practices, and Financial Policies

Returning patients:  Please update facesheet annually or sooner if patient information changes.

Download Our Patient Forms