Patient Information

It’s our mission to ensure you experience the highest quality of care in a compassionate setting from our first contact and medical consultation through treatment and recovery. If we can help you at any time, please do not hesitate to call us.

Whether you have been referred by another provider, or you are “self referring” with a hernia that is need of repair, we will work with you on a thorough consultation, comprehensive diagnosis and we’ll present you with an appropriate treatment plan.

If you acquired your hernia at work and insurance coverage is available, we’ll help with your worker’s compensation plan.

BEFORE YOUR APPOINTMENT

You’re welcome to download and complete the medical forms below, bringing them with you to the appointment. Or, you may arrive at the office 30 minutes in advance of your appointment to complete them, allowing us time to review the information.

If you bring your documents with you, please arrive fifteen minutes in advance of your appointment, so we can review them for complete information.

ONLINE PATIENT FORMS

Self Referral Patient Form: If you’re referring yourself as a patient to Bend Hernia Center, please fill out this form and we will contact you during business hours.

If you’re being referred by another physicians, please call to request a link to our online patient web forms for your convenience and to save time.

DOWNLOAD PATIENT FORMS TO COMPLETE AT HOME

PATIENT MEDICAL HISTORY

PATIENT INFORMATION – HIPAA

MEDICAL CLINIC POLICIES

MEDICAL RECORDS REQUEST TRANSFER

PATIENT FINANCIAL INFORMATION

INPATIENT AND OUTPATIENT SURGERY

Most surgical procedures for hernias are performed in an outpatient setting at Bend Surgery Center or St. Charles Hospital in both Bend and Redmond, where patients are able to go home after the surgery. If an inpatient stay is required, surgery is performed at St. Charles Hospital.

BILLING AND INSURANCE ASSISTANCE

For information and assistance with your medical billing and insurance process:

CALL (541) 322-1794

FAX | (541) 749-2126

OUR PATIENT FINANCIAL AND INSURANCE COORDINATOR IS HERE TO HELP YOU

Dana Jorgensen, Bend Hernia Center’s patient financial and insurance coordinator, is committed to helping our patients better understand the costs associated with care, provide payment options based on individual insurance plans and will help finalize billing arrangements between all parties.

PAYMENT – We accept most insurance carriers’ coverage plans, however, the patient is ultimately responsible for the total cost of medical services provided by Bend Hernia Center. Changes in deductibles, coverage dates, pre-existing conditions and other insurance plan details may affect insurance reimbursements.

We will do the best we can to help you understand the costs of care and your insurance coverage options as well as work with you regarding payment options.

For more detail on financial policies, please review the document: Patient Financial Information

WORKERS COMPENSATION

Bend Hernia specializes in helping patients navigate their worker’s compensation claims. Give us a call and let us help you.