Understanding the insurance aspect of orthopedic treatment
At Western Pennsylvania Orthopedic & Sports Medicine, we understand that navigating through the health insurance process can be tricky and often overwhelming. Be assured that our office support team, which has years of experience working with insurance companies and processes, will help you through the insurance aspect of your care experience.
Health insurance Western Pennsylvania Orthopedics accepts
We’re members of most area Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs), and we accept assignment from the following insurance companies:
- HealthAmerica (a subsidiary of Coventry)
- Penn Highlands Health Plan
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Many insurance plans require pre-approval or a referral from your primary care physician to see a specialist. If this applies to your plan, please have your referral from your primary care physician sent to our office before your scheduled appointment.
If your managed care plan requires a pre-certification number, we will assist you in getting the approval for your services.
If you do not see your insurance company listed above, or to determine if WPOSM participates in your plan’s network, please contact your insurance company or plan administrator directly.
Out-of-pocket cost information for patients
We are required by law to bill you for amounts considered to be “Patient Responsibility” by insurance companies, including Medicare.
If you are covered by a managed care (HMO or PPO) plan, your copayment must be collected at the time of service. This is a contractual requirement of insurers. We also accept most major credit cards.
You will receive a monthly statement for all charges considered “Patient Responsibility.” Our policy is for all accounts to be settled in 90 days. You may contact our billing department if you need special arrangements. Again, we accept most major credit cards.