Patient Information

McDowell Mountain

Gynecology Office

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Welcome to McDowell Mountain Gynecology! Here, we strive to make your experience as smooth as possible. Below, you'll find downloadable and fillable forms for your convenience, including medical history and family questionnaires. We also accept various insurances, ensuring accessibility to our services. Please review our insurance and financial policies, and don't hesitate to contact us with any questions.

For seamless continuity of care, Dr. Spieldoch may require your previous medical records. Use Arctrieval, a free and secure online service, to transfer your records hassle-free. Complete the Medical Records Release Form and send it to us via fax, email, or bring it along to your visit. We look forward to providing you with exceptional gynecological care!

Please complete the following forms depending on what treatment you require

For your comfort, you can print and bring the forms in the day of your appointmaor complete them online.

Insurance and Financial Policies

It is very important for you to bring your current insurance card(s) each visit and to inform us if there has been any change in your coverage or in your address. As changes may occur in the plans that we accept, please verify our acceptance at the time you make an appointment. Call (480) 483-9011 for more information.

Benefits and Elegibility

Although we will bill your insurance, full payment is the patient’s responsibility. We will make every effort to verify your coverage prior to your appointment, yet we cannot guarantee coverage of services by your insurance company. To determine your insurance benefits and eligibility please contact your insurance carrier directly. Note that you are ultimately responsible for payment for all services that are not covered by your insurance plan. Any patient balance after insurance is normally due within 30 days but we are able to set up a payment contract for outstanding accounts. We request payment or co-payment for office services at the time they are rendered unless prior arrangements have been made.

Here is a list of the insurance we accept:

Aetna

Arizona Foundation

BCBS

Cigna

HealthNet

Humana

Medicare

PacifiCare

Secure Horizons

TriCare

United Care

Self-pay patients

If you are a self-pay patient (if you plan to pay without the use of insurance) we will work with you to determine an appropriate payment schedule.

Our Insurance Providers

Transfer Medical Records

For seamless continuity of care, Dr. Spieldoch may require your previous medical records. Use Arctrieval, a free and secure online service, to transfer your records hassle-free. Complete the Medical Records Release Form and send it to us via fax, email, or bring it along to your visit. We look forward to providing you with exceptional gynecological care!

Please complete the form and fax or email it to the office. Alternatively, you can bring it with you to your visit. 

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