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Nephrology Associates of Kentuckiana 
Online Patient Forms

We look forward to meeting you at your first appointment.

Our physicians are here to provide the best care for you. We want you to have the best healthcare experience while visiting our office.

Below you will find a list of helpful advice to make your visit with us successful.

  • Appointment Cancellation or Reschedule - 24 hour notice is requested.

  • Address/Phone Number Change - please provide us with your current address & phone number.

  • Insurance Co-pays are collected at the time of your appointment. We accept cash, check, debit & credit cards.

  • Deductibles - Medicare's annual deductible applies every January. There is also a 20% co-insurance. Please contact our Patient Account Coordinator if you have any questions or concerns regarding payment, deductible, or co-insurance responsibilities.

  • Monthly Statements - if you have a balance on your account you will receive a statement each month. Payment is expected within 20 days of receipt of your statement. Accounts with a balance over 90 days old, with no contact with our office will be reviewed and forwarded to an outside collection agency. We want to work with you to help you with your balance. Please call our Patient Account Representative to discuss a payment plan to meet your needs.

  • Account Balances - if your account has a balance, a statement will be provided on the day of your appointment. Payment is expected at that time.

We take debit and credit cards by phone or you can pay your bill online by clicking this link: PAY ONLINE.

Thank you for choosing Nephrology Associates of Kentuckiana, PSC.





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