Call Us: (330) 899-9350 | Pay Online
Billing & Payments (330) 974-0788
I UNDERSTAND THAT I WILL BE HELD FINANCIALLY RESPONSIBLE FOR ALL CHARGES RESULTING FROM SERVICES PROVIDED. I AUTHORIZE DIRECT PAYMENT OF MEDICAL BENEFITS FROM MY INSUARANCE COMPANY TO PIONEER PHYSICIANS NETWORK, INC. IN ADDITION; I AUTHORIZE THE RELEASE OF MY MEDICAL INFORMATION NECESSARY FOR THE PROCESSING OF THESE CLAIMS FOR PAYMENT INCLUDING FACSIMILE TRANSMISSION OF INFORMATION.>