Patient Forms
Most new patients will be required to complete their consent forms at the clinic. However, if you have been directed by an Ideal Option staff member to complete your new patient forms online, please click on the "New Patient Packet" below. The release of information (ROI) forms can be completed online and submitted as needed.
New Patient Packet Release of Information to Outside Provider Release of Information to Individual Release of Information to Insurance Provider Ideal Balance DisclosuresGet Support
/ Ideal Option: Patient Forms
Insurance & Billing
How much does treatment cost?
Your out of pocket cost for treatment depends on your insurance and specific benefit package. When you call to make an appointment, you’ll be transferred to a financial counselor to verify your insurance, your deductible, and any out of pocket costs you may incur. Our financial counselors will also provide you with an estimate of the total cost so you will know what to expect. Most Medicaid plans do not require a co-pay, but every state differs.
How much does treatment cost?
For the majority of our patients who are Medicaid members, the medication is fully covered. For Medicare and commercially insured patients, the co-pay varies depending on the plan you are enrolled in. If you have non-standard Medicaid coverage, our insurance verification team will send you an explanation of your benefits including any out-of-pockets costs before your first appointment.
What if I am uninsured and can't pay for treatment?
An Ideal Option financial counselor will work with you to apply for Medicaid, financial hardship assistance, or to develop an affordable payment plan for your treatment or even co-pays if you are insured. If you are committed to your recovery but experiencing financial duress, we will do everything possible to help you. Please contact us and ask to speak with a financial counselor today.