Insurance & Billing

 

Payment Policies

Fees and Payments

Our fees are based upon the reasonable and customary charges prevailing in this area, and take into account the complexity of a particular problem. Fees for a visit or new problem are higher than for a routine follow-up because more time and resources are required to diagnose and treat a new problem than to follow an existing one. If you have questions regarding the fee for a particular problem, please feel free to ask our staff for clarification.

Payment for office visits and services such as x-rays, injections, casts, braces and splints are expected at the time of your appointment. Many insurance plans require co-payments and/or deductibles. You may pay with cash, check, VISA or MasterCard. We will collect these at the time of registration, prior to seeing the physician.

For planned surgery, we will contact your insurance company to verify your benefits and any co-insurance amounts you will owe. A pre-surgical deposit may be required based upon these verified benefits. For major expenses such as emergency surgery, fracture care or elective surgery, we will work with you to ensure that you are able to obtain all benefits that are due you from your insurance company, and that you are able to satisfy your payment obligation to us.

The Insurance Company and You

Frequently health insurance companies may pay only part of the physician's fee and services. Certain insurance companies will not reimburse you for soft goods or durable medical equipment (DME) items such as braces or splints. The extent of your benefits is determined by your individual policy. Please keep in mind that services have been rendered to you, the patient, not the insurance company, and you are ultimately responsible for any outstanding balance on your account. We allow thirty (30) days for submission and processing of insurance claims.

We will be glad to assist you with questions regarding claims with your insurance company.

If multiple attempts to collect payment from you are unsuccessful, we reserve the right to turn the outstanding balance due to a collection agency. In addition to the principal balance due, you will also be responsible for any interest accrued plus any legal or collection agency fees incurred.

We currently accept assignment from Medicare and participate with most preferred provider insurance plans. A list of participating plans is provided above. The patient is responsible for any deductible and co-insurance balance.

Workers' compensation claims must be authorized by your employer. At the time of your appointment, be prepared to provide:

• Workers' compensation claim number
• Date of injury
• Necessary claim forms
• Name, address and telephone number of employer, immediate supervisor, and workers' compensation insurance carrier

If a workers' compensation carrier denies a claim, you will be responsible for charges incurred as a result of the claim. If you have any questions, please speak with our billing office personnel.

Automobile Accidents

If you have been in an auto accident, we do not file to your auto insurance. It is your responsibility to file to your auto insurance. The only exceptions are if you are a pedestrian hit by a car or if you have been in a motorcycle accident and do not have medical coverage through your motorcycle insurance. In these cases, we will file to your medical insurance. If you feel that your medical insurance should be filed for an auto accident, you will need to call your medical insurance for verification and then contact our billing department at 703-383-6469.

Patient Records, Correspondence and Forms Completion

Copies of pertinent medical records are available to the patient or an authorized representative for a nominal fee, after we receive a signed release. Please allow five (5) working days notice. Special documentation requests other than insurance company requirements, such as letters and forms completion, will be honored for a fee. Please speak with our staff for details.

Are you uninsured? Do you have a pre-existing condition?

If your answer is yes to both questions, you may be eligible for the Pre-Existing Condition Insurance Plan - a new federal program for children and adults who have been uninsured for at least 6 months, have a pre-existing condition, and can?t find health insurance.

For more information and how to apply, go to "Find Your State" at www.pcip.gov and click on your state from a map of the United States or select a state from a drop-down menu for information about how to apply. You can also call a toll-free line at: 1-866-717-5826 (TTY 1-866-561-1604). The Call Center is open from 8 AM to 11 PM Eastern Time.

For more information about sources of health coverage that may be available to you, please go to: www.healthcare.gov.