NEW PATIENT FORM
PATIENT PORTAL
PATIENT INFORMATION
Accordia Health strives to provide the most trusted healthcare. We accept most major commercial insurance as well as Medicaid and Medicare. We also offer services to uninsured people, depending on their symptoms and needs. Please refer to our Sliding Fee Discount Program. New patients will need to fill out the New Patient Form. For more information about your rights as a patient, please review our Privacy Practices and Patient Rights and Responsibility forms. Please review Your Rights and Protections Against Surprise Medical Bills to learn more about our CMS Price Transparency.
Accordia Health complies with applicable federal and state civil rights laws and does not discriminate against any individual on the basis of race, color, ethnic or national origin, ancestry, sex, gender, age, sexual orientation, gender identity and expression, religion, creed, political beliefs, or disability in admission, treatment, or participation in its programs, services, and activities, or in employment, or on the basis of sex in its health programs and activities. To learn more about our Non-Discrimination policy, click here.
340B PARTICIPATING PHARMACIES
340B is a medication pricing program made possible by the US Federal government that assists in making medications affordable to those who are eligible. Those covered by Medicaid may not be eligible.
340B PARTICIPATING PHARMACIES – DOWNLOAD HERE
PATIENT FORMS
SLIDING FEE DISCOUNT PROGRAM – DOWNLOAD HERE
SLIDING FEE DISCOUNT PROGRAM POLICY- DOWNLOAD HERE
SLIDING FEE DISCOUNT PROGRAM APPLICATION – DOWNLOAD HERE
NEW PATIENT FORM – DOWNLOAD HERE
PATIENT RIGHTS AND RESPONSIBILITY – DOWNLOAD HERE
AUTHORIZATION TO DISCLOSE PHI FORM (PRIMARY CARE) – DOWNLOAD HERE
OPEN ENROLLMENT – DOWNLOAD HERE
CARE MANAGEMENT – DOWNLOAD HERE
INFORMED CONSENT FOR PSYCHIATRIC/MEDICAL TELEHEALTH – DOWNLOAD HERE
MEDICAL BROCHURES
ENGLISH BROCHURES
OVERVIEW BROCHURE – DOWNLOAD HERE
SERVICES BROCHURE – DOWNLOAD HERE
PATIENT CENTERED MEDICAL HOME BROCHURE – DOWNLOAD HERE
SPANISH BROCHURES
OVERVIEW BROCHURE – DOWNLOAD HERE
SERVICES BROCHURE – DOWNLOAD HERE
PATIENT CENTERED MEDICAL HOME BROCHURE – DOWNLOAD HERE
SLIDING FEE DISCOUNT PROGRAM POLICY – SPANISH
SLIDING FEE DISCOUNT PROGRAM APPLICATION- SPANISH
VIETNAMESE BROCHURES
OVERVIEW BROCHURE – DOWNLOAD HERE
SERVICES BROCHURE – DOWNLOAD HERE
PATIENT CENTERED MEDICAL HOME BROCHURE – DOWNLOAD HERE
SLIDING FEE DISCOUNT PROGRAM POLICY – VIETNAMESE
SLIDING FEE DISCOUNT PROGRAM APPLICATION – VIETNAMESE
CERTIFIED APPLICATION COUNSELORS
NEED HELP FINDING AN INSURANCE PLAN OR SIGNING UP?
As federally qualified health centers (FQHC), Accordia Health provides expert care to all patients, regardless of their ability to pay, and offer free support services like insurance enrollment counseling and a Sliding Fee Discount Program to help patients maintain access to quality care.
To assist individuals in the ongoing implementation of the Federal Affordable Care Act (ACA), Accordia Health has two specially trained Certified Application Counselors (CAC) available to help people without health insurance who might qualify. Our staff can help you navigate and enroll in an insurance plan.
CAC’s have undergone the required comprehensive training and testing related to the Affordable Care Act to be certified as application counselors for the Federal plans. We can also assist with Medicaid questions, applications, and eligibility letters by appointment.
If you need help navigating, choosing a health plan or have Medicaid questions please contact our Bayou La Batre office at (251) 824-8320.
Accordia Health provides services regardless of a patient’s ability to pay. Discounts are offered on services based on a sliding fee scale depending on your household size and income. Translation services are available. Accordia Health is a Federally Qualified Health Center. This health center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals. All calls are answered 24/7.