Overland Park 1-913-364-1314
Theme - DefaultPatient Information
During the first scheduled New Patient visit, we make sure to obtain important background information such as your pertinent medical history and give you time to get to know your doctor. We accept most insurances, but contact your carrier to ensure Dr. Ali Davis in an in-network provider.
Please arrive 15 minutes early to your scheduled appointment if you are unable to complete the initial paperwork. The following items are strongly recommended to ensure accurate and safe patient care:
- Insurance card(s)
- List of current prescriptions and/or over-the-counter medication, including dose and frequency
- Pertinent medical and surgical history (cancer, diabetes, rheumatology, cardiology, etc)
- Recent labs results, x-rays, or relevant records
Surgery Forms
New Patient Forms
Consent to Treat Minor Children
Self-Pay Information
Insurance and Payment Information
Out of Network Insurance:
- EPO Plans
- Medica
- Oscar
- Blue Select
- Blue Cross Medicare Advantage
- Kansas Medicaid
- United Healthcare Community
- We are currently not accepting new patients with Humana Medicare Replacement plans
Dr. Davis does not participate with Health Share Benefit plans such as One Share, Medi-Share, Aliera, etc.
If your plan has a deductible that has not been met, we will collect payment at check in:
New Patient: $100; Follow-up visits: $50.
It is the patient's responsibility to know the terms of their insurance plan. Please verify that you have podiatry benefits with your insurance company.
The patient is responsible for copayments or charges that are not covered by the insurance plan. Overpayment at The Foot Clinic will result in a refund after claims have been processed by your insurance.
Specific questions regarding insurance coverage and benefits should be directed to your employer or insurance company. For our billing and processing information, please contact our Billing Department at 1-913-364-1314, ext #3.
