co-pay information | medicare patients | surgery

In today's modern insurance world it seems everyone has a different type of insurance coverage requiring special considerations.  It is the patient's insurance plan, therefore the patient's responsibility to inform the office prior to making an appointment as to the type and special circumstances of their plan.  We are a member of most groups but we do not belong to all insurance plans.  Our facilities are participating with Medicare program. We will submit a claim for your services to Medicare, and you will be responsible for payment of any deductible, co-payment, and/or non-covered services. 

Please remember that insurance is considered a method of reimbursing the patient for fees paid to our facility and is not a substitute for payment. Some companies pay fixed allowances for certain procedures and others pay a percentage of the charge. It is your responsibility to pay any deductible amount, co-insurance or any balance not paid by your insurance company.

When questions on insurance matters arise, please feel free to discuss them our patient account representative.  She will be happy to help you receive maximum benefits; however, the agreement by the insurance company to pay for your medical care is a contract between you and your insurance company.

We are asked many questions as they relate to insurance.  Following are some of the more frequently asked insurance questions.

Co-pay vs Percentage of claim

Most insurances cover DME and Orthotics at a certain percentage, unlike a physician’s office where you have set co-pays.  Please check your policy under DME/Orthotics section of your policy booklet.  But benefits quoted to us by your insurance are only a quote of your benefits not a guarantee. Until the insurance receives our claim and establishes medical necessity and coverage under your individual policy, they will not guarantee payment.

Medicare Patients

Medicare’s policy is to cover one brace for a certain part of your body every five years, unless your condition has changed, on a condition change, we will require documentation from your physician.

Foot supports or surgical boots/shoes are non-covered by Medicare, these items will not be covered.

Diabetic patients may have coverage for some foot orthotics, with proper documentation from your physician.  Please call our office for more details.

Surgery

If you are having surgery it is better to come into our office before your surgery, we will work with your schedule, a lot of times you can schedule our visit on the same day you have to do your pre admission testing at your hospital. 

There are several reason to pre-fit your brace, you wont be in as much pain as right after surgery, swelling, and more time to understand the proper fit of your orthosis.

Your medical insurance is an agreement between you and the insurance carrier designed to help you with orthotic needs. Paying the bills is your responsibility, of course but you should get as much reimbursement as you are entitled to from the insurer. FSO will help you collect from insurance carriers, although this is not our responsibility.

One final reminder. Do not be afraid to talk over your bill with us ahead of time. This is your right and privilege.

Every effort is made to keep down the cost of your medical care. You can help by paying at the time of your office visit. We accept cash, checks, Master Card,  VISA, and Paypal.