Insurance Information

hands signing papers

Insurance Card

Please have this with you so we can copy all of the necessary information. This will make the billing process easier for all of us. If your insurance should change, please inform the office at the time of your next visit.

Co-Pays

Have your payment ready when checking in at the front desk. This is a contractual obligation with your insurance company for which you are responsible and it is mandatory that we collect it from you.

Referrals

As a member of an HMO, You have become a partner with your Primary Care Physician (PCP) and it is mandatory that you get a referral from your PCP to see a specialist and have x-rays. THE INSURANCE COMPANY WILL NOT PAY FOR THE VISIT WITHOUT A REFERRAL. Please call your PCP in advance to ask for a referral. If possible, ask to get multiple visits so you do not have to repeat the process every time you come to the office. If a referral has not been obtained and the claim is denied, you will be responsible for payment in full.

Insurance Benefits

There are many insurance companies and many plans within insurance companies therefore it is in your best interest to verify benefits. Know your deductible amounts and confirm that the doctor is a member of your plan.

If Surgery Is Necessary

Please check with your insurance company to understand what costs you may encounter. Take into consideration that there will be hospital costs as well. We will be happy to direct you to the appropriate person in charge at the hospital or surgery center. We will obtain an authorization number for your surgery if required but this does not guarantee payment.

Workers Compensation

In order to schedule an appointment, we need to have your date of injury, address information, claim number, adjuster's name and telephone number. If you make an appointment using your private health insurance and inform us at any time that it should be a workers' comp claim, we reserve the right to cancel your appointment if the claim cannot be verified or other payment arrangements are not made. If claim is over 3 months old, we request that you have back-up insurance.

Motor Vehicle Accidents

Capital Orthopaedic Specialists bills MVA insurance carriers or attorneys for services rendered. All visits are to be paid in full at the time of the visit. We will provide you with any documentation in order for you to get reimbursement from your insurance company. If claim is over 3 months old, we request that you have back-up insurance. We do not accept Letter of Protection (LOP).

Self-Pay

Payment is to be made at the time of all visits.

Soft/Rigid Orthotics

Your Physician may recommend that you get Soft/Rigid Orthotics. Please know your insurance coverage for these items. Most time there is a patient portion to be paid.

Our staff will be happy to assist you through any process listed above. We understand insurance policies and programs can be quite confusing. Your patience and understanding will be greatly appreciated in helping resolve any problems.