Pulmonary Associates, LTD
Robert D. Herscowitz, MD & Juliette L. Wohlrab, MD

5216 Dawes Avenue, Alexandria, VA 22311
(703)-931-4746

Patient Information

Patient Forms:

Download the New Patient Registration Form (right click and Save Target/Link As…) 
 
Download the Privacy Form (right click and Save Target/Link As…) 

Download the Authorization for Release of Information Form (right click and Save Target/Link As…) 

Appointments: Patients are seen by appointment only between 9:00am and 3:45PM. If you need an urgent appointment please notify the receptionist and every effort will be made to accommodate you. Please allow 24 hour advanced notice of canceled appointments so that this time can be made available for other patients. A cancellation fee is assessed if no notification is given. Arrive 15 minutes prior to your initial visit and bring your insurance referral (if required), any medical records or x-ray/CTscans, and a list of your medications. If you are late for your appointment, it may be necessary to reschedule it.
 
Billing and Insurance: We suggest that all patients be familiar with their own insurance coverage. Please bring your insurance card, picture ID and any needed referral with you. If you are a member of an HMO, it is your responsibility to obtain the referral from your primary care physician. If the required paperwork is not received by your scheduled appointment, you will be rescheduled for another time due to HMO requirements. We currently participate with Medicare and most major insurance carriers. Please call the office to confirm insurance coverage when you make your appointment.
 
Participating Insurance CarriersAETNA ● ANTHEM BC BS ● CAREFIRST BCBS ● CIGNA HEALTHCARE ● COVENTRY HEALTH/ FIRST HEALTH PPO ● GREAT WEST HEALTHCARE PPO ● NCPPO/UNICARE ● MEDICARE ● MEDICARE RAILROAD RETIREMENT ● ONENET PPO ● OPTIMUM CHOICE/MAMSI ● PHCS/MULTIPLAN ● TRICARE STANDARD ● UNITED HEALTHCARE ● VA STATE MEDICAID
 
Payments: All payments are due at the time of service, including insurance co-pays which are required before seeing the physician. We file insurance for all plans with which we participate. Ultimately, the patient is responsible for any charges incurred that are not covered by insurance. We accept cash, personal checks, and credit cards (Visa and Mastercard).
 
Prescription Refills: Please ask for your refills at your office visit. Refills are handled only during regular business hours. Most prescription refills can be handled by calling your pharmacy directly. If necessary, the pharmacist will contact our office. If a new prescription is required, please have your pharmacy's name, address, and telephone number available. If you receive your prescriptions though a specialty pharmacy or mail and require a 3 months supply please notify us. You are responsible for any paperwork that may be required by your insurance company. Please allow 24hrs for refills. We do not participate with pharmacies outside of the United States.
 
Emergencies: In case of an emergency, go to the nearest emergency room. Call 911 if life threatening. A physician is on call 24 hours a day. Please have the emergency room physician contact us if your illness relates to your pulmonary condition. If the office is closed, the on call physician will be contacted through the answering service.
 
Fees: A list of non-covered charges is available upon request. These may include fees for copying records, filling out forms, and missed appointments.
 
Insurance Prior-Authorizations: Your insurance company may require prior-authorization for medication or diagnostic tests. Prior-authorization is a time consuming process that may include your physician making multiple phone calls, completing forms and providing additional medical information to your insurance carrier, including peer to peer review.

Privacy Policy: Our practice is dedicated to maintaining the privacy of your health information. A copy of our Privacy Notice is provided at your initial appointment and is available upon request.

Inclement Weather: In case of inclement weather, the office will contact you as soon as possible to reschedule your appointment for the next available opening. If you have not heard from us with regard to office status, please call the office to confirm our opening or closure.