Patient Information

Proud Affiliates of Planetree

Planetree is an internationally recognized non-profit organization whose philosophy is based on a simple premise: care should be organized first and foremost around the needs of patients. The Planetree Designation Program is the only program to formally recognize excellence in patient- and person-centered care. It converts the aspirational aim of becoming more “patient-centered” into actionable, attainable and sustainable practices. To learn more about Planetree, please visit www.planetree.org.

Preparation for Your Appointment 

Please arrive 15 minutes prior to your scheduled appointment with completed Patient Registration, Medical History, and Release of Information forms completed. These forms can be downloaded by clicking the icons below:

New Patients

   PCC205 New Patient Questionnaire.pdf

   PCC201 Authorization to Release.pdf

   PCC197 Patient Registration.pdf

   PCC042 Medicare Split Billing Notice.pdf

What to Bring to Your Appointment

  • Insurance card(s)
  • Driver’s license (or government identification)
  • List of current medications (including dosages)
  • Records from health care provider, when applicable
  • Patient Registration
  • Medical History and Records Release Forms (completed)

Billing and Insurance

Please bring your insurance card(s) with you to each appointment. All co-pays, deductibles and co-insurances are due at the time of your visit. We are happy to assist you with any billing or insurance questions. Please call (907) 714-5640 for support.

Central Peninsula Internal Medicine is a Preferred Provider for

• Aetna
• Blue Cross Blue Shield
• CPH Self-Insured Plan
• First Choice PPO
• GEHA/PPO USA
• NPPN/Multiplan PPO Network
• MODA
• Three Rivers Provider Network
• Viant/Beechstreet PPO
• Medicare/Medicaid (Combination only)
• Kenai Peninsula Borough
• Kenai Peninsula Borough School District