Welcome to the orthopaedic practice of Drs. Beck, Griffith, Cirillo, Patel, and Taliaferro. If this is your first visit for specialty care as a private-pay patient, as a referral from a primary care physician, as a result of an auto/motorcycle accident or work-related injury, this letter will briefly review our billing procedures with you.
1. All patients are responsible to make sure their bills are paid in a timely fashion. For your convenience we accept VISA, MasterCard, cash and checks. Please be aware there is a $37 fee for returned checks.
2. As a courtesy to you, we will bill your insurance provided the correct information is given at the time of your first visit. We require a $200 deposit if the correct information is not provided prior to being seen by the physician.
3. We will allow 30 days for your insurance company to make payment. If your insurance company requires additional information from you before they process your claim, please respond promptly to their request. *You will be expected to pay your account balance if your insurance has not paid after 30 days. (*does not apply to patients using HMO benefits or workers’ compensation).
4. HMO/PPO patients should review their particular guidelines. Coverage varies widely among individual groups and we may not be aware of specific rules unique to your group. We make every effort to provide the care you need within your plan rules, please do not ask to be treated outside of their requirements. Without the proper referral you will NOT be seen. All patients are required to pay their co-payment at the time of service.
5. X-rays are part of your permanent medical record; however, you may obtain copies on a disk with prior notice. The fee for this service is currently $7.00 per disk and must be paid prior to receiving your disk.
6. Copies of medical records may be obtained with advance notice. We have retained a professional service to handle the duplication and transfer of medical records. The company performing these services is Record Reproduction Services (RRS) which can be contacted at (410) 919-9253. If you are asking for records to be delivered directly to you, for a non referred treatment or second opinion there is a $20 charge for reproduction and delivery. Referred second opinions, continuance of care, and records sent directly to your PCP will be processed at no charge. All payments for medical records should be made to RRS.
7. You may have special forms that need to be completed by your physician for disability benefits and other types of coverage. Please allow 7-10 working days for completion; if the treating physician is not available, this may take longer. The form fee is $27.00 per form.
8. Braces and splints are stocked in our office for your convenience, and we will bill your insurance company directly for items dispensed to you. If you are a self pay patient, payment is due at time of service. You may choose to have a prescription written for the item if you prefer to obtain the item elsewhere.
9. If you were injured in an automobile/motorcycle accident, we will provide service on a cash basis until the day we receive the PIP (Personal Injury Protection Insurance) “exhaust letter” from the insurance company who covered the vehicle at the time of the accident. On the date you present the PIP Exhaust letter, our office will start filing claims to your health insurance carrier from that date forward. Prior Claims will remain the patient’s responsibility. Our office will not bill automobile/motorcycle insurance nor will we wait for settlement in automobile/motorcycle related cases. If you wish to be treated for your auto/motorcycle injury, a $200.00 deposit must be made before services are rendered. Any additional balance must be paid at check-out.
10. We will bill your employer’s workers’ compensation carrier for work-related injuries; please provide all necessary information, such as name and address of the insurance carrier (your employer is required by law to post this information in a conspicuous place) and evidence that a claim was filed. We will keep your health insurance information on file in the event you require emergency care or your claim is denied. Patients are responsible for payment of all denied claims. HMO patients are required to bring referrals for all visits, no exceptions. If your injuries were a result of any other type of liability then those mentioned in this form, we will bill your health insurance or you may elect to be seen on a cash basis. We do not bill third party carriers.
10. If you need to cancel your appointment for any reason, please allow 48 hours notice.
11. Please be aware that we will make every effort to collect your account “in house.” If your account is referred to an outside agency for collections, please note that it will be reported to the Credit Bureau. Every effort will be made to avoid this.