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Insurance Plans/Financial Information |
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YOUR INSURANCE
COMPANY
AND OUR OFFICE
WHAT YOU NEED TO KNOW ABOUT
GETTING YOUR HEALTHCARE SERVICES PAID |
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YOUR FINANCIAL RESPONSIBILITY
We will file your insurance claim, but
you are ultimately responsible for paying for services received in this
office. Many of the services provided in this office are covered and
paid by your insurance company. We gladly file the claims for you so
that you do not have the additional worry and effort of dealing with
this during a time of illness.
Unfortunately, insurance companies
do not pay for all services.
In cases where the service has
not been paid, you will be personally responsible for the bill. Before
we bill you, we will use our best efforts to verify that all of the
information sent to the insurance company is accurate and clearly
describes the services you received
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FRACTURE CARE
Some insurance companies require that
fracture care billing be done on a “global” basis. This means that for a
predetermined amount of time, all professional services related to the
“surgery” or fracture care are included within the initial fee. X-rays
and casting/splinting, along with related supplies, are not included
within the global fee and are billed separately. Please note, that there
are other insurance companies that require each visit to be billed
separately.
Injections, joint aspirations and fracture care are all procedures
listed as “surgical” for billing purposes by insurance companies. Though
these services may be provided in the office or emergency room, they are
generally listed on your explanation of benefits or bill as “surgical”.
NON-EMERGENCY SURGERY
Please be aware that non-emergency
surgical procedures may require a deposit prior to the scheduling of
surgery based on your individual insurance policy. Please speak with our
billing representative regarding this policy.
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INSURANCE FILING AND THE LAW
Federal Laws addressing all insurance companies require
that we submit every claim to an insurance company accurately, reporting
the exact services performed and the exact reason for performing them.
We are not allowed to change billing information simply to get paid for
services. This is considered fraudulent behavior. Our practice is
committed to these laws, and will submit all claims to all payors in
this manner.
COPAYS
Due to insurance regulations, we are required to
collect copays at the time of service.
Falmouth Orthopaedic Center accepts Cash, Personal Checks, MasterCard,
Discover and Visa.
CONTACT INFORMATION
If you have any questions, please contact our billing
department at
(207) 781-4446.
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NON-COVERED SERVICES ARE YOUR
RESPONSIBILITY
Insurance companies do not pay for all medical services,
even some that may be beneficial to the patient.
When a service is not covered by your insurance policy, you will be
responsible for paying the bill.
We cannot change information on an insurance claim simply to get the
claim paid.
If you are not sure if a service is covered by your plan, please contact
your insurance company representative. They will be happy to assist you
in understanding your health plan.
It is your responsibility to be certain that a referral has been
generated for any visit to a specialist.
We will be glad to work with you on payment plans for non-covered
services, but these arrangements must be made in advance.
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FALMOUTH ORTHOPAEDIC CENTER
PARTICIPATES WITH THE FOLLOWING INSURANCE COMPANIES:
Medicare
MaineCare / Primecare
Anthem Blue Cross & Blue Shield
Tri-Care
Aetna
Tri-care
Cigna
Harvard Pilgrim
Mednet
This is not an all-inclusive list. Please call the office
if you have questions regarding participation.
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