Patient Forms, Map, and Directions to Hilton Head Island and Bluffton South Carolina
If you're planning your first visit to Buffalo Gastroenterology, we look forward to meeting you. To help prepare you, you'll find all the information you need about our practice and Orchard Park midwives on this page, including:
We are dedicated to providing the highest quality of care in digestive disease diagnosis, evaluation and management to our patients. We pledge utmost respect and compassion for the patient and strive to provide convenient, reputable endoscopic care in a cost-conscious manner for our patients and payers.
Please print and fill out these forms so we can expedite your first visit:
- Our Office Policies
- Patient Information Form
- Medical & Family History
- Authorization to Disclose Patient Information
- Notice of Privacy Practices
- Acknowledgment of Privacy Policies (requires signature)
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
Insurance and Billing
Please contact our office to verify acceptance of your insurance plan. Qualifications for insurance coverage may differ due to the uniqueness of each procedure. We are happy to file insurance for your reimbursement as long as you are free to choose your own gastroenterologist.
Patient Financial Policy
Thank you for choosing our practice for your care. We are dedicated to providing the best possible care and service to you and regard your complete understanding of our financial policies as an essential element of your care and treatment.
Your insurance policy is a contract between you and your insurance company. It is your responsibility to know your own coverage.
We accept and will file claims for all insurances as a courtesy to our patients. This does not mean we participate with all plans. Insurance companies are continually adding new policies and sometimes limit which providers may be in-network. If you have any concerns regarding participation, we suggest you contact your insurer directly.
As we are specialists, some insurance companies require a referral from your primary care physician. It is your responsibility to know if a referral is required and to obtain it before your appointment.
We accept cash, personal checks, MasterCard, Visa, American Express and Discover. Please be aware there is a $60 fee for returned checks.
For patients with financial need, we may offer no-interest payment plans. Please contact our billing office immediately upon receipt of your statement to avoid collection letters for non-payment.
While we strive to collect only the proper amounts due and promptly post payments received, there are times when overpayments occur. It is our policy to refund most overpayments within 30 days of receipt: If you have an upcoming appointment within 3 months, a refund will not be issued until that visit has been processed. Refunds under $5 will not be issued, unless by request.
If your account is in bad debt status, a payment is required prior to your appointment and arrangements can be made for a payment plan until your account is made current.
What to Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It will also help alleviate any unnecessary anxiety you may be feeling prior to your first appointment. Educate yourself on your symptoms by reviewing the content on our Patient Education page.
Also, take some time to review our Our Physician & Staff page and familiarize yourself with Dr. Bell and his team. We also have compiled a list of the conditions that we treat and the procedures that we perform on the Our Services page.
We look forward to your first visit to Coastal Gastroenterology!