Patient Center

Patient Center

Forms & Billing

Your health is of utmost importance to us. Therefore, to ensure that we have all the needed information to properly care for you, we have several patient information forms for you to complete. Please remember that accuracy and honesty are extremely important when filling out any official paperwork, especially information related to your health.

Although these forms are available online, they are not electronically submitted. However, you can print the forms, complete, sign and bring them with you to your appointment. Or you may receive these forms in the mail from our office, with instructions to complete them prior to your appointment. Filling out your forms ahead of time helps us maintain efficiency for everyone.

Patient Information

Education can enhance the interaction you have with your surgeon. In addition to interaction with your surgeon and other healthcare professionals, this website contains an overview of various procedures. If you still have questions after reviewing our site, we have provided a variety of links for your convenience.

Please note that by clicking on the links on this page, you will be leaving our site. Peoria Surgical Group, Ltd. does not endorse, maintain or contribute to these sites and is not responsible for their content. These sites are not intended as medical advice and should not be a substitute for consulting with your primary care physician or surgeon

Notice of Privacy Practices
Discrimination Policy


In order to register and treat you promptly, we request that our patients bring their current insurance information with them to each visit.

Please keep in mind that each patient policy is different and the patient is responsible for checking their carrier for participation.  We will bill your insurance directly for all services if you provide us with the updated insurance information.

We are happy to file the claim for you, but the balance is your responsibility if your insurance company or plan does not pay after 90 days (exceptions for State of Illinois employee coverage).

Medicare: We gladly accept Medicare patients.  As a courtesy, we will also bill your secondary insurance provider directly.  You will be asked to sign an Advanced Beneficiary Notice for services not covered under Medicare.  You will be accountable for covering these services.

Referral Prior-Authorizations: Some insurances require the patient to have a prior-authorization before your initial appointment.  If you do not have a prior authorization, your insurance will deny all services.  Some, but not all, of the insurances are listed below: 

Humana HMO
Tricare Prime
United HealthCare

We are NOT IN-Network for the following insurance:


“Understanding Colorectal Cancer” by Steven Tsoraides, MD
It’s the third most common cancer in the United States, affecting 1.3 million individuals across the globe each year, and the fourth most common cause of cancer death. In the U.S., 150,000 new cases will be diagnosed annually, and approximately one-fourth of adults older than age 50 will have at least one colorectal polyp, a precursor to cancer. Become acquainted with the warning signs, risk factors and available treatment options.

The Current Role of Mediastinoscopy in the Evaluation of Thoracic Disease

Perioperative Complications After Living Donor Lobectomy

Sternal Resection and Reconstruction After Renal Cell Carcinoma Metastatic to the Sternum

A Case of Chest Wall Angiosarcoma Associated With Breast Implants Brief Technique Reports

The Novel Use of Nuss Bars For Reconstruction of a Massive Flail Chest

Spindle Cell Sarcomatoid Carcinoma of the Trachea: First Case Report of Surgical Resection

New Patient Portal -

Register Today!

At, you can:

  • See all your health information, including your care plan and lab results, on any Internet-enabled device, including smartphones and tablets
  • Send secure messages to ask non-urgent questions about your care and receive prompt replies
  • Request prescription refills and appointments
  • Send your health records to other providers electronically

Some of the insurances we accept are: