Helpful Documents

A completed Medical Visit Verification Form may be used to provide additional information for a medical visit.

Accessia Health’s current Patient Policies are available for review.

Accessia Health Notice of Privacy Practices is available for review. Questions or concerns regarding our Notice of Privacy Practices should be directed to our HIPAA Privacy Officer at:

EMAIL
HIPAAPrivacyOfficer@accessiahealth.org

MAILING
Accessia Health: HIPAA Privacy Officer
PO Box 5930
Midlothian, VA 23112

If you are helping a patient navigate their care, you can securely upload documents to Accessia Health on their behalf; no account or login required. Have the patient’s basic information ready, including their name, date of birth, and phone number, along with your own contact information. You will receive an email confirmation once your upload is complete.

Before you begin: Have the patient’s full name and Accessia Health ID number (if known) ready. This helps us match your documents to the correct file.

What you can upload:

• Enrollment forms, proof of income
• Medical records
• Other supporting documents requested by our team.

Once submitted, our team will review your documents and reach out if anything additional is needed.

Accessia Health is required by the IRS to obtain a W-9 form from all physicians, hospitals, treatment centers, infusion pharmacies, and insurance third party administrators (COBRAs) to which we provide payment.

The completed W-9 must be on file prior to releasing any payments.

EMAIL COMPLETED FORMS
Completed W-9 forms can be emailed to assistance@accessiahealth.org

This form is required to request reconsideration of an income decision regarding a patient’s eligibility for assistance.

Frequently Asked Questions regarding your Accessia Health payment assistance card.

As a result of the Inflation Reduction Act (IRA), several changes to Medicare took effect on January 1, 2025,
potentially impacting Medicare beneficiaries. Read for FAQs that explain what has changed and how to
make the most of your Accessia Health assistance.