 The
Services We Provide and How It Affects Your Bill
Shasta Orthopaedics & Sports Medicine physicians, physician assistants
and technical staff provide professional medical and radiology services
as well as some of the supplies required by your orthopaedic medical
need.
The bill from Shasta Orthopaedics & Sports Medicine 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 & Sports Medicine and to receive payment for our services.
We will also need to take copies of your insurance card(s). Please, notify
us immediately should any of this information you have provided changes.
We will also need to take copies of your insurance card[s], so 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 & Sports Medicine 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 & Sports Medicine 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 & Sports Medicine 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 & Sports Medicine 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 & Sports Medicine’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 & Sports Medicine 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 & Sports
Medicine will discount its fees 10%. Any payment arrangement must be approved
by our Business Office prior to the day of your service.
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