CSMO Financial Policy

Thank you for choosing Center for Sports Medicine & Orthopaedics for your healthcare needs. We are committed to providing exceptional medical care while maintaining transparency regarding our financial policies. Please read this policy carefully. By receiving services at our practice, you acknowledge your responsibility for payment of services rendered.

Insurance

As a courtesy, Center for Sports Medicine & Orthopaedics will file claims with your primary and secondary insurance carrier when applicable. We do not file tertiary insurance. Verification of insurance benefits is not a guarantee of payment. Your insurance policy is a contract between you and your insurance company, and you remain financially responsible for any balance not paid by your insurance, including deductibles, copayments, coinsurance, non-covered services, and custom splints or orthotic devices not covered under your plan. Patients utilizing school-sponsored athletic insurance must provide the required insurance information prior to treatment. Because coverage and benefits vary by policy, any balance not paid by the school insurance plan remains the patient’s responsibility.

Many insurance plans limit the number of physical therapy and/or occupational therapy visits covered during the calendar year. To help us accurately verify your available benefits, you are responsible for informing us if you have received physical therapy or occupational therapy services from any provider during the current calendar year. Although we make every reasonable effort to verify your remaining therapy benefits, the benefit information provided by your insurance company is not a guarantee of payment. Any services that exceed your available insurance benefits or are otherwise not covered by your plan remain your financial responsibility.

Motor Vehicle Accident

For motor vehicle accident-related care, Center for Sports Medicine & Orthopaedics accepts BlueCross BlueShield (BCBS) insurance only. Patients must have an active BCBS policy at the time of service. Verification of benefits is not a guarantee of payment, and patients remain responsible for applicable copayments, deductibles, coinsurance, non-covered services, and denied charges. Center for Sports Medicine & Orthopaedics does not accept letters of protection or defer payment while an automobile claim or legal settlement is pending.

Self-Pay

Patients without insurance or who elect not to utilize their insurance are considered self-pay. Separate fees may apply for office visits, imaging, procedures, durable medical equipment, therapy services, injections, and surgery. Please visit our website https://sportmed.com/pricing/ for more information.

Workers Compensation

If your visit is related to a work-related injury, you must provide complete Workers’ Compensation information before receiving services, including your employer’s name, the workers’ compensation insurance carrier, claim number, social security number date of injury, and, if available, your claims adjuster’s name and contact information. If prior authorization or claim acceptance is required, it is the patient’s responsibility to ensure the necessary authorization has been obtained before the appointment unless other arrangements have been made by the practice. While Center for Sports Medicine & Orthopaedics will submit claims to the appropriate workers’ compensation carrier when applicable, the patient remains financially responsible for all charges if the claim is denied, determined to be non-compensable, authorization is not obtained, or coverage cannot be verified. If your workers’ compensation authorization is pending claim is pending, denied, disputed, or coverage cannot be verified, the patient could be held financially responsible for payment at the time of service until the claim has been resolved. Should claim later be approved and payment received from Workers’ compensation carrier, any applicable overpayment will be refunded or credited to the patient’s account.

Diagnostic Imaging Request

Treating provider may determine that imaging is medically necessary and will be subject to the patient’s insurance benefits and financial responsibility, including applicable copayments, deductibles, coinsurance, and non-covered services.

Patients may request copies of diagnostic imaging performed by the Center for Sports Medicine & Orthopedics, including X-rays, MRI, and CT scans, for personal use. Imaging may be provided through a secure digital download link or compact disc. The patient is financially responsible for an upfront payment prior to receiving their imaging. For the digital link, please visit our website https://sportmed.com/medical-records/. For a compact disc, please visit a local office and complete the imaging form.

Missed Appointment/Late Cancellation Fees

Center for Sports Medicine & Orthopaedics values the time of both our patients and providers. If you are unable to keep your scheduled appointment, please notify our office as soon as possible so that we may offer the appointment to another patient in need of care. Patients who fail to provide the required notice to cancel or reschedule an appointment, or who do not arrive for their scheduled appointment (“no-show”), may be assessed a missed appointment fee. Missed appointment and late cancellation fees are the patient’s financial responsibility and are not billable to insurance. The practice reserves the right to waive missed appointment fees in the event of emergencies or other extenuating circumstances at its sole discretion.