
New Patient Forms
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New Patient Intake
For faster service, please print or email to cassie@rotnc.com prior to first visit.
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MD Order Form
For referrals from physicians. Please email to cassie@rotnc.com or fax to (910) 672-7869.
Insurance & Billing
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We currently accept Medicaid, Aetna, Blue Cross and Blue Shield, Tricare, Carolina Complete Health, and Trillium.*
Before starting services, we will complete a benefits verification to help you understand your coverage and any out-of-pocket costs. We’re happy to walk you through the process and answer any questions you may have.
*In-network services with Cigna, MedCost, and United Healthcare are currently pending. -
We are considered out-of-network for all insurance plans not listed as in-network. This simply means your insurance may still cover part of the cost, but often at a different rate—and you may have a separate out-of-network deductible to meet first.
You would be responsible for any portion your insurance does not cover. We’re happy to provide a superbill to help you submit claims for possible reimbursement. If you’re unsure what your out-of-network benefits include, calling your insurance provider can give you a clearer idea of what to expect.
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Whether we're in-network or out-of-network for your plan, it’s a great idea to call the member services number on the back of your insurance card before starting services. You can give them our name and ask a few key questions to better understand your coverage and out-of-pocket costs:
“Is this provider in-network for my plan?”
“Will I need to meet a deductible before coverage begins?”
“Do I have a co-pay or co-insurance? If so, how much will that be per session?”
Getting this information ahead of time helps avoid surprises and gives you a clear picture of what to expect. If you have any questions, we’re always happy to help you navigate the process!
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We believe in transparency and trust—especially when it comes to the cost of care. If you don’t have insurance or are choosing not to use insurance, you have the right to receive a Good Faith Estimate that outlines what you can expect to pay for services.
You can request a Good Faith Estimate at any time, even before scheduling your first session.
If you ever receive a bill that’s $400 or more above your estimate, you may have the right to dispute it. We recommend saving a copy of your estimate for your records.
For more details about your rights, visit www.cms.gov/nosurprises or call 1-800-985-3059.
We’re always happy to walk you through your estimate and answer any questions—just ask!