Information for Those Who Live Far Away

We are accepting new patients from the northern half of Virginia only. You can appeal this limitation by sending us an email. Appeals by phone will NOT be accepted. In only very rare and selective cases have we made exceptions. Read why we instituted this policy.

We have had patients come to our practice from all over the United States and even internationally from Canada, Italy, Phillipines, Mexico, etc. In order to help with any patients who live far away be seen in our office, these steps have been created to help expedite the visit. Please note that from first contact to having the surgery peformed (if applicable) may take a few weeks, especially if insurance coverage of the visit and surgery is desired. The exception is minimally invasive ambulatory type procedures such as botox injections in which the visit and procedure can all be done on the same day (a Friday).

PLEASE keep in mind that at least for our practice, follow-up visits after any procedure is recommended. If you are not willing to commit to possible follow-up appointments, do not make an appointment with us. Why are we requiring this? After a procedure, it is not unusual that a patient may experience some problems or encounter a situation in which they are not sure what to do. In this scenario, it is very difficult if not impossible to answer questions over the phone without an examination leading to frustration and even anger (as follow-up examinations are very inconvenient especially if you live far away). As such, do NOT make an appointment with us unless you are willing to commit to follow-up visits. Although not mandatory, a routine follow-up appointment is generally made for 1-2 weeks after a procedure.

With that understanding...


Contact your insurance company to make sure you are able to go out-of-network for your care (if you have Medicare, you are covered). This is YOUR responsibility. Not ours. Obviously, if you are self-pay, this step is not necessary.

In event we do not participate with your health insurance plan, you can request a "Letter of Medical Necessity" from you primary care doctor for temporary non-par provider health insurance coverage.

Email/Call Dr. Chang with your interest.

If applicable, mail a CD of applicable images and include a paper report to Dr. Chang's attention. A CD can be created for you if you request it from the radiology department where you had the exam performed.

Once the information is reviewed and it is felt that you are a surgical candidate, we will contact you. At this time, we may request additional studies.


Fax (540-347-5224) your complete health insurance information to the office as soon as possible (front and back of all your health insurance cards).

If surgery is being considered, a complete history and physical within the last 30 days from your medical doctor for preoperative clearance faxed to our office as soon as possible. Be sure that a list of all your medications is included.

Download, complete, and fax our office forms to us.

Once the office receives all this information, our office will obtain preauthorization from your health insurance company if applicable. Depending on your health insurance company, your primary care doctor may need to write a letter of medical necessity as to why you are going out-of-network for your treatment.


Call (540-347-0505) to schedule your appointment and surgery. Typically, this will be handled personally by Dr. Chang.

Please note that Dr. Chang reserves the right to have you see any necessary physicians locally in Warrenton, VA (pulmonologist, cardiologist, internist, radiology, etc) before your surgery (if applicable) to make sure you are optimized medically (will occur same day as appointment or immediately before surgery).

It would be worthwhile to carefully read the informed consent for the procedure you are interested in and call us with any questions you may have.

Lastly, though you may have committed the time and expense to come to have a procedure done, if there are any medical concerns that you may not tolerate the procedure or are not a surgical candidate, Dr. Chang reserves the right to delay or even cancel the procedure.


Once your surgery (if applicable) is scheduled, you can contact the hospital at 540-316-5014 to make hotel arrangements for you at a deeper discount than you may find on your own.

Hotels nearby where you can stay.