Office Visit Information
Thank you for making an appointment with Colorado ENT & Allergy! In order to expedite the check-in process during your visit, please complete the following prior to your appointment:
Registration/Check-In
Please note, Colorado ENT & Allergy leases its patient portal from Centura Health and, therefore, you may have already created a MyChart account. If so, you will use your existing login rather than signing up for a new account.
Consent & Financial Policies
HIPAA
Allergy Testing & Treatment
Please complete the following prior your allergy testing appointment:
Referral
A number of insurance plans require a referral or authorization to be seen by a specialist. As we are unable to determine the specific requirements for all insurance plans, please work with your primary care physician and insurance company to complete the referral or authorization process.
Insurance Card(s)
Please bring your current insurance card(s), primary and secondary (if applicable), with you. We will scan your card(s) into our practice management system to ensure we have the correct information to file claims with you insurance company.
Co-Pay
If your insurance plan requires a co-pay for a physician office visit, we will collect the applicable amount when you check-in. Keep in mind, our physicians are specialists, and your insurance plan may, thus, require a higher co-pay than for a primary care physician office visit.
Payment Information
If your account has a balance for any services we have provided in the past, we will send you a statement. To pay by mail, please tear off and complete the form on the statement and return it to the address listed on the form. You may also make a payment online.
For dates of service BEFORE February 1, 2021, use the following:
For dates of serve ON or AFTER February 1, 2021, use one of the following below:
You may make a payment online via your MyChart account. Please note, Colorado ENT & Allergy leases MyChart from Centura Health, and, therefore, you may have already created a MyChart account. If so, you will use your existing login rather than signing up for a new account. Also, you will see balances due for visits at both organizations in MyChart. Please ensure you select the Colorado ENT & Allergy-specific visit when making your payment.
If you do not want to use your MyChart account to make a payment, you may also pay online as a guest.
Medical Records Request
To request copies of your medical record, please print out, complete, and fax the following form to (719) 867-7899: