Requesting an Appointment for an Evaluation
If you are a new patient and would like to be seen for an evaluation, we need the following information from your primary care provider or other treating physician, using this Provider Referral/Request Form.
- A written request for an evaluation
- Include patient's name and contact information
- Pertinent medical records related to the pain condition
The above information should be faxed to our office by the referring provider at 410-448-7150. Once we receive the above information, we will call to make the appointment.
- Patients: Please call 410-448-6836 to speak with a New Patient Coordinator.
- Referring Physicians: Please call 800-373-4111 with questions.
Prior to your first patient appointment, please download and complete the Initial Pain Evaluation Questionnaire and bring it with you to your appointment.
We participate with a variety of insurance plans including Maryland Blue Shield, Medicare and many HMOs. Services requiring authorization are secured by our office staff. If a referral is required for the visit, it is the responsibility of the patient to secure this and bring it to the appointment. Patients without a required referral cannot be seen and will have to be rescheduled. Deductibles and non-covered services are the responsibility of the patient.
Patients will receive two bills for pain management services: one from University of Maryland Rehabilitation & Orthopaedic Institute for a facility fee and another for the physician's professional fee. Questions regarding professional fee bills may be directed to the Department Of Anesthesiology billing office at 667-214-1616. Questions regarding University of Maryland Rehabilitation & Orthopaedic Institute bills may be directed to 410-821-4140.