PLACER FAMILY MEDICINE
Dr. Manpreet K Gill, M.D., Physician and Surgeon A
American Board of Family Medicine Certified
New Patients
Establishing Care with Dr. Gill
Becoming a patient of Placer Family Medicine is a simple, straightforward process. Follow the steps outlined below, and you will be ready to establish care with Dr. Gill.
STEP 1: Complete the New Patient Intake Packet (NPIP) entirely, sign each form legibly, provide clear copies of your insurance card(s)/insurance beneficiary and guarantor photo IDs. There are two ways to complete the PFM NPIP: electronically on FormDr or by paper. Please see below the instructions to complete the electronic and paper PFM NPIP.
FORMDR SUBMISSION INSTRUCTIONS (ELECTRONIC)
Please allow 15 to 30 minutes to complete the packet in one sitting. The information is not saved until you submit the forms.
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Click the following blue hyperlink to access our New Patient forms packet: New Patient Intake Packet
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Fill out the New Patient Intake Packet and then submit them via FormDr. Make sure you complete the forms entirely, sign them legibly, and upload clear copies of your insurance card(s)/insurance beneficiary and guarantor photo IDs (Driver License or Other Government Issued Document). If you are unable to upload your insurance card(s)/insurance beneficiary and guarantor photo IDs on FormDr, please email insurance card(s)/insurance beneficiary and guarantor photo IDs to: HELLO@PFM.HEALTH
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Once Placer Family Medicine receives your completed PFM NPIP, we will then begin the process of verifying your insurance benefits and eligibility.
PAPER SUBMISSION INSTRUCTIONS
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If you would like to complete a paper version of the PFM New Patient Intake Packet, please contact our office by emailing us at HELLO@PFM.HEALTH or telephoning us at 530-888-9978. If we do not answer and want us to call you back, please leave an audible voice message including your name, date of birth, phone number, and purpose of the call.
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Please note, we do not mail New Patient Packet Forms to prospective patients. We do not allow prospective patients to walk-in without an appointment to fill out the forms at our office.
STEP 2: Once a complete packet has been accepted for processing, staff will begin verifying insurance benefits and eligibility.
STEP 3: The PFM New Patient Intake Process is completed via email correspondence. PFM provides prospective patients the result of their insurance verification of benefits and eligibility before offering an establishing care appointment. This information is provided to prospective patients to comply with the "No Surprise Billing Act". Prospective patients are required to confirm the offered Video Establishing Care appointment slot in-writing (via email response). PFM uses a HIPAA compliant video and audio interface for all telehealth appointments. Please see the "Telehealth Information" tab for more information.
** No doctor-patient relationship exists until Dr. Gill and the patient complete the Establishing Care appointment and both parties consent. **