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Canadian Urology Topmedx
Canadian Urology Topmedx

McLean County Neurology

McLean County Neurology Accepts Assignment
on All Medicare Claims.

What to Bring to Your Appointment
Patient Forms
Payment and Insurance
Hospital Affiliations

What to Bring to Your Appointment

  • Your insurance card
  • Physician referral forms if required by insurance
  • A list of current prescription or over-the-counter medications you are taking, including dose and frequency
  • Pertinent information about your medical and surgical history
  • Any related x-rays or appropriate records

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Patient Forms

If you are a new patient to our practice, please print and complete the Registration form, Medical History form, Medication list, and Medicare Signature form. It will save you time the day of your appointment.

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Payment and Insurance Information

Payment is required at the time of service. We do not bill insurance for office visits, but we will give you the appropriate form with your charges to turn in to your insurance company for reimbursement. Our office does bill Medicare, but we do not bill secondary insurance. We accept Visa and Mastercard.

We wish to stress that the financial responsibility for services rendered rests with the patient or their family regardless of any insurance coverage or pending litigation. The copy of the bill that you receive at each visit has all the information on it that the insurance company needs. Attach it to your claim form with your portion filled out and mail it directly to the insurance company. The doctor's signature is not required on the claim form.

Your insurance policy is a contract between you and your insurance company. We cannot guarantee payment of your claim. If it is not paid, the insurance company should explain to you why it was rejected. We look to you for payment, not your insurance company.

Please allow several days for any special forms you may need the doctor to fill out. There may be a charge for this service. We do charge for disability forms.

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Hospital Affiliations

For our patients' convenience, we are affiliated with the following hospitals:


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McLean County Neurology

2204 Eastland Drive
Bloomington, IL 61704
Tel: 309.662.9461
Fax: 309.663.0222