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Billing/Financial Policies

Orthopaedic Specialty Group participates in many insurance plans (please click here to see our Accepted Insurance Listing). We follow your insurance policy guidelines, collecting applicable copays, deductibles and co-insurance at the time of the visit. For particulars about your plan, please refer to your insurance carrier.

Self- Pay – For those patients without insurance benefits, we do expect payment at time of the visit.

Referral – If you have an insurance plan that requires a referral, it is the patient’s responsibility to obtain this pre-approval from your primary care physician or the referring doctor prior to your visit with the OSG specialist. Your insurance policy is stating it requires notification deeming it necessary for you to see a specialist for your issue. Without a referral in place, you run the risk for being responsible for 100% of the office visit.

Personal Injury – Orthopaedic Specialty Group does not accept Letters of Protection. Payment is expected at the time of the visit unless other arrangements have been made however, we will not be a party to any litigation suits that are being filed.

Motor Vehicle Accident – Orthopaedic Specialty Group treats patients with injuries sustained in motor vehicle accidents. Our policy requires the patient obtain the auto insurance carrier information and the claim number to be given at the time of scheduling. This will allow our billing department to verify benefits before you come in. At the time of the visit, we will also require the patient’s health insurance information in the event the auto insurance benefits are limited or have been exhausted.

Workers Compensation – For work related injuries patients must report the injury to their employer, who will in turn contact their worker’s compensation carrier to file a claim. Once claim information is available, the patient is responsible for providing the claim information to our office, so that we can obtain authorization for treatment. Our policy requires that the patient’s health insurance information be obtained as back up in the event that the claim is not approved. If a patient refuses to provide health insurance information and we have not yet received approval from the workers’ compensation carrier, an appointment cannot be scheduled unless the employer agrees to pay for the visit and provides an acceptable method of payment in advance. If the patient does not have health insurance and approval has not yet been received by the workers’ compensation carrier, an appointment can only be scheduled if either the patient or employer agree to pay at the time of the visit and an acceptable method of payment is provided to our office in advance.

Below are some definitions that will help define our financial policy.

Copayment – A fixed amount determined by your insurance carrier to be paid at the time services are rendered. (Amounts may vary depending on the type of service.)

Deductible – The amount you pay for healthcare services before your health insurance begins to pay.

Coinsurance – Your share of the cost of a healthcare service. It is usually a percentage of the total charge for the service and begins after you have paid your plans’ deductible.