Category: For Patients

Request Records

Need to Request a Copy of Medical Records from SMPC?

To obtain records, submit a signed and dated Authorization for Use or Disclosure of Protected Health Information to the clinic.  The form may be obtained at the clinic, or through this link:

Southern Michigan Pain Consultants Release of Info/HIPAA & Fee Letter

After you complete and submit the form to the clinic, it is reviewed by the clinic staff and put in your file. Your request is processed by BACTES Imaging Solutions, our HIPAA Business Associate.

Some requests are processed at no charge to the requesting party (such as referrals for continuing care).  Other requests are charged a fee, in accordance with state statutes. BACTES bills requesting entities such as attorneys, insurance companies, etc. directly; patients are not billed for this work.

Patients who request records for their personal use or for transferring to another pain clinic, or similar provider, will be charged a fee.  This explained in the fee for records letter available at the clinic or at above link.
BACTES processes the requests and delivers an invoice detailing the fee for the requested records.  Upon receipt of payment, BACTES delivers a copy of the records to the requestor.

Please allow 7 business days after your forms have been accepted by SMPC for processing and delivery of the invoice.
After 7 business days, patients with questions on the status of their request should call the BACTES center for personal medical records requests (248) 977-3926.

After 7 business days, attorneys, insurance companies, etc. with questions on the status of their request should call the BACTES center for third party medical records requests (800) 560-3800.


Need to Send a Copy of Medical Records TO SMPC?

New and returning patients often need to have certain medical records sent to SMPC to assist in their diagnosis and treatment.  If you need your current (or previous) provider to send your records to SMPC, a request form may be obtained at the clinic, or through this link:

Release of Info/HIPAA Form TO Southern Michigan Pain Consultants

Do you need help with where the info should be sent? Please check with SMPC clinic staff to obtain the mailing address for where your records should be mailed.

New Patient

Southern Michigan Pain Consultants offers many resources for patients and their families to learn and understand more about chronic pain. The menu on the left includes additional information for patients, including information on different painful conditions and the part of the body affected by them as well as treatments and procedures offered.

To become a patient with our practice you may need a referral if your insurance requires one. You can call toll free (877) 377-6227 or contact us using the form below and one of our schedulers will get in touch with you.


Request Appointment Online


If you prefer to submit a new patient appointment request online, please fill out the form below. When filling out the form, please select Scheduling as the Inquiry and include your name and your preference for contact, email or phone call. If you prefer a phone call please also include your phone number with area code and a good time to call. One of our schedulers will contact you back within two business days with more information.


Patient Information

Scheduling & Billing


Southern Michigan Pain Consultants strives to make communication as easy as possible for our patients. We try to offer as much information about pain as possible online, if you need assistance with something you don’t find on this page, please contact us.

CURRENT PATIENTS

Pay Your Bill

Bill payments can be made online through the patient portal, by phone by calling our billing department at (877) 377-6227, in person on your next visit, or via postal mail to the office.


Change or Schedule an Appointment

If you would like to change or schedule a follow up appointment, please use the patient portal or call the scheduling department at (877) 377-6227.

NEW PATIENTS

To make a new patient appointment with one of Southern Michigan Pain Consultants physicians call (877) 377-6227. You may need a referral from your physician if your insurance requires one.

You will need to know your current health insurance information as well as the name of your primary care or family physician. You may need a referral from your physician if your insurance requires one.

You may also Contact Us Online to request a new patient appointment.

New Patient Packet


Patient Forms


The following forms are available online for your convenience. If you have any questions please feel free to contact us.
Medical Records Request

To obtain copies of medical records, a signed Request for Records or Authorization to Release Health Information must be filled out, submitted to the clinic and placed in the patient’s file. Forms may be obtained at the clinic or by following this link.


Other Forms

Scheduling & Billing

To make a new patient appointment with one of Southern Michigan Pain Consultants physicians call (877) 377-6227.

You will need to know your current health insurance information as well as the name of your primary care or family physician. You may need a referral from your physician if your insurance requires one.

You may also Contact Us Online to request a new patient appointment.

Billing Address:
SMPC
61 Commerce Ave SW
Grand Rapids MI 4950
General Billing and Scheduling Inquiries

If you have questions about scheduling or billing, please call (877) 377-6227 or contact us online and one of our office staff will get back to you within 48 hours. Please remember that only a physician or provider can answer specific medical questions. Our business office staff are happy to assist you with the non medical inquiries.

Accepted Insurance

Southern Michigan Pain Consultants accepts and participates with many different insurance plans.

  • Aetna
  • Auto
  • Blue Cross Blue Shield (BCBS)
  • Blue Care Network (BCN)
  • Blue Choice
  • Choice Care Network (Humana)
  • Cofinity
  • Community Choice
  • Medicare
  • Physicians Care
  • Priority Health
  • United Health Care
  • Workers Comp

Note: Not every SMPC location participates with the same insurance. If you are unsure if we accept or participate with your insurance plan, please call (877) 377-6227 for more information.