What to Bring to Your Appointment

• Your insurance card
• Physician referral forms if required by insurance
• A list of current prescriptions and/or over-the-counter medications you are taking, including dose and frequency
• Pertinent information about your medical and surgical history
• Any recent x-rays or appropriate records you may have

Insurance and Payment Information

Leitner Urology, P.A. is a provider for Medicare and contracts with the following insurance plans:

Aetna HMO/US Healthcare Aetna PPO/POS BCBSNC-Personal Care, Cost Wise, Preferred Care, Med Point Carolina Access - Medicaid CHAMPUS CIGNA CNA Partners Coventry Doctor's Health Plan Guardian Resources Health Care Savings Healthsource/Provident

Jefferson Pilot MAMSI-Alliance Preferred PPO-Optimum Choice HMO Maxicare Med Cost NC Medicaid - Carolina Access NC Teachers/State Employees Principal Health Care of the Carolinas Private Health Care Systems Provident Preferred HMO/PPO SC Medicaid US Healthcare/Aetna One Health

We provide insurance billing. Anything not covered by insurance will be your responsibility.

We request payment at the time of your appointment for services that are not covered by insurance. Your insurance company may also require you to pay a co-payment at the time of your appointment. When necessary, our staff will work closely with patients who require a payment plan.

If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company.

Patient Forms

You can view and/or print the necessary patient forms for your appointment by following these easy instructions. In order to view and/or print the forms, you must have the Adobe Acrobat Reader™, which you probably already have on your computer. If not, you can easily and quickly download a free version of Adobe Acrobat Reader by going to their website Download Reader.

When viewing the forms in Adobe Acrobat Reader, the text might appear somewhat fuzzy; this is normal (the forms will print out clearly). To print, just click on the printer icon in the Adobe Reader toolbar above the document.

Once you have the Adobe Acrobat Reader installed, click on these links to view and print the following forms:

• Preparation for prostate biopsy
• Before/after your vasectomy

Dr. Leitner maintains privileges at the following area hospitals:

• Union Regional Medical Center
• Presbyterian Hospital Matthews