Insurance & Forms

Chambers Medical Group accepts most insurance carriers.  You may also be seen for a visit even if you do not have insurance.  Check with the office for current self pay charges.

We DO NOT accept:

  • Essence
  • UMR/Health Link BJC Gold
  • Anthem Medicare Preferred Care
  • Total Care Advantra
  • Gold Advantage 1&2
  • Advantage PPO/Advantage Gold
  • Health Care USA
  • Medicaid GHP-PPO Select
  • Mercy Medicare/Medicaid
  • Medicaid HMO
  • No State Insurance (unless employed by the State)

Chambers Medical Group Forms

PDF-Document-Logo-1Adult Health History Form

PDF-Document-Logo-1Medical Records Release Form

PDF-Document-Logo-1Our Financial Policy

Payment Policies
In an effort to keep down our administrative cost, and therefore our fees, we ask that you pay for your medical care at the time of your visit. We will gladly accept cash, a personal check, a MasterCard, or a Visa payment.

If you are a member of a health maintenance organization (HMO) or preferred provider organization (PPO), let us know, if we are participating provider, we will submit charges for you.

You will be responsible for any co-payments, deductible amounts, or other non covered charges by your insurance plan or Medicare.

Please let us know if your address, phone number, marital status, or insurance changes.