Orthopedic Institute Billing & Insurance - Key Takeaways
Here’s a breakdown of the crucial facts from the provided text, organized for clarity:
1. Before Yoru Visit – Preparation is Key!
* Insurance Card: REQUIRED at every visit. Orthopedic Institute cannot file claims without it.
* Co-payment: Must be paid before your appointment.Amount is persistent by your insurer.
* Insurance Verification: Contact your insurance provider to:
* Confirm Orthopedic Institute is in-network.
* Understand referral requirements (some plans require a referral from your primary care doctor).
* Understand prior authorization requirements (often needed for injections, imaging, surgery).
* Prior Authorization: Orthopedic Institute will initiate the request, but you are responsible for confirming it’s approved before your procedure.
* Uninsured/Self-Pay: Payment is due at the time of service. Ask about rates, deposits, and payment options before scheduling.
2. During & After Your visit - What to Expect
* Claim Submission: The billing team submits claims to your insurance company after your visit.
* Explanation of Benefits (EOB): Your insurance provider sends this to explain covered services and your patient responsibility.
* Billing Statement: Orthopedic Institute sends a statement (within 30-45 days) if a balance remains after insurance payment.
* Out-of-Pocket Costs: Bills after insurance may include:
* Co-pays
* Deductibles
* Co-insurance
* Non-covered services.These are determined by your insurance, not Orthopedic Institute.
* Medical supplies: Braces, boots, etc., are billed separately and may require approval or have limitations based on your plan.
3.Accepted Insurance Plans (Commonly)
* Avera Health Plans
* Sanford Health Plans
* Aetna
* Blue Cross blue Shield (BCBS)
* Cigna
* UnitedHealthcare
* HealthPartners
* Important: Participation varies. Always verify with your insurer.
4.Medical Records
* Call 605.331.5890 to request.
5. Contact Information
* General Questions/Help: 605.331.5890
In essence: Proactive communication with your insurance provider and bringing your insurance card to every appointment are the most critically important things you can do to ensure a smooth billing experience.
