A reality of today’s health insurance system is that most insurance companies do not cover 100% of medical charges. Most patients are responsible for a co-payment or deductible, which is generally billed once we receive your Explanation of Benefits (EOB). You will be asked for your co-pay when you arrive. Please be prepared or we may need to re-schedule. Additional fees may apply if not paid at the time of visit. If your insurance carrier is one with whom we do not participate, you will be asked for payment in full at the time of your visit.

Patients are required to present their insurance card for verification at each appointment. The fees billed to your insurance carrier are based on usual and customary rates, which are competitive with physicians of the same specialty in our area. Insurance carriers, however, have their own methods of determining standard “allowable” charges, which at times are lower. Patients should check to see if their policy requires a referral before scheduling an appointment. If you do not have a referral or pre-certification in place upon arrival, you may be held responsible for payment or your appointment may need to be rescheduled. Our Physical Therapy department is compliant with Medicaid for patients 18 or younger.

Workers Compensation

Patients are responsible for providing all employment and insurance information when scheduling an appointment. It is required to have authorization from your carrier or employer prior to your visit. If you do not have authorization, we will be more than willing to treat you. However, Comprehensive Orthopaedics will bill your primary health insurance in cases where worker’s compensation denies the claim for any reason. Any balance not paid by the worker’s compensation carrier or primary health plan will be the patient’s responsibility. If you have any questions please call our billing office 203.265.3280×2003.