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Glossary of Terms

OFFICE LOCATIONS
Carmel Office
12289 Hancock St.
Carmel, IN 46032
Ph: (317) 815-8950
Fax: (317) 815-8951

Avon Office
1115 Ronald Reagan Pkwy.
Suite 235
Avon, IN 46123
Ph: (317) 272-3880
Fax: (317) 272-9068

Kokomo Office
2302 S. Dixon Rd.
Suite 150
Kokomo, IN 46902
Ph: (765) 453-0506
Fax: (765) 453-0793

Mooresville Office
902 N. Samuel Moore Parkway
Mooresville, IN 46158
Ph: (317) 272-3880
Fax: (317) 272-9068

Muncie Office
3631 N. Morrison Rd.
Suite 200
Muncie, IN 47304
Toll Free Ph:
(866) 815-8950
Fax: (317) 815-8951

Patient Info

What To Expect
What do I need to bring to my appointment?
MPI Insurance Contracts
MPI Newsletter

Patient Forms
In order to improve patient care and efficiency we have made some of our forms available for you to download. Please read the New Patient letter and HIPAA Notice of Privacy Practices and then print and complete Forms #1-4 and bring to your first appointment.

New Patient Letter

HIPPA Notice of Privacy Practices

Form #1: Consent Authorization & Assignment of Benefits Form

Form #2: Medical Record Request and Release Form

Form #3: History and Physical Form

Form #4: HIPPA Receipt of Notice

What To Expect

Patients are typically referred by their primary care physician who is educated about the benefits of Interventional Pain Management. Other referring physicians include; Family Practice , Internal Medicine, Orthopedic Surgery, Neurosurgery, Occupational Medicine, and Physical Medicine and Rehabilitation physicians. Patients are also welcome to contact us directly.

The patient completes an initial Pain Assessment and is then interviewed, examined and evaluated by the physician to see if any interventional therapies are appropriate. In addition to a physical exam there will be a review of previous x-rays, diagnostic studies and consultations. A treatment plan is then developed and discussed with the patient. A letter is sent to the referring physician (and family doctor if different) immediately after any consultation or procedures are performed.

Most of the procedures are performed in a modern, fully equipped fluoroscopy suite in our office. All of the diagnostic and therapeutic procedures are performed on an outpatient basis, which means that patients typically are in the facility for less than 2 hours. A full diagnostic and treatment plan may require several visits which can be scheduled on successive days.

What do I need to bring to my appointment?

1. Referral - Because pain management is a specialty practice, you may be required to obtain a referral. It is your responsibility to obtain this referral from your primary care physician and bring this with you to your appointment. This referral is needed in order to obtain reimbursement from your insurance company.

2. Insurance Card - We need to make a copy of the front and back of your insurance card. This is done so that when we file a claim to your insurance company, we will ensure that we have all the correct information specific to your coverage.

3. Insurance Benefits - It is strongly suggested that you verify coverage with your insurance company prior to your visit, if possible. It is your responsibility to make sure your visit will be covered. We will assist you if needed in order to verify benefits, but we cannot guarantee payment by your insurance company.

MPI Insurance Contracts
Advantage Health Solutions
Aetna
Anthem Health & Medical Insurance
Encore Health Network
Humana
Indiana Health Network
Medicare
Senior Smart Choice
Principal Healthcare
Private Health Care Systems (PHCS)
Sagamore Health Network
Pro Health Network Suburban Health Organization
United Health Care

MPI Newsletter
Click here to download the MPI Newsletter