Carolina Ortho Prosthetics |
2500 W. 5th Street Greenville, NC 27834 |
Phone: (252) 752-1253 Fax: (252) 757-3058 |
Last Revision: 10/16/2007 |
Fees Fees are based upon our professional skill, the time and complexity of procedures involved and the amount of follow-up care required. More than one visit may be necessary in providing your care, and we ask that you be prepared to leave a deposit for services upon completion of a thorough evaluation. When the type of service has been decided, appointments will be set up, an estimated fee will be established and financial arrangements can be discussed with the secretary. It is preferred that patients pay the office for the services rendered and let their insurance companies reimburse them. When this is not possible, please make prior arrangements with the insurance clerk. Payment in full is requested at the delivery, unless other financial arrangements are made. If credit is extended you will receive a statement at the end of each month, and prompt payment is appreciated. If care is prescribed by your physician and authorized by your employer for a work related injury, bills will be sent directly to your employer or the appropriate insurance carrier. |
Insurance Your insurance policy is a contract between you and your insurance company. We urge you to be fully aware of the provisions of your policy prior to your appointment, and understand that not all types of insurance are accepted. There is no charge for completion of insurance forms, but final responsibility for payment remains with you. We recognize that some patients are unable to pay for services without insurance assistance; it is your responsibility to make this known at the initial visit. Before services are rendered we require 1) a complete and signed current insurance card, 2) your prescription, 3) the name and telephone number of the insurance carrier and 4) the name and telephone number of the representative for us to contact who is familiar with your case. Upon authorization, we will submit the claim directly to your insuror. You will then complete an assignment of benefits form. This permits payment directly to us from the insurance company, after which you will be reimbursed for any overpayment. In order to control administrative costs, we reserve the right to refuse direct insurance billing for repairs, modifications and some services. |
Medicare It is your responsibility to provide us with the prescription needed to process your claim. We will provide the forms, complete the information and submit the claim for you, and for established office patients requiring only minimal care. However, Medicare assignments are not routinely accepted and must be arranged at the initial visit. If accepted, a deposit will still be required before services are completed. |
