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Home / Patient Resources / Insurance, Billing and Payments

Insurance, Billing & Payments

Insurance

Our physicians participate in most of the health plans in the area. Please check your provider manual if you are unsure about our participation. Insurance is an important part of your healthcare. Verifying coverage allows you to focus on your treatment and a hassle-free recovery. We accept most insurance plans and welcome Medicare, Medicaid and Workers' Compensation claimants. We file insurance claims as a service to our patients.

We will provide you with care that adheres to your insurance guidelines; however, we must have your help. It is impossible to keep track of all individual insurance plan requirements. We depend on you to know your coverage requirements. We will file your claims for you and assist you in obtaining maximum reimbursements, but ultimately, you are responsible for your bill.

For insurance plans that require referrals, you must obtain and bring your referral at the time of visit. Please make sure our office has the referral. The required authorization must be received to avoid rescheduling of the appointment.

You are expected to have your insurance card(s) with you at each visit. You are responsible for notifying us of any change in your coverage at EACH visit. Please advise the receptionist of any change in address or telephone number.

The insurance card must be provided to avoid treating you as a self-pay patient and requiring payment for each visit as they occur.

Co-payments must be paid at time of visit in order to avoid rescheduling your appointment.

Insurance is considered a method of assisting the patient with medical expenses and is not a substitute for payment. We accept cash, check, Visa, MasterCard, American Express, and Discover for the co-payment or any amount not covered by your insurance.

Below is a list of the most common types accepted. Anytime you have questions about charges, call our business office at 910-332-1553 where we'll gladly assist you.

  • Accordia

  • Blue Cross Blue Shield

  • Cigna

  • Corvel

  • KeyRisk

  • Medcost

 
  • Medicaid

  • Medicare

  • TRICARE

  • United Healthcare

  • Worker's Compensation

  • Other Commercial Insurance Carriers

Payment Policies

You are responsible for all co-pays, co-insurance and deductibles at the time of service. You are responsible for charges not processed by your insurance carrier. In the event that you have an unpaid balance from your insurance company, you will receive a statement from our office clearly identifying insurance payments and your balance due. Payment in full is expected when you receive your statement. Please contact our Billing Department at 910-332-1553 if you wish to set up payment arrangements on your unpaid balances. Partial payments must be approved by the Billing Department to keep your account from being transferred to external collections. Should you default on your balance, OrthoWilmington, PA may not accept new diagnoses and you will be responsible for all incurred services prior to re-establishing you as a patient.

No Insurance (Self-Pay)

Payment is required at the time services are rendered unless other arrangements have been made in advance. An initial down payment of $150 is expected and will be required. Please contact our Billing Department at 910-332-1553 if you wish to discuss payment arrangements on your unpaid balances.

Medicare / Medicare Advantage Plans

OrthoWilmington, PA participates with and will file claims for Medicare and Railroad Medicare. Please contact our Appointment line at 910-332-3800 and a representative will help you with accepted insurance plans. We periodically review plans and make changes whereas participation is concerned.

Medicaid

OrthoWilmington, PA accepts North Carolina Medicaid. Medicaid co-pays are due at time of service.

Tricare

OrthoWilmington, PA accepts Tricare. Tricare co-pays are due at time of service.

Workers Compensation

If you have an accident or are injured at work, please contact your employer and notify them of the injury. We must receive authorization from your employer prior to scheduling an appointment. Please have your assigned case worker or employer contact our Workers Compensation Department at 910-332-3800 and ask to speak with the Worker’s Compensation Liaison.

Refunds

OrthoWilmington, PA will refund any credit considered overage and belonging to the patient. The overpayment will be refunded to the patient, or guarantor, no later than 31 calendar days after it is identified. Refunds will be paid by check.

Return check fees

A $25 fee will be added to your account for any returned check.


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