Payment Policies and Information
• Methods of Payment
• Medicare / Medicaid
• Managed Care - What is it?
• What does HMO, POS and PPO mean?
• Managed Care - Your Responsibility
• Functional Orthotics
Methods of Payment
• Cash
• Check
• VISA
• MasterCard
• American Express
Payment is expected at the time of service unless other arrangements have been made with the office. We accept cash, check, Visa MasterCard, and American Express. Please see our Financial Policy Agreement for further information.
Medicare / Medicaid
The office participates with both Medicare and Medicaid HMO & non-HMO insurance products. Our staff will gladly submit your insurance claim. You are responsible for any deductible or non covered services. Medicare will not routinely pay for cutting nails and callus. This service may be covered if you have advanced vascular disease and or Insulin Dependent Diabetes.
Managed Care - What is it?
In response to the escalating cost of health care, Insurance plans have entered into contractual arrangements with doctors to provide medical services for a discounted rate. The number of doctors who participate with each plan is limited.
What does HMO, POS and PPO mean?
Health Maintenance Organizations. Some plans further limit costs by restricting patient access to specialists. To see a specialist in such a plan the patient must first visit his or her Primary Care Doctor or “Gate Keeper”. If the Primary Care provider deems necessary, a “referral” is made to the specialist physician. This type of Plan is typically called an HMO (Health Maintenance Organization). If you have an HMO plan, you can not be treated in our office without a valid referral and/or referral number, even if you are an established patient.
Point of Service Plans. If your Insurance plan allows you to go to a specialist either with or without a referral, you may have a POS (Point of Service) plan. This plan is a hybrid between an HMO and PPO plan. Technically it has the same restrictions with regard to tests and professional services as an HMO. If you choose to see a participating specialist without a referral you may incur a higher out of pocket expense.
Preferred Provider Organizations. A PPO allows you to see a specialist without a referral. However, the specialist must be selected from a list provided by your insurance company. Such plans allow greater freedom for the patient to choose a doctor and for the specialist to take tests and provide necessary procedures. Usually PPO’s will cover a wider array of medical services, including functional orthotics.
Managed Care - Your Responsibility
Each time you are seen in the office you will be asked to make a small payment or co-pay. The co-pay, usually between 10 and 40 dollars, is part of the discounted reimbursement your doctor receives for his services. Co-payments also help keep the cost of your insurance premium down, by cost shifting some of the financial responsibility to those individuals who utilize professional medical services. Co-payment is expected at time of service unless other arrangement have been made prior to your visit.
Managed Care insurance plans – Office policy
Many recent changes to our healthcare delivery system have made the delivery and payment for care quite confusing to doctors and patients alike. In an effort to minimize confusion and make the process as streamlined as possible we have created the following office policies based on your insurance companies requirements:
- The patient is responsible for obtaining and bringing referrals at the time of service. Your primary care provider’s office is set up to assist you in getting this done. Most doctor offices require several days notice to generate a referral, please be sensitive this requirement.
- Referrals may be for one visit or more. Additional visits beyond the amount indicated will require another referral to be generated.
- Referrals do have an expiration date. Most are good for up to 60 or 90 days from the date of issue.
- A report will be sent to your medical doctor after your initial visit and as necessary for subsequent follow up visits.
Blue Ridge Foot and Ankle Clinic staff is always available to answer any questions regarding your insurance and treatment in our office. We look forward to assisting you in any way possible.
Functional Orthotics Payment Policy
Functional orthotics are custom-made arch supports. Orthotics are produced from a plaster mold of your feet. The foot is held in "neutral position" during the casting process. This position allows the orthotic to control excessive pronation while providing physiologic motion for proper shock absorption by your feet. After casting, the molds are sent to an outside laboratory to be manufactured. This process can take 3 to 4 weeks.
Our fee is $375.00 for one pair of orthotics. The orthotic fee includes casting supplies, outside laboratory fees and one follow up office visit for needed adjustments in the month after dispensing the orthotics.
If your insurance does not cover orthotics, you will be required to make a deposit of half the orthotic fee at the time of casting, with the balance due upon dispensing the device in 1 month.
A discount is available for a second pair of orthotics, should a special type be needed for dress shoes, etc. The second pair must be ordered in the first six months after you receive your orthotics. After six months, the lab may discard your molds and the casting process must begin again.
We can refurbish of your current orthotic devices for component wear, regardless of source of device (Dr’s office) and manufacturer. Cost for this service will vary depending on wear and modifications needed to make your device biomechanically functional.