(770)436-9700














(770)436-9700
 

  
 


Ask a billing question or dispute a charge
All of us at CPG are here to help.  Whatever the question we'll try to answer it quickly and efficiently.  Towards the bottom of this page you will see three questions that need to be answered if you are disputing a charge.  If you prefer to fax or mail us this information the button below will provide you with a hard copy of the dispute resolution form that you can print out. 
 

  
   

  NOTE:  Information that is required is denoted by a red * next to the box.
  Name:                  *Required

  Patient's Name:  

  Email address:    

  Phone:                 *Required


  Patient's Date of Birth:  *Required
                                                Please use MM/DD/YYYY format
 

  Question:
 

 

  The date of the charge I am disputing is:
 
  The charge I am disputing is for:
 
 
  I should not have to pay this charge because: