Patient Resources
Appointment Information
Our office makes every effort to contact you before your appointment to confirm time, location and insurance and referral requirements. Referrals, if required, are the patient’s responsibility to arrange in advance of the appointment with your primary care doctor.
We make every effort to accommodate urgent and emergent appointments as well as our regularly scheduled elective patients in an efficient and expeditious manner. However, from time to time, there are un-avoidable delays due to high patient volume. During these times, we appreciate your patience and will do our best to ensure a pleasant and informative visit.
All new patients (or those returning for a new problem) are asked to arrive 15 minutes in advance of their scheduled appointment time to check in/ fill out paperwork. Existing patients may be asked to update patient forms so that we have current information and signatures on file for insurance requirements.
For your convenience, patient forms are available on this website.
Please bring with you to your appointment the following items: any X-rays, Mri’s and diagnostic imaging disks or films and reports, a current copy of your insurance card, identification, referral and a method of payment: cash, check or major credit card.
Routine Appointments
Routine appointments should be scheduled in advance by calling during normal business hours.
Emergency Appointments
Emergency appointments are processed through our triage department. Our nurses carefully review all information regarding your child’s situation with a physician who directs the scheduling of these patients.
Cancellation Policy
We require at least 24-hour notice for appointment cancellations or changes. Same day cancellations are subject to service charges.
Patient Forms
New Patients: PLEASE CHECK WITH THE PRACTICE REGARDING OUR UPDATED FORMS AND HOW TO GET THEM.
Billing
For all Billing inquires please refer to number for the billing department on your statement. Our office staff cannot answer billing questions as this is handled by a separate department.
Your insurance company requires that we bill our services using a coding system known as CPT (Current Procedural Terminology). The codes used to describe these services are found in the “surgery” section of the CPT codebook. However, this does not necessarily mean or imply that we performed a surgical procedure. This is merely the way the CPT book is organized for ease of use by both the insurance companies and physicians.
According to CPT guidelines, fracture care is billed as a “packaged” service. This means that at the time of initial care a bill is generated that includes:
- Evaluation of fracture
- The first cast or splint application
- 90 days of normal, uncomplicated follow-up care
The things that are NOT INCLUDED in package are:
- X-Rays
- All casting supplies (including those used in first cast or splint)
- Any replacement cast applications
- The evaluation and management of any additional problems or injuries
- The treatment of complications
- Any and ALL DME’s
There will be a separate charge for the above items.
If you have any questions, please do not hesitate to contact the billing dept at (732) 390-1494 Monday through Friday between 10:00 am and 4:00 pm.
Insurance
Accepted Insurances
- Aetna
- Aetna Better Health
- Americhoice / UHC Community Plan
- Amerihealth
- BCBS Out of State
- Cigna
- Great West Health
- Horizon BCBS of NJ
- Horizon NJ Health
- JFK / Solaris
- Federal BCBS
- Magnacare
- Meridian
- RWJ / Barnabas
- Qualcare
- Starmark
- St. Peter’s
- Tricare
- United Healthcare
- Oxford
Non Participating Insurances
- Amerigroup
- Straight GHI
- Straight Multiplan
- Straight Medicaid
- Medicare (JAB / PT Patients Excused)
- Out of State Medicaid’s
- Straight PHCS
- Welfare (Medicaid Plan)
Note: the above list is subject to change. Please call today to confirm participation with your specific plan.
Note: some plans (including NJ health, Oxford and Aetna) require referrals from your primary care doctor.
How Insurance Works
A co-payment is required at the time you arrive for your appointment. The specialist co-payment printed on your insurance card is the amount we will collect. If we participate with your insurance, we will submit our charges to your carrier. If however, we do not participate with your insurance, we will require payment at the time services are rendered. Patients who self-pay for services will receive an itemized bill for reimbursement.
Depending upon your specific Plan, deductibles or a co-insurance may apply. In some cases, patients may be billed for un-covered services or the difference between our charges and the insurer’s rate. The Billing Department will be happy to assist you with all financial issues should they arise.
We recommend that all patients know and understand their specific insurance Plans as they can differ widely. The following are important items for a patient to know before they seek health-care services: current participation-status of the provider, referral requisites, co-payments, deductibles, co-insurance, in-network and out-of-network obligations, limits of coverage and un-covered services or items.
The requirements of the patient’s insurance plan represent a contract between the patient and the patient’s insurer. Pediatric Orthopedic Associates as the provider, will make every effort to assist the patient with financial issues, however, the patient is ultimately responsible for all charges incurred for services provided.
A good resource to obtain more information about your plan is through your Employer’s Human Resources Office. You may also contact your insurer’s membership hot line printed on the back of your card if you have specific coverage questions or require clarification about specific issues.