Member fee schedule

Annual OTMG Membership (1 year commitment) Fee:

Member: 1 individual

• Billing options: Monthly, Quarterly or Annually

• Credit, Debit, Check or Cash Accepted

Oaktree Medical Group receives many requests to complete various patient forms such as insurance, disability, FMLA, DMV, utility, doctor notes/excuses, prior authorizations, verifications, and Health Clearance Forms. Completion of these forms requires medical expertise and a review of medical record documentation. For this reason, a fee based on complexity and length of the forms will be collected prior to releasing the form. It is the patient’s responsibility to complete their portion of the form and submit it to the requesting party.

★ Nursing home entrance form

★ Disability forms

★ Assisted living forms

★ FMLA

★ DME and other Mobility Aid Forms (Scooters, Hoverounds, Orthotics) etc.)

Fee: $50

★ Prior Authorizations

★ Medicare Requirement Forms

★ Utility Forms

★ DMV Placard

★ Health Clearance Forms (Gyms, Diet Clinics, etc.)

★ Doctor excuse / work notes

★ Dept of Justice & DEA Cures / PDMP controlled substance record review with utilization

Medical record requests are priced individually. Please call our Medical Records Dept to determine your cost.

Please note:

★ Charges are NOT billable to your insurance provider and are your responsibility

★ All fees MUST be paid before records are sent

★ Typically no charge for pertinent records sent directly to a specialist