Patient Forms, Map and Directions to Greenbelt, MD Office
If you're planning your first visit to Raja M. Din MD, PLLC, we look forward to working with you. Please find some information about us below.
Our goal is to empower you to regain control of your digestive health utilizing an integrative, holistic approach.
To fulfill this mission, we are committed to:
- Working with you to determine your digestive health goals.
- Helping you to understand your health and be a partner in optimizing your care.
- Exploring a multitude of options for treatment, both traditional and holistic.
- Provide cutting edge technology and services.
- Create a community of mutual respect between our providers, staff, and patients.
What To Bring With You For Your First Visit With Us
When you visit us for the first time, please make sure you bring your:
- Photo ID
- Insurance card
- Referral (If your insurance requires one)
- List of current prescription and over the counter medications
- Lab, Radiology or other results
- Patient Forms (found below)
- If you have a co-pay, it will be collected before your doctor’s visit, and is payable by cash, check, or credit card
Please print and fill out these forms so we can expedite your first visit:
- Welcome Letter
- Patient Information Form
- Patients Privacy Notice
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it. If you are unable to print these forms, please call our office at least a week prior to your appointment and we will mail you hard copies.You may pick them up from our office as well if that is most convenient for you.
Insurance and Billing
Participating Insurance Plans:
|AETNA referral required for HMO||ALLIANCE||COVENTRY|
Referral Required for the Following Plans :
|MARYLAND PHYSICIANS CARE||AMERIGROUP||PRIORITY PARTNERS|
We Accept the Following Plans as SECONDARY INSURANCE ONLY:
- Please verify your coverage and benefits directly with your insurance company.
- Please note that regardless of what is listed above, your insurance may require a referral. Please check your insurance card.
- Dr. Din is listed as Raja M. Mohi-Ud-Din in most insurance databases.
- If your insurance is not listed above, please feel free to contact us.
- Please click here for our contact information. We are happy to assist you!
Payment is due at the time of service or within 30 days of receiving a statement for your balance due.
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It will also help alleviate any anxiety you may be feeling prior to your first appointment. Educate yourself on your symptoms by reviewing the content on this website. Also, take some time to review our staff page and familiarize yourself with your doctor. We look forward to your first visit.