ShastaOrtho

The Services We Provide and How It Affects Your Bill

Shasta Orthopaedics physicians, physician assistants and technical staff provide professional medical and radiological services as well as some of the supplies required by your orthopaedic medical need.

The bill from Shasta Orthopaedics is for these services only. As a courtesy we will bill your insurance company for you. Any services provided by the laboratory, pathologist, anesthesiologist, assistant surgeon, medical equipment supplier, etc. will be billed separately from our services.

With your consent we will give your billing information to these providers. Please, direct any questions that you have about these services to the appropriate provider's office. Our staff can assist you if you need to contact these providers.

To provide excellent service it is necessary that we have accurate information about you, your employer and your insurance. We will ask you to complete a registration form, health questionnaire and consent for use and disclosure of information.

These items will be necessary for your treatment, the operations of Shasta Orthopaedics and to receive payment for our services. We will also need to take copies of your insurance card(s). Please remember to bring them to your appointment. We also ask that you notify us immediately should any of the information you have provided us change.

Based on your insurance policy, you may be required to pay a co-payment. Insurance companies mandate that we strictly collect co-payments prior to your visit.

Insurance Plan Policies

Below is a list of various insurance and payment plans with descriptions of our related policies

Medicare

Shasta Orthopaedics is a Medicare Participating Provider. As a Participating Provider we will bill Medicare directly for you and will honor Medicare’s “allowance”.

If you have provided us with the information, we will also bill your secondary insurance. We will send you a statement that will detail all charge and payment activity. You will be required to pay only the amount Medicare determines to be your responsibility that is not paid by your secondary insurance.

Medi-Cal

Shasta Orthopaedics participates in the Medi-Cal Program. As a Medi-Cal Provider we will bill Medi-Cal directly and accept Medi-Cal’s “allowance”.

You will be responsible to pay only the amount determined by Medi-Cal to be your “Share Of Cost”. To comply with the Medi-Cal Program requirements it is necessary that your share of cost be paid at the time the service is rendered.

PPO, Indemnity Insurance, and HMO Plan

Shasta Orthopaedics is a participating provider of many insurance plans. To ensure that your insurance benefits are maximized, we will verify eligibility and estimate benefits of your insurance from the information you provide us. Prior to your surgery we will notify you of the eligibility and benefit results. Any deductible, co-payment and co-insurance amounts are to be paid prior to your surgery. These amounts are estimated during eligibility and benefit verification process.

Worker's Compensation Insurance

Shasta Orthopaedics accepts Worker’s Compensation. It is necessary that you provide us accurate information about yourself, your injury, your employer and your Workers Compensation Carrier. Prior to your service we will obtain your claim number and pre-authorization from your Workers Compensation Carrier.

You will not receive a bill for these services unless your claim is denied as “not work related”. In these instances your private insurance company should pay for Shasta Orthopaedics’s services.

Actual benefits can only be determined when your insurance company processes your bill. You will be promptly refunded in the event you have over paid; conversely you are obligated to pay any balance. We will send you a statement that details all charge and payment activity. Should your insurance company not pay within sixty days of your surgery, we will seek payment from you. Please assist us by communicating with your insurance company to ensure that their financial obligation is met.

Third Party & Liens

Shasta Orthopaedics does not accept Third Party or Lien Claims. As a courtesy we will submit a claim to a Third Party you designate, however, full payment is required prior to your service.

If you do not have health insurance

If you do not have insurance, full payment is required prior to your service. When full payment is received prior to your service, Shasta Orthopaedics will discount its fees 20%. Any payment arrangement must be approved by our Business Office prior to the day of your service.