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NEW ADULT PATIENT FORMS

If you are a new patient please fill out ALL of the following forms:

  1. New ADULT Patient Form
  2. Annual Patient Health and Medical Claims Processing Release
  3. Medical History

NEW CHILD PATIENT FORMS

If you have a child that is a new patient please fill out ALL of the following forms:

  1. New CHILD Patient Form
  2. Annual Patient Health and Medical Claims Processing Release
  3. Medical History

Patient Information & Resources

Welcome to our resources page. Here you will find information such as insurance plans that we accept, Health Maintenance Information, and links to sites that may be of interest to you. You can also print forms to fill out before your visit to one of our offices.

HIE Notice

We participate in one or more Health Information Exchanges.  Your healthcare providers can use this electronic network to securely provide access to your health records for a better picture of your health needs.  We and other healthcare providers may allow access to your health information through the Health Information Exchange for treatment, payment or other healthcare operations.  This is a voluntary agreement.  You may opt-out at any time by notifying your physician’s office.

Televisits

For many people today, telemedicine is a convenient and effective way to see their healthcare provider. Before beginning your TeleVisit, make sure that you:

  • Have an active Patient Portal account, with username and password
  • Set aside a secure, private location

CLICK HERE to learn more about how to participate in a televisit or WATCH VIDEO.

Patient Portal

TELEVISITS

PATIENT DOCUMENTS

BILLING QUESTIONS

Any questions that you have regarding your billing needs, please call (330) 974-0788 Monday through Friday, 8am to 4:30pm.

Insurance

What insurance plans will you be accepting in 2026?

Insurance Plans Pioneer Physicians Network Accepts*

Aetna*Paradigm Senior Health Connect
Aultcare*SummaCare Medicare Advantage
Primetime Senior Care Advantage*Aetna Medicare Advantage
AnthemAnthem Medicare Advantage
Anthem MedicaidUHC Medicare Advantage
Buckeye (Community Ohio Medicaid)
Bureau of Workers Compensation (BWC)Miscellaneous Plans
CignaAM First Insurance (Secondary Only)
HealthsmartBeechstreet
Medicare (Traditional)Emerald Health Network PPO
Medical MutualFlume Health
Multiplan-PHCSFortified Provider Network PPO
Ohio PPO ConnectLucent Health
SummaCarePremium Savers Supplemental (Secondary)
The Health Plan Commercial (Hometown)UMR-UHC (United Health Care)
Tricare**UPMC
United Health Care (UHC)CHAMPVA
UHC (Community Ohio Medicaid)JP Farley

PLEASE NOTE:

*Some physicians may not be in network for specifics plans of insurances listed above. Please check with your physician’s office or call our Patient Navigator for assistance at 330.648.0487.
**Tricare plans: Limited physicians are accepting out of network benefits only. Please contact our Patient Navigator for assistance at 330.648.0487.

Select Medicaid Plans: Some physicians may not be in network, which may include Buckeye and United Health Care plans. Please check with your physician’s office or call our Patient Navigator for assistance at 330.648.0487.

For any other questions regarding coverage or changes in participation, please contact our Patient Navigator.
T: 330.648.0487

What insurance plans are you accepting in 2025?

Insurance Plans Pioneer Physicians Network Accepts*

Aetna*Paradigm Senior Health Connect
Aultcare*SummaCare Medicare Advantage
Primetime Senior Care Advantage*Aetna Medicare Advantage
AnthemAnthem Medicare Advantage
Anthem MedicaidHumana Medicare Advantage
Buckeye (Community Ohio Medicaid)UHC Medicare Advantage
Bureau of Workers Compensation (BWC)
CignaMiscellaneous Plans
HealthsmartAM First Insurance (Secondary Only)
Medicare (Traditional)Beechstreet
Medical MutualEmerald Health Network PPO
Multiplan-PHCSFlume Health
Ohio PPO ConnectFortified Provider Network PPO
SummaCareLucent Health
The Health Plan Commercial (Hometown)Premium Savers Supplemental (Secondary)
Tricare**UMR-UHC (United Health Care)
United Health Care (UHC)UPMC
UHC (Community Ohio Medicaid)CHAMPVA
JP Farley

PLEASE NOTE:

*Some physicians may not be in network for specifics plans of insurances listed above. Please check with your physician’s office or call our Patient Navigator for assistance at 330.648.0487.
**Tricare plans: Limited physicians are accepting out of network benefits only. Please contact our Patient Navigator for assistance at 330.648.0487.

Select Medicaid Plans: Some physicians may not be in network, which may include Buckeye and United Health Care plans. Please check with your physician’s office or call our Patient Navigator for assistance at 330.648.0487.

For any other questions regarding coverage or changes in participation, please contact our Patient Navigator.
T: 330.648.0487

Are co-pays required to be paid at check in?

If you have one of the listed insurance plans above, co-pays are required to be paid when you check-in. Please bring your insurance card to every visit. We do accept cash, personal checks, debit, Visa, MasterCard and Discover.

Questions

What are the rights and responsibilities of the patient?

The patient has the right to choose his/her own physician.

The patient has the right to choose his/her own medical facility or hospital.

The patient has the right to privacy, confidentiality of medical records, and confidentiality of any conversations they may have with the employees of the medical facility of their choice.

The patient has the right to be free of abuse or harmful situations.

It is the right of the patient to agree or disagree with the type of treatment and/or medication with which they are to be treated.

It is the patient’s responsibility to ask questions about recommended treatment and if agreeing to treatment, following the treatment plan.

The patient has the right to refuse such treatment.

Refusal of treatment eliminates the physician and staff from the responsibility for patient outcomes.

What is a guarantor number?

A guarantor is the person responsible for bill payment. We use the guarantor number to pull up information in our system.

Where can I find information about age-related health maintenance screening?

You can click on the look Patient Education section on this page for this information.

Will my doctor see me if I am admitted to the hospital?

Our doctors rotate schedules at local hospitals. One of them will visit you while you are in the hospital.

What is a Physician Assistant (PA)?

A Physician Assistant is a person trained and licensed to provide basic medical services, usually under the supervision of a physician.

What is a Nurse Practitioner?

A registered nurse with special training for providing primary health care, including many tasks customarily performed by a physician.

Docs and Forms

General Information About Our Forms

Thank you for choosing Pioneer Physicians Network. We look forward to serving you at one of our locations. If you are a new patient or a current patient with a change in your information (such as address, insurance, etc), please review and complete the forms listed below before your next visit. Please note that all documents are PDF and require Adobe Acrobat or Adobe Reader.

What is a guarantor number?

A guarantor is the person responsible for bill payment. We use the guarantor number to pull up information in our system.

Notice of Privacy Practices and Consent Form

CLICK HERE to download our Notice of Privacy Practices and Consent Form

Medical Record Release Authorization

CLICK HERE to download our Medical Record Release Authorization. Use this form to allow us permission to send your protected health records to a third-party.

Patient Education

Hospital Follow-up Appointments

If you are in the hospital for an overnight stay, your Pioneer physician wants to know. Please call your doctor’s office within 24 hours after discharge to set up an appointment.

Health Maintenance Males

20-40 Year Male:

Yearly PE, Cholesterol check every 5 years, Monthly testicular exam, Eye exam every 2-3 years, Update Tetanus/Pertussis every 10 years, Exercise 45 minutes 4 to 5 times per week, Eat low fat diet

40-50 Year Male:

Yearly PE, Education #8211; heart disease, Cholesterol and glucose every 5 years, Yearly PSA and Prostate Digital Rectal Exam for African Americans and males with family history, Monthly testicular exam, Exercise 45 minutes 4 to 5 times per week, Update Tetanus/Pertussis every 10 years, Eye exam every 2-3 years

50-65 Year Male:

Yearly checkup, Education #8211; heart disease, stroke, cancer, Cholesterol and glucose every 5 years, Colonoscopy, stoll cards, PSA, Prostate exam, Exercise 45 minutes 4 to 5 times per week, Update Tetanus shot, Vision and glucose screening every 2 years

65 and Older Male:

Yearly PE, Education #8211; heart disease, stroke, cancer, Cholesterol, blood work determined by doctor, Yearly PSA, prostate exam, Colonoscopy every 5-10 years, DXA/VFA every 2 years, Flu shot every year, pneumovax age 65 and then 2nd one, 5 years later, Exercise 30 minutes 4-5 times per week, Tetanus shot every 10 years, Vision exam every 2 years

Glossary of Terms:

PE: Yearly Checkup PSA: Prostate screen for cancer Colonoscopy: Screen for colon cancer DXA/VFA: Screen for osteoporosis Osteoporosis: Bone loss leading to fracture PAP: Screen for cervical cancer Mammogram: Screen for breast cancer Testicular Exam: Screen for Testicular Cancer HPV: Human Papilloma Virus (causes cervical cancer)

Self Care Wellness

If you are looking for educational materials, classes, or programs to help manage Diabetes, Nutrition and other wellness issues, explore the links below.

Diabetes Education Information:

Summa Health Systems

Akron General Health Wellness Center

Mercy Medical Center

Aultman Hospital

Nutrition Education Information

Summa Health Systems

Akron General Health Wellness Center

Mercy Medical Center

Preventative Care

At Pioneer Physicians Network preventative care is of the utmost importance in managing your health. To start your own “good health” practices, there are four things you can do immediately without any medical knowledge:

-Don’t smoke or use other tobacco products; Drink only in moderation (and red wine in the most acceptable use of alcohol)

-Eat a proper, balanced diet to get the correct amount of nutrients and calories daily

-Exercise at least three days per week; Aerobic exercise will build muscle and endurance

-See your doctor regularly for check-ups

Please schedule routine exams with your doctor and discuss which testing is appropriate for you.

To see Preventative Health Care Gaps CLICK HERE

DISCLAIMER: You may be charged an extra copay by your insurance company if you are scheduled for a physical and you have a new health issue or have been previously diagnosed with a health issue that is considered unstable and needs attention at that visit.

Helpful Links

MerckEngage.com is a free online resource which includes healthy recipes, ideas for getting fit, and practical planning tools for better health.

American Academy of Family Physicians

American Osteopathic Association