Patient Information
PATIENT APPOINTMENTS
To schedule an appointment at either location, or for general inquiries, please call our main office at (309) 691-6616.
Midwest Hearing Center/Audiology Appointments:
Peoria - (309) 691-6616
Morton - (309) 284-0164
The following patient registration forms are available to print out and complete prior to your scheduled appointment. Please bring the completed forms, along with your current insurance card(s) and a government issued photo ID with you to your appointment. Please call if you have any questions.
Patient Forms
To follow are forms you will need to complete prior to your visit in our office.
Although these forms are available online, they are not electronically submitted.
You can print the forms to complete and bring with you to your appointment.
You may receive these forms in the mail from our office,with instructions to complete them prior to your appointment.
Filling out your forms ahead of time helps us maintain efficiency for everyone.
Insurance Info & Financial Policies
Insurance/Payment Policies
Our physicians are participating with Medicare and accept assignment. We are contracted with most major insurance carriers. It is the patient's responsibility to verify our participation in their plan with the insurance company.
Your payment or co-payment is due at the time of service. If you are not covered by an insurance plan you are required to pay all charges on the date of service. We accept cash, check, Mastercard, Visa and Discover. As a courtesy to our patients we will submit the bill to your insurance carrier. Please bring all plan ID cards so your claims may be filed with the correct carrier.
If you are a member of an insurance plan with which we participate, we will follow their billing requirements. If a referral authorization is required, please obtain it prior to your visit.
You are required to present a valid government issued ID upon registration.
Terms of Use
The information provided by Midwest Ear, Nose & Throat and Midwest Hearing Center on this site or by any links attached to this site is for informative and educational purposes only and should not be interpreted as a recommendation for a specific treatment, product or course of action. We do not endorse any medical or professional service obtained through information provided on this site or any links to this site.
Use of Midwest Ear, Nose & Throat and Midwest Hearing Center website does not replace medical consultations with a qualified medical professional to meet your health care needs. You should exercise your own judgment when purchasing any product or selecting a physician through any site or service linked to this site.
Midwest Ear, Nose & Throat and Midwest Hearing Center frequently update the contents of this site but medical information changes routinely therefore some information may be out of date or contain inaccuracies.
Please contact a physician or health care professional if you suspect you are ill.
