1. Instructions

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Please read all of the instructions before starting the Pre-Registration Process.
On-line pre-registrations must be submitted AT LEAST TWO DAYS PRIOR to coming to the hospital for service. If there are less than 48 hours before your scheduled admission/procedure, please call (806) 212-6284 to pre-register by phone instead.

Pre-Registering for Childbirth
  • If you are interested in taking one of our Childbirth Education Classes, we suggest that you plan to do so 24 - 32 weeks into your pregnancy. Call 212-BABY to register for a class.
  • When you are 34 - 36 weeks into your pregnancy, please call to schedule a Pre-Admit Appointment and Tour of the Women's Center. Call 212-BABY to schedule an appointment. 
Online Pre-Registration will benefit you by:
  • Allowing us to communicate with your insurance company to verify benefits and eligibility, start pre-certification, obtain referrals and preauthorization if needed, and resolve any insurance concerns before your service date.
  • Informing you of financial obligations beforehand so you can plan for the unexpected.
  • Providing us with information about yourself now can help save time in the future. 
If you prefer, you may pre-register by telephone at (806) 212-6284 or 1-800-234-5055.

In each section the required fields are denoted by an asterisk. Please try to fill in as many of the optional fields as possible. All information is kept strictly confidential and will be verified upon your visit. Information contained in this form is transmitted via a secure internet connection. 

Please have the following information available when you Pre-Register:
  • Physician's name
  • Date and time of procedure, test or surgery
  • Description/name of procedure, test or surgery
  • Insurance cards
You will be responsible for deductibles and/or copayments at the time of service. BSA is considered a preferred provider for many insurance plans. If BSA is not your plan's preferred provider, you will be responsible for a higher copayment or percentage of your hospital charges for choosing a "non-network" hospital. It is your responsibility to confirm the preferred provider status of BSA with your insurance carrier.

Some insurance companies do require pre-certification and/or referral from your primary physician in advance of service. BSA recommends that you call the insurance company to verify that the pre-certifications and referrals have been completed. It is the responsibility of the patient, guarantor or patient's physician to notify or call the insurance company. Failure to gather pre-certification, physician referral or preauthorization may result in reduced payment or denial of benefits by insurance company.