Insurance & Billing

Fees and Payment

Our fees are based upon reasonable and customary charges prevailing in this area, and take into account the complexity of a particular problem. Fees for a new visit or new problem are higher than for a routine follow-up, as more time and resources are required to diagnose and treat a new problem than to follow an existing one. If you have any questions regarding the fee for a particular problem, please feel free to ask our staff for clarification.

The amount you pay will depend on your insurance, the benefits available. All insurance policies are verified at the time of your visit but we are only provided with an estimate from your insurance company; no benefits are guaranteed until the claim is processed. You will be responsible for any co-payment, deductible, or co-insurance percentage, as advised by your insurance company. If you do not have insurance a $250 deposit is required, which will normally cover your first visit and an x-ray. You will be responsible for any additional treatment costs (e.g., injections, casts, splints) at the time treatment is rendered.

For planned surgery, we will contact your insurance company to verify your benefits and any co-insurance amounts you will owe. A pre-surgical deposit may be required, based upon these verified benefits.

The Insurance Company and You

Frequently health insurance companies pay only part of the physician’s fee for services. Certain insurance companies will not reimburse you for items such as braces or splints (Durable Medical Equipment / DME). The extent of your benefits is determined by your individual policy. Please keep in mind that services have been rendered to you, the patient — not the insurance company — and you are ultimately responsible for any outstanding balance on your account. We allow thirty (30) days for submission and processing of insurance claims.

We are happy to assist you with any questions regarding claims with your insurance company. Please contact our billing office at (504) 897-0674.

If multiple attempts to collect payment from you are unsuccessful, we reserve the right to turn the outstanding balance due over to a collection agency. In addition to the principal balance due, you will also be responsible for any interest accrued plus any legal or collection agency fees incurred.

We currently accept Medicare and participate with most insurance plans. Scroll down to see a full list of insurance plans we participate with. The patient is responsible for any co-pay, deductible, or co-insurance balance.

Patient Rights

• To receive services without regard to race, color, age, gender, sexual orientation, religion, marital status, handicap, national origin, or sponsor.
• To be provided reasonable physical access
• To be provided a safe environment
• To be provided with appropriate privacy
• To be treated with respect, consideration, and dignity
• To expect all disclosures, communications and records are treated confidentially, except when required by law, and to be given the opportunity to approve or refuse their release.
• To be provided, to the degree known, complete information concerning your diagnosis, treatment, and prognosis. When it is medically inadvisable to give such information to a patient, the information is provided to a person designated by the patient to be a legally authorized person.
• To be given the opportunity to participate in decisions involving their health care, except when participation is contraindicated for medical reasons.

Insurance & Billing

To meet the needs of our growing patient population, Southern Orthopaedic Specialists strives to participate with most health insurance companies. Healthcare is an ever-changing environment; therefore we suggest that you consult your insurance company to determine if we are providers for your specific plan.