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Modern Kidney
& Transplant Care

Phone

346-478-1222

Patient Resources

Patient Forms

New Patients:
If you are a new patient, please print the following forms, fill them out, and email them to appointment@modernkidney.com, or bring them with you to your appointment:

  1. New Patient Packet
  2. HIPAA Privacy Practice Acknowledgment Statement

 

Returning Patients:
If you are returning patient, please print and fill out the following form so we may update your medical status:

  1. Follow-Up Patient Questionnaire

Financial Policies

Modern Kidney is committed in providing conscientious cost-effective medical care for you. Payment of the bill is considered an important part of that partnership. Thank you for reading our Financial Agreement. Please let us know if you have questions or concerns.

The following is a statement of our Financial Policy, which we require you to read and sign.

It is your responsibility:

  • To understand your benefit plan
  • To know if a referral is required
  • To know if pre-authorization is required prior to any procedure
  • To know what services are covered


Full payment for self-pay patients and co-payments are due at the time of service.
We accept cash, checks, Visa/MasterCard/Discover/American Express. Other arrangements must be made in advance with our billing office.

Regarding Insurance

Your insurance policy is a contract between you and your insurance company. Payment of your bill is ultimately your responsibility. Modern Kidney contracts with, and bills, most insurance carriers. We also participate with both Medicare and Medicaid of Texas. If you are insured by a company with which we do not contract, we can supply you with a statement of your charges. You may submit this, along with any additional forms your insurance requires, to your insurance company.

Patient Education

Covid update

Modern kidney is excited to see new vaccines emerge to aid in the prevention of Covid 19. Our recommendations are based from the CDC and FDA. Wearing of facemask is optional at this time.

Covid vaccine

Modern kidney is recommending all patients to receive either the Pfizer or maternal Covid vaccine. This vaccines are safe and effective in preventing infection.

Modern kidney will not be administering Covid vaccines. Fortunately this vaccines are now widely available. Check with your local pharmacy.

Booster vaccine

On 8/18/2021 the FDA announced that booster vaccines have been authorized for all prior recipients of Covid vaccination after 8 months have elapsed since the last dose. This has been available since September 20, 2021.

Kidney transplant recipients who have received the Covid vaccine
Available data suggests 50% of kidney cancer when patients will have detectable antibody after vaccination after receiving messenger RNA vaccine.

On 8/12/2021, the FDA announced approval for a booster dose of Pfizer or maternal Covid vaccine for all kidney transplant patients and patients on immunosuppressive therapy. These have been available.
We are not 100% certain at this point if antibody response reflects protection, or if there is still some element of protection provided by the vaccination regardless of antibody response. What we have observed is that patients tend to be less sicker if they have received the Covid vaccine prior to their Covid infection, regardless of whether they mounted an antibody response or not with the vaccination.
You can choose to undergo antibody testing 4-6 weeks after completing vaccination in order to better understand her vaccine response and help you make decisions about what precautions she feel are necessary.

If you were tested and do not have vaccine associated antibodies, you can consider a booster dose or revaccination.  If you were tested and were found to have developed vaccine associated antibodies, you can follow CDC recommendations for social distancing that apply to the General, fully vaccinated population.