Info & Billing
- 1New Patient
Are you a new patient? Please pre-register here.
If you are an existing patient please log-in to the patient portal to request prescription refill.
- 3InsuranceCurrently accepted insurance carriers are listed below.
If you are a beneficiary or a member of a plan For Women, Ltddoes not participate with, your paid receipt will provide you with a detailed statement of services, charges and diagnosis so that you may file a claim with your carrier for personal reimbursement.We do not accept IDPA.For questions regarding your insurance, please call the office or email firstname.lastname@example.org
- AETNA- PPO, POS, CHOICE POS II
- AETNA OPEN ACCESS
BLUE CROSS BLUE SHIELD – PPO
(BCBS Blue Options Tier 2 Only – Following acronyms may display bottom left of card: BCE, BCO, CTY, EPO)
CIGNA- PPO, POS, HMO
COVENTRY-PPO (Tier 2 plans only)
First Health Network & State of IL OAP
FIRST HEALTH- PPO
GREAT WEST- PPO, POS
HUMANA- PPO, POS
PHCS- PPO, POS
PHCS SAVILITY- PPO
UMR/FIRST HEALH – PPO
UNITED HEALTHCARE- PPO, POS, HMO
- 4Online Bill Pay
For Women, Ltd. is pleased to offer online bill payment as a convenient, secure way for you to pay your bills by Authorize.NET.
To pay your bill, please have your billing statement in front of you and fill in the requested information below.
- 5Forms & PoliciesThank you for choosing For Women, Ltd. The forms below are available for you to print, fill out, and bring with you to our office. These forms may also be provided to you in the office. For questions related to any form, please email email@example.com. Effective August 1, 2017 all appointments not cancelled within a 24 hour notice are subject to a $50 fee.To download PDF, simply click on the form or right click and choose “Save Link As…”Get free Adobe Reader to view PDF.