Thank you for choosing Hinsdale Orthopaedics as your health care provider. We are committed to building a successful physician-patient relationship with you and your family. Your clear understanding of our Patient Financial Policy is important to our professional relationship. Please understand that payment for services is a part of that relationship. Please ask if you have any questions about our fees, our policies, or your responsibilities. It is your responsibility to notify our office of any patient information changes (i.e. address, name, insurance information, etc.)
Methods of Payment
We accept the following methods of payment:
Credit Cards (American Express, Discover, Mastercard, Visa)
The patient is expected to present an insurance card at each visit. All co-payments and past due balances are due at the time of check-in unless previous arrangements have been made with a financial counselor. We accept cash, check or credit cards. Absolutely no-post dated checks will be accepted.
Insurance is a contract between you and your insurance company. In most cases, we are NOT a party of this contract. We will bill your primary insurance company and any secondary insurance as a courtesy to you. In order to properly bill your insurance company, we require that you disclose all insurance information, including primary and secondary insurance plans, as well as any change of insurance information. Failure to provide complete insurance information may result in patient responsibility for the entire bill. Although we may estimate what your insurance company may pay, it is the insurance company that makes the final determination of your eligibility and benefits. If your insurance company is not contracted with us, you agree to pay any portion of the charges not covered by insurance, including but not limited to those charges above the usual and customary allowances. If we are out of network for your insurance company and your insurance pays you directly, you are responsible for payment and agree to forward the payment to us immediately.
This listing reflects our current insurance contracts. However, individual physician's network participation may vary. Please check with your health plan to verify physician participation.
Blue Cross/Blue Shield
Coventry/First Health/Personal Care
If your insurance company requires a referral, you are responsible for obtaining this document. Failure to obtain the referral may result in a lower or no payment from the insurance company, and the balance will be your responsibility.
All self-pay accounts will require a $250 deposit. Self-pay accounts are patients without insurance coverage, patients covered by insurance plans in which the office does not participate, or patients without an insurance card on file with us. Liability cases will also be considered self-pay accounts. We do not accept attorney letters or contingency payments. It is always the patient's responsibility to know if our office is participating with their plan. If there is a discrepancy with our information, the patient will be considered self-pay unless otherwise proven. Extended payment arrangements are available if needed. Please ask to speak with a financial counselor to discuss a mutually agreeable payment plan. It is never our intention to cause hardship to our patients, only to provide them with the best care possible and the least amount of stress.
The DME (Durable Medical Equipment) department at Hinsdale Orthopaedics is committed to providing the highest quality products and services available to our patients. We supply several orthopaedic devices and products from crutches, canes and walkers to custom knee bracing, post-operative bracing, and cold therapy right in the office so that we may provide the most convenient and efficient service to our patients.
Our DME staff will take you through the entire process, explaining everything from application and maintenance to cost and insurance coverage. We strive daily to present you with quality products at competitive pricing while working directly with your insurance company for payment to keep your out-of-pocket expenses as low as possible. Please note that each patient’s insurance provider determines the allowable fees for each item; therefore, any remaining balance will be the patient’s responsibility.
Any insurance deductibles unmet at the time a surgery is scheduled will be required to be paid prior to surgery. Arrangements can be made with a Financial Counselor to set-up payment(s) of your deductible.
Workers Compensation and Automobile Accidents
In the case of a worker's compensation injury or automobile accident, you must obtain the claim number, phone number, contact person, and name and address of the insurance carrier prior to your visit. If you have elected to opt out of your Employers Preferred Provider Program for a work-related injury, please bring your signed opt out letter with you at the time of your first visit. If this information is not provided, you will be asked to either reschedule your appointment or pay for your visit at the time of service.
All Hinsdale Orthopaedic offices require a 24-hour notice of appointment cancellation. Office visit appointments missed that are not previously cancelled will be charged a fee of $50.00. All missed MRI appointments will be charged a fee of $200. This fee will be billed as patient responsibility and is not reimbursable through insurance.
The charge for a returned check is $25 payable by cash or money order. This will be applied to your account in addition to the insufficient funds amount. You may be placed on a cash only basis following any returned check.
In the event that an overpayment is identified that has resulted in a credit due to patient or insurance, a refund will be processed and sent to original payer. All refunds are issued in a CHECK format.
Medical Record Copies
Patients requesting copies of medical records will be charged:
$10 - Under 20 pages
$15 - 21 - 49 pages
$20 - Over 50 pages
Attorneys will be charged a $25 fee plus postage
An additional handling fee of $10 will be charged if records must be delivered within 48 hours of request.
The parent(s) or guardian(s) is responsible for full payment and will receive the billing statements. A signed release to treat may be required for unaccompanied minors. If you are participating in our online MyChart Patient Portal system, you will be asked to complete additional paperwork to access this information on behalf of a minor.
Outstanding Balance Policy
It is our policy that all past due accounts be sent two statements and a letter. If payment is not made on this account, a single phone call will be made to try to make payment arrangements. If no resolution can be made, the account will be sent to the collection agency, or attorney, and possible discharge from the practice.
In the event an account is turned over for collections, the person financially responsible for the account will be responsible for all collections costs, including attorney fees and court costs. All collection agency balances will be expected to be paid prior to new appointments being scheduled.
Regardless of any personal arrangements that a patient might have outside of our office, if you are over 18 years of age and receiving treatment, you are ultimately responsible for payment of the service. Our office will not bill any other personal party.
This financial policy helps the office provide quality care to our valued patients. If you have any questions or need clarification of any of the above policies, please feel free to contact us.
If you have any questions or need clarification on any of the above policies, please contact our billing office at 866-619-8236