Orthopaedic Specialties requests that you familiarize yourself with the rules and regulations of your insurance policy. The rules concerning insurance procedures are subject to change, and we remind you of the following:
When your insurance states that you need a referral, it is your responsibility to obtain a referral from your Primary Care Physician PRIOR to your visit with our orthopedic doctor. We must have the referral in our office by the time of your appointment, or we will have to reschedule your appointment for a later date. Insurance contracts do not allow retroactive referrals anymore. Failure to adhere to the above procedure will deem any Specialist appointment you make your own financial responsibility.
You must be certain that our orthopedic doctor, that you are going to see, is listed as a Provider on your insurance plan. It is essential that you complete the following steps for any Specialist that you are going to see:
- Check your insurance directory
- Check with your Primary Care Physician’s Office
- Call your insurance company
Upon seeing one of our orthopedic doctors, you must also contact your insurance company if any of the following are prescribed or ordered by our physicians to determine if prior authorization is required:
- Physical therapy and/or occupational therapy
- Diagnostic testing (MRI, bone scan, CT scan, blood work, etc.)
- Durable medical equipment (braces, etc.)
- Referral to another Specialist for a second opinion and/or treatment
- Pain management, epidural blocks, etc.
Failure to contact your insurance company regarding any of the above may result in your insurance company denying payment for services rendered. It is important that you present your current insurance card when you arrive at our office. Your insurance card contains vital information we must have to properly submit and process your claim. If you have a co-payment, your insurance company requires that you pay at the time of your office visit.
Please call our billing office at (727) 298-0423 if you have any questions. These guidelines are presented in order to help us help you. Thank You!
Participating Insurance Companies at Orthopaedic Specialties
We are a Medicare participating provider and also participates in most HMO and PPO plans. Please call our Billing office at (727) 298-0423 with any questions about specific insurance plans.