Patient Forms
Thank you for choosing Innovative Medical Billing LLC. Submitting the VOB form or the Client Registration Form are necessary to accurately verify your benefits, obtain an exception or GAP when allowed, and submit and process any claims. Please do not submit a request for a policy not yet activated, only for current policies.
Payment for services is $55 and can be made on the Payment page.
Secondary insurance VOB is $40.
Please note that HMO and EPO plans have no out of network benefits and must be preauthorized by either your group or insurance plan. You would need to call your insurance for this prior authorization.
Please submit copy of insurance card by email to: [email protected]
Payment for services is $55 and can be made on the Payment page.
Secondary insurance VOB is $40.
Please note that HMO and EPO plans have no out of network benefits and must be preauthorized by either your group or insurance plan. You would need to call your insurance for this prior authorization.
Please submit copy of insurance card by email to: [email protected]
Verification of Benefits Directions (VOB): Please complete the online VOB form. Then email a copy of your insurance card, front and back to the address above. Once completed, please go to the payment page and submit the $55 fee for this service, this is a non-refundable fee. Once I have received your VOB form, copies of insurance card, and payment, I will complete the VOB within three business days and email you the results.
VOB Online Form
Patient Registration: Please use this form if VOB page is down so that Innovative Medical Billing LLC will have accurate demographic and insurance information. Please include a legible copy of your insurance card, front and back, with this form. Please also indicate what your preferred place of birth is, whether home, birth center, or hospital. The $55 VOB payment can be made on the Payment page. If you want two policies verified, please include an extra $40 for the secondary policy.
Patient Registration PDF
VOB Online Form
Patient Registration: Please use this form if VOB page is down so that Innovative Medical Billing LLC will have accurate demographic and insurance information. Please include a legible copy of your insurance card, front and back, with this form. Please also indicate what your preferred place of birth is, whether home, birth center, or hospital. The $55 VOB payment can be made on the Payment page. If you want two policies verified, please include an extra $40 for the secondary policy.
Patient Registration PDF