Billing Information

All charges will be submitted to your insurance company. Co-payments must be paid at the time of service.

All accounts are considered past due after 60 days, even if insurance has been filed. Therefore, it is very important to give your insurance information to us as soon as possible. If you have an unpaid balance after payment of benefits from your insurance company, this is due and payable when you receive your statement.

There is a $10 fee for all co-pays not collected at the time of service
(effective May 1, 2007).

Fracture Billing
Insurance
Payment Arrangements
Referrals
Workers’ Compensation
X-Ray Billing

Accepted Methods of Payment:
Cash, Check, Debit card, Visa, Mastercard, Discover, American Express

Explanation of Fracture Billing
Your insurance company requires that we bill our services using a coding system known as CPT (Current Procedural Terminology). The codes used to describe the services we did for you are found in the "surgery” section of the CPT code book. This does not mean we are implying that you had an operation. This is merely the way the CPT book is organized for ease of use by both your insurance company and physicians.

According to CPT guidelines, fracture care is billed as a “packaged or global” service. This means that at the time of initial care, a bill is generated that includes:

1. Physician evaluation of the fracture
2. The first cast or splint application
3. Usually 90 days of normal, uncomplicated follow-up care.

What is not included in the package. (There will be a separate charge.)

1. X-rays
2. All casting supplies (fiberglass, Gortex, ace wraps, slings, cast shoes, etc.)
3. Any replacement cast application
4. The evaluation and management of any additional problems or injuries.
5. The treatment of complications.

If you have any questions about fracture billing, please contact our billing department.

Insurance
If you have insurance coverage, it is your responsibility to provide all information to us. Unless your bill has been paid in full, we require that you assign insurance benefits to the Orthopaedic Center for Spinal and Pediatric Care.

Payment Arrangements
If there is an unusual financial situation in your family that causes medical expenses to be a difficulty, please discuss this with the billing office.

Please feel free to talk to our medical office specialists about fees for services provided. Check your statement carefully when you receive it. The sooner you let us know of a mistake on your account or a question you might have, the more promptly we can correct it.

Referrals
Your insurance plan may require that you have a referral by your primary care doctor for a visit to an orthopeadic specialist. If so, please tell that office to mail or fax the referral to our office at The Children’s Medical Center (937 641-5003) or our South Point office (937 208-6974) before your appointment. Many insurance plans state that you are responsible for the fee charged if this referral is not made before the appointment with the orthopaedic specialist.

Workers’ Compensation
You should receive a claim number within 45 days after filing your claim. You must provide us with this claim number so we can promptly take care of the paperwork. If you don’t get a number in 45 days, we will look to you for payment of the account in full. Please provide us with the name, address and phone number of the managed care organization (MCO) processing your claim.