Dear Valued Patient:

Thank you for choosing Plano Orthopedic.

Before scheduling an appointment with our physicians, we ask that you contact your insurance company to verify our participation with your plan and review your benefits and eligibility.   

Please be advised that deductibles, co-payments, co-insurance, items and/or services not covered by your insurance and any prior balances are your responsibility and are due at the time the services are rendered.

Keep in mind that your insurance policy is a contract between you and your insurance company. If you did not follow your insurance plan’s terms, they may not pay for all or part of your care, and you may not qualify for any managed care discounts.

We ask that you present your insurance card at each appointment along with identification.

This is how the insurance billing process works:

• A claim will be sent to your insurance company.  (We do not file on secondary insurance).
• After your insurance company receives the claim, the insurance company may contact you for additional information such as an accident report or to coordinate your benefits. Please respond to your insurance company’s questions as quickly as possible so that payment is not delayed.
• It usually takes 30-45 days for your insurance company to pay your claim. After your insurance company has paid their portion, any remaining balance will be your responsibility.
• You will receive an explanation of benefits (EOB) from your insurance carrier that advises you of any amount you may owe.  The EOB should match your physician’s statement. 
• You will receive one statement for any balances remaining.  Please pay promptly to avoid jeopardizing your credit standing and avoid forfeiting your managed care discounts.  

If you do not have insurance or we do not currently contract with your insurance company, payment is expected at the time of service. An administrative discount will be applied for all medical care paid in full at the time of service.

If you have a Health Savings Account (HSA) or a high deductible consumer driven healthcare plan, we require payment at the time of service and we are able to calculate your managed care rate for any services rendered.

We do not bill Auto or Liability Insurance; therefore, payment is expected in full at the time of service. However, we will provide you with the necessary paperwork and forms to help you submit your claim to the appropriate insurance carrier.

We do require that payment of deductible and co-insurance be paid in advance of any surgery or procedure.  We are able to calculate your managed care contracted portion due prior to the surgery.

You will likely receive separate bills from other physicians for services or tests that they provided while you were in the hospital. Those bills are separate and apart from our physicians’ bills. If you have questions about those bills, please call the telephone number printed on their statements.
 
Our patient account representatives are available to help you with your billing questions or to provide more information. When calling, please have the patient’s account number and date of birth available.

We accept the following forms of payment: cash, check, Visa, MasterCard, American Express, and Discover Card. You may also pay your bill on line at www.paythisbill.net (you will need the user name and pass code that is printed on your statement.)

We understand that the financial issues related to healthcare can be confusing and difficult to understand and hope that this information helps explain some of the issues.

Thank you again for choosing Plano Orthopedic Sports Medicine and Spine Center, P.A., for your orthopedic needs.