Forms & Payment
Accepts new patients
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Medical insurance plans and payment options
Anthem, BeechStreet, Bureau of Workman's Comp., Bureau for Children with Medical Handicaps, Business Administrators Consultants,Caresource, Coresource, Direct Care America, Emerald Health Network, Flora/PPOM, Fortified Provider Network, Healthspan, Healthstar/ppoNEXT, Medicaid, Medical Mutual, Medicare, Mid VAlley CareNet, MultiPlan, National Provider Network,Nationwide Health Plans HMP/PPO, Network Preferred (KMC Network Plan), One Health Plan of Ohio, Ohio Preferred Network, Primary Health Services,Tricare, Tricare Prime, United Health Care This is a partial list. Please check with your insurance carrier to see if we are preferred providers.
CREDIT: Visa, Mastercard, Discover
OTHER: Cash, check or debit card
Office information from Michael C Albert, MD
HIPAA Notice of Privacy PracticesThis is our Notice of Privacy Practices. We work diligently to respect and maintain your privacy.
Acknowledgement of Receipt of Notice of Privacy Practices
Please sign and return to the office after reading our Notice of Privacy Practices.
Authorization Form
This form must be filled out before we can send your protected health information to anyone for any reason, other than for treatment, payment or office operations.
Medical History Form
Please fill this form out and bring it with you to your first appointment.
Contact Information
Other staff in my practice
Henry W. Albers, MD
Jeffrey L. Mikutis, DO
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