Medical Records and Deps
MEDICAL RECORDS AND OTHER ADMINISTRATIVE REQUESTS
If you wish to request a copy of the medical record, please submit a request via email to our Medical Records Department to cpop@rivernorthpmc.com; make sure to include a check for the processing fee, payable to River North Pain Management Consultants for the amount of $45.00. Once payment is received, allow 2-3 weeks for processing.
Do not send medical record requests to the facilities, as this may result in you not obtaining the record, or delaying its procurement.
If you wish to schedule a deposition with one of our physicians, please send a written request via email to cpop@rivernorthpmc.com; please be aware that there is an hourly fee (subject to change) of $1,800.00 payable to River North Pain Management Consultants, S.C. Depositions are typically scheduled only on Wednesdays, contingent on the physician’s surgical schedule.
For further questions contact Cristina Pop at
Phone: (888) 951-6471
Cell: (312) 961-6471
Fax: (888) 961-6471
e-mail: cpop@rivernorthpmc.com
Insurance Information
We do accept most private insurance plans, as well as Workers’ Compensation, and major credit cards.
However, in some cases, our physicians may not be contracted with some insurance plans, in which case you will be considered “Out of network”. Please be sure to ask if we are “in network”.
Financial arrangements can be made for non-insured and self-pay patients as well as patients considered “Out of Network”.
We maintain experienced and highly trained staff in charge of insurance verification and proper insurance pre-certification.
The staff at our billing companies are certified and experienced both in billing and coding. They will be happy to answer any questions.
For any questions regarding billing, insurance, or financial arrangements, you can contact the billing administrator directly:
Rosa Jimenez
Billing Specialist
Phone: (847) 877-6476
Fax: (888) 961-6471
rjimenez@rivernorthpmc.com
UnisLink
1 George J. Michas Drive, Suite 200
Romeoville, IL 60446
Phone: (800) 369-3534
Fax: (602) 457-7396
unislink.com
MedicBC
Phone: (312) 998-3598
Fax: (312) 994-2335
billing@medicbc.com
medicbc.com
Business Office
Our Business Office is located at:
137 E. Grand Avenue, Unit GD
Bensenville, IL 60106
*we do not see patients at this location
Patient Forms
Once you have been scheduled to see any of our physicians, please take some time at home to fill out the following forms and fax them to our office before your consultation. This speeds up the paperwork and allows your doctor to spend more time with you.
Fax: (888) 961-6471
To protect your privacy, please do not e-mail completed forms, as they contain your health information. If you prefer, you can print the forms below, fill them out, and bring them with you on the day of your visit.
If you are coming for a follow-up visit, please fill out the follow-up visit questionnaire form below.
To our Referring Physicians
At River North Interventional Pain Management Consultants, we truly appreciate your referrals, and strive to rapidly accommodate your Patient’s needs.
As you know, pain is a devastating and incapacitating experience, and therefore we try to see your Patients on an semi-urgent basis. To accommodate your patients promptly, our contact person is readily available either on our office or on her cell phone/page number.
In order to further expedite the care of your Patient, we need your cooperation :
You would need to fill and either fax or email us a FAX/Sheet form which can be printed from the link below.
You would need to fill and either fax or email us a FAX/Sheet form which can be printed from the link below.
Contact Information
We also need all of your patient’s relevant information such as:
- Patient’s address and phone numbers
- Insurance Information
- Diagnosis
- Medications he/she in currently taking
- Copy of the referring physician’s notes
- Copies of any available Mr’s, X-Rays, or CT scans.
Finally we would need the procedure requested by the referring physician.
Workers Comp. Verification Forms
If your patient is a Workers Compensation case, please take a minute to verify his or her benefits.