Insurance / Billing

General Payment Information

All charges for office services are due and payable on the day of service unless other arrangements are made in advance. All charges for hospital services are due and payable 30 days from the date of service.

Reasonable, Customary Fees

We believe the fees for our services are fair and reasonable. They are based upon national and local studies of fees for similar services and are updated annually.  Some insurance companies have adopted a fee schedule they call "Reasonable & Customary."

Unfortunately, each insurance company has a different schedule. If an insurance company adopts an unusually low "Reasonable & Customary" schedule, they may pay less than you expect.  If you are concerned that your insurance carrier may not pay your entire bill, please contact our office, and we will be happy to provide you with the procedure code and our charges.  You can then contact your insurance carrier to determine any potential problems prior to your orthopaedic treatment or surgery.

Insurance

Midwest Orthopaedic Center will file claims with up to two insurance companies for our patients. If claim forms are necessary, you must complete your portion of the forms and bring or mail them to our office promptly.

HMOs, PPOs & Networks

If your insurance is provided by a PPO, HMO, Network or any other form of managed care, you must let us know about any restrictions regarding payment for services. We at Midwest Orthopaedic Center try to stay informed about the ever-changing plans that are currently available, but it is impossible to remain current on all of them. Ultimately, it is your responsibility to keep informed of your own insurance coverage and any restrictions that may apply.

Medicare

Midwest Orthopaedic Center is a participating provider for Medicare patients.

Office Visits - We bill Medicare directly for office visits. The co-payment (percentage of the bill that Medicare law requires you pay) is due at the time of your office visit. If you have secondary insurance for the co-payment, we will bill the insurance company for you. However, you are still responsible for any amounts not paid due to deductibles or eligibility problems.

Surgery - We bill Medicare directly for surgery. The co-payment for surgery is due and payable 30 days from the date of service. If you have secondary insurance, we will bill the insurance company for you. However, Medicare patients still are responsible for any unpaid amounts due to deductibles or eligibility problems.

Illinois Department of Public Aid

All Public Aid patients need to provide a current Public Aid card for every scheduled appointment in order to receive services.

Accident Case Liability

This office does not file claims for accident or liability cases. You are personally responsible for any charges for our services. We do not accept "Letters of Protection" from your attorney for our charges.