New Patient Information

Before Your Visit

To ensure your first visit goes smoothly, we ask that you complete our new patient questionnaire to the best of your ability. Not all questions will pertain to you.

Please be aware that if the paperwork is not completed at the time of your appointment, your appointment time may be delayed.

Please Bring The Following To Your Appointment:

• Completed new patient questionnaire (click here to download)
• Updated insurance cards
• If required by your insurance plan, please obtain a valid referral from your Primary Care Physician (PCP).

Please arrive 10-15 minutes early to make sure all paperwork is in order.
We may need to obtain a urine specimen during your visit, so please arrive with a comfortably full bladder. Of note, we are unable to provide annual exams and general gynecology services.

We look forward to meeting you. We will do our best to provide you with the highest quality of care tailored to your personal needs and concerns. Thank you so much for choosing Northeast Ohio Urogynecology.

Insurances We Accept

We participate with most local and many national insurance plans. However it is your responsibility to understand whether your insurance has limits on the doctors you can see, or the services you can receive. Depending on your insurance coverage, you may be responsible for co-payments, co-insurance, or other deductible amounts.

We strongly recommend, request and encourage you to be familiar and verify your benefits with your insurance company prior to being seen. Please be aware, that even then, it is still not a guarantee of benefits or payment.

Below is not a comprehensive list but a fairly accurate list of the insurance companies we are contracted to provide services.

If you do not see your insurance company listed, please call your insurance carrier and ask if we can be put on their list.

IN NETWORK

• Aetna
• Aetna (First Health Network/Coventry PPO)
• Anthem
• Anthem (Medicare Preferred/Senior Advantage) – SHN
• Aultcare – (Effective for PPO/PTHP/Medicaid)
• Beech street – SHN
• Buckeye – SHN (Medicaid HMO / Medicare HMO)
• CareSource (Only MyCare/Medicaid)
• CHN Employee Health Plan – SHN
• ChoiceCare Network – SHN
• Cigna
• Cofinity – SHN
• DirectCare America – SHN
• Emerald Health Network – SHN
• First Health Network – SHN (PPO)
• Fortified Provider Network – SHN
• Gateway – Processing
• Healthsmart Accel – SHN
• The Health Plan
• Humana – SHN
• Medicaid

• Medicare
• Medical Mutual of Ohio
  – SuperMed PPO
  – SuperMed POS (Select)
  – SuperMed HMO
  – SuperMed Preferred
  – HMO Health Ohio
• Molina – SHN
• MultiPlan – SHN
• Ohio Health Choice – SHN
• Ohio Preferred Network – SHN
• Paramount – SHN
• Primary Health Services – SHN
• Private Healthcare Services – SHN
• SHN PRO
• TriCare (Only Standard)
• United Healthcare
• Specialty

NOT IN NETWORK

• Highmark BCBS
• Railroad Medicare
• Health span

Hospital Privileges

Dr. South has privileges to perform surgery at the following hospitals:

• Summa Akron City Hospital
• Akron General Medical Center
• Western Reserve Hospital