Insurance

Insurance Verification

You will be required to provide our office with your insurance identification card. If your insurance changes during your treatment with us, we ask that you provide us with the updated insurance information. We  suggest that you contact your insurance company prior to surgery to determine your benefits and to ascertain if your insurance company requires a second surgical opinion. When you contact your insurance company, you should verify the extent of coverage for surgeon fees, hospitalization, surgery, recovery center, anesthesiologist fees, diagnostic testing, rehabilitation equipment and physical therapy.

Please remember that verification and/or pre-certification is not a promise of payment from your insurance company.

 

Financial Policy

Orthopaedic Associates of Reading participates with many insurance plans. As a participating provider we will accept the carrier’s allowable amount. Patients are responsible for co-payments, co-insurance amounts and/or deductibles and payment for services not normally covered by the carrier. Co-pays will be collected at each visit. If co-pays and past due balances are not paid, your appointment may be rescheduled and payment must be made prior to the next scheduled visit.

If you are insured under a plan that we do not participate with and you choose to receive your care with us, we can make arrangements to courtesy bill the carrier, however, the patient is responsible for the bill in its entirety.

Please remember that your insurance plan is a contract between you and your insurance carrier. This contract usually requires a shared responsibility between the insurer and the patient in payment for services. While we will act on your behalf to obtain payment for our services, once we have exhausted all efforts, the patient is responsible for the balance due. Our Billing Department at Orthopaedic Associates of Reading can develop a payment plan to suit your needs to ensure that your account remains in good standing, should this become necessary. Our office also accepts Visa, MasterCard and Discover in addition to cash and personal checks as methods of payment.

 

Referrals

If your insurance requires a referral form from your primary care physician for your visit with our practice, the referral must be obtained by the patient and presented to us at the time of the visit. If a referral from your primary care physician is not present at the time of the visit, the visit will be rescheduled to allow time to contact your primary care physician and arrange for a referral.

 

Secondary Insurances

We strive to provide complete billing service to our patients. We will submit your secondary insurance claim a maximum of two times. After two submissions, the balance will be billed to the patient.

 

Collection Accounts

Our office will make every effort to communicate with you about your account and will present reasonable options for payment. In the event that we involve a third party for collection of an account, we will add an additional fee to your account for administrative costs involved. This additional fee will be 25% of the balance at the time we turn the account over for collections.

 

Checks Returned for Insufficient Funds

If we receive a returned check for insufficient funds, we will immediately reverse the payment on your account, thereby adding the amount back onto your account and we will also charge a $30.00 returned check fee to your account.

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