Patient Resources

Providence Family Medical Clinic Patient Resources

Patient Registration (PDF) | Policy & Procedures (PDF) | Medical Release (PDF)


If your insurance is not on the list, or if you are unsure, please contact us to determine if we accept your insurance.

  • Medicare
  • Medicare HMOs
  • Molina
  • iCare
  • Managed Health Services
  • Workers Compensation
  • Self-Pay
  • Medicaid Straight T-19
  • Anthem Blue Cross Blue Shield
  • Children’s Community Health Plan
  • Trilogy Health Networks
  • Trilogy Health Insurance
  • Common Ground Healthcare Cooperative Health Payment Systems
  • United Healthcare Community Plan
  • United Healthcare Medicare & Retirement
  • Medicare:
    Accountable Care Coalition Of Southeast Wisconsin
  • United Healthcare
  • Humana

Policies and Patient Responsibilities

  1. Please arrive on time for your appointment. For new patients, please arrive 15 mins early for your appointment.
  2. Please provide past medical records or assist us in obtaining them by knowing the name of your previous physicians and telephone number.
  3. Co-payments, fee applied to deductibles and co-insurance fees are expected as services are rendered. We will assist you however possible with insurance companies, but it is ultimately the patient’s responsibility to settle outstanding balances, and to contact insurance companies regarding questions of coverage, benefits, etc.
  4. We accept cash, personal checks, and major credit and debit cards.
  5. Please give us the courtesy of at least a 24-hour notice when cancelling scheduled appointments.
Patient Resources Staff
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