Billing & Insurance
Patients are responsible for all medical bills. The amount your insurance company will pay is determined by the terms of your policy. Each insurance company handles surgery and coverage differently. Some require referrals and pre-certification, some require one but not the other and some require nothing at all. It is important that you obtain a referral before your office visit if you insurance requires one.
Regarding surgery, it is our responsibility to contact your insurance company to precertify your admission. It is your responsibility to check your benefits booklet or call your insurance company regarding deductibles, co-payments, pre-existing clauses and the need for second surgical opinions (rare).
HMO patients may need referrals for your surgery to be covered. If there is any question regarding referrals which have not been answered by our office please call.
If this is a workman’s compensation case or a motor vehicle accident, we require you to give us back up insurance (your regular medical insurance) information on the day of your visit. This is to protect you from unnecessary charges should these insurances deny coverage in the future. This includes obtaining referrals for HMO patients.
Main Line Orthopaedics currently contracts with most major insurance companies. To determine if we participate in your insurance plan, please contact your insurance company.