FairDoctor Patient Advocacy GuideNPI: 1326322322
Patient Appointment & Billing Prep Checklist
Bring this sheet to your appointment. It outlines expected visit times, billing baselines, and protective questions to ask before receiving care.
DoctorDr. Lois Verbaan, OTROccupational Therapist in Private Practice · Sitka, AK
Patient Name & Date
Name: ____________________ Date: _________
Expected Consultation TimeStandard PacingBased on clinical documentation
Pricing Markup Tier2.5x BaselineFair / Standard
Standard Office Visit Baseline$130 to $210Customary allowable rate
4 Essential Questions to Ask at the Reception Desk
1. In-Network Confirmation: "Can you verify that Dr. Verbaan and this specific facility address are actively in-network with my insurance plan?"
2. Laboratory Routing: "If blood work, biopsies, or cultures are collected today, will they be sent strictly to an in-network lab?"
3. Itemized Procedure Estimates: "If any in-office scope, injection, or minor procedure is recommended today, can you provide a written estimate before performing it?"
4. Self-Pay / Prompt Pay Discount: "If I pay out-of-pocket today, what is your discounted cash settlement rate?"
My Health Priorities for Today’s Visit (Write Down Before Entering)
1. Main symptom or question: ____________________________________________________________________
2. Secondary concern or medication refill: ____________________________________________________________
3. Treatment plan or follow-up steps agreed upon: ___________________________________________________
FairDoctor Independent Patient Directory · fairdoctor.orgIndependent healthcare transparency reference