Thank you for choosing Midwest Orthopaedic Center. To continue to provide comprehensive, progressive care in a cost-effective manner, we have developed the following financial policies.
General Billing Information
Our billing office staff will answer any questions you may have regarding your bill. Please call 1-888-816-0288, ext. 1259, Monday – Friday, 8:00 a.m. – 5:00 p.m.
Payments can be made using cash, check, money order, or credit card. We currently accept Visa, Discover and MasterCard. All co-pays, deductibles and co-insurance are due at the time of service. If payment is not made, we reserve the right to reschedule your appointment. Balances are considered past due after 30 days. Please pay your balance promptly or contact our billing staff to make payment arrangements.
An insurance card must be presented at your first visit. You may be asked to present this card for verification purposes at subsequent visits. If you do not have your card and we cannot verify benefits, you may be asked to reschedule your appointment.
Please familiarize yourself with your health insurance policy and know your co-pay, deductible, co-insurance and policy benefits before your appointment. Your insurance is a contract between you and your carrier. We will assist you in receiving appropriate reimbursement from your carrier; however payment is ultimately your responsibility. You will be required to make payment at the time of service depending upon your insurance plan.
While we accept most health insurance plans, we participate as in-network providers with the carriers listed below. It is the patient's responsibility to contact their insurance carrier to verify that Midwest Orthopaedic Center is contracted with them. If a referral is required by your insurance plan, it is your responsibility to contact your primary care physician before your appointment.
We will bill all services to the appropriate primary and secondary insurance carrier. If they fail to respond to our claim, you will receive a statement for charges. Statements are sent monthly and payment is due within 30 days.
Participating Insurance Networks/Plans:
- Blue Cross/ Blue Shield PPO and HMO Plans
- Health Alliance Medical Plans
- Medicaid - Illinois Department of Health and Family Services (Public Aid)
- Methodist First Choice Network
- Mutual Medical Consumer Care Network
- OSF Direct Access Network (DAN)
- United Healthcare
- Workers Compensation (prior authorization required)
Patients with insurance from a non-contracted carrier (out of network) will be responsible for any co-insurance, over usual and customary or unpaid balances. If your insurance company indicates a charge is above usual and customary, please understand that this means it is above their allowable rate. 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. Questions related to usual and customary should be directed to your insurance carrier.
Uninsured Patients (Self Pay)
If you are not covered by a health insurance policy, you will be considered self-pay. This requires that new patients pay a minimum of $250 at their first visit and a minimum of $50 at any subsequent visit. This is a deposit on services rendered and any balance over the deposit will be billed to you. We accept discounted fees from insurance carriers and are wiling to negotiate a discount for those without insurance coverage. Please ask to speak to our patient advocate at registration.
Department of Health and Family Service (Illinois Public Aid, KidCare)
A primary care referral is required for all Public Aid appointments including those treated in a hospital Emergency Department. Public Aid recipients must provide a current Public Aid card for every scheduled appointment in order to receive services. Any co-pay designated by the plan must be paid at the time of service.
Workers' Compensation/Employment Injuries
Treatment under workers’ compensation must be pre-authorized in writing by your employer or workers’ compensation carrier. No appointment will be made if you do not have prior approval, if the claim is disputed or denied, or if you are considering filing a workers' compensation claim. Once authorization or determination by the Illinois Workers’ Compensation Commission has occurred, you are encouraged to contact our office to discuss an appointment.
If a workers’ compensation carrier denies further authorization for patients already under care by Midwest Orthopaedic Center, it is the patient's responsibility to contact their health insurance carrier to receive approval for continued treatment.
Accident Case Liability/Auto Accident Injuries
This office does not routinely file claims for accident or liability cases. If your injury is a result of a liability, you must provide that information at the first visit including any attorney information. We will bill your own personal liability carrier as a courtesy if we can obtain verification of the incident with the carrier. We will not bill a third party liability carrier on your behalf. Once the liability insurance has reached its maximum, the patient's health insurance will be billed. Ultimately, the patient is responsible for the billed services 30 days after initial billing. Please note that litigation is NOT considered a valid reason to withhold payment for services. Collection action will begin after no payment is received.