CSMO Financial Policy
If your insurance plan assigns a COPAY amount to your visit, the COPAY is due at time of service.
If your insurance benefits indicate that services rendered will be applied to your deductible and coinsurance, then it is our policy to collect a deposit toward any deductible/coinsurance at the time of service. We will file your insurance claim. You will be responsible for any additional balance not paid by your insurance.
A deposit of $175.00 (new patient) or $75.00 (established patient) is required BEFORE you are CHECKED IN at the front desk. You will be responsible for any additional balance for services rendered upon CHECK-OUT at today’s visit.
If a REFERRAL or AUTHORIZATION is required by your insurance carrier but has not been obtained for this visit, it is your responsibility to request/obtain the referral for today’s visit and any future visits to our office. Our staff will assist you as much as possible, but the ultimate responsibility lies with you, the patient. Without the referral or authorization you are responsible for payment in full for today’s visit. If a retro-active referral is obtained, then notify us immediately and we will file a claim to your insurance on your behalf. Once insurance has paid, we will refund you any credit balance that is due to you.
If our physicians/providers DO NOT PARTICIPATE in your insurance’s network, then your out-of-pocket expenses will be more than if you see an in-network physician. The cost to you depends on your out of network benefits. We will file your insurance as a courtesy to you. If your insurance pays more than the balance, then we will refund you any credit balance that is due to you.
If you do not currently have insurance coverage, Center for Sports Medicine & Orthopaedics offers a self-pay option. Please visit www.sportmed.com/pricing for more information.
If this is a work-related condition/injury and a work comp authorization has not been received by our office, you are responsible and may be required to pay the balance for these services. If a retroactive authorization is obtained, then notify us immediately.
If your physician determines that and MRI or surgery is required, we will estimate your out-of-pocket expenses based on your insurance benefits. It is our policy to collect payment towards this estimate prior to the service being rendered.
Individuals who fail to call at least 1 business day in advance to cancel/reschedule an MRI may be charged a “no show” fee of $75.00. A “no show” fee of $75.00 may be charged for failing to call at least 3 business days in advance to cancel/reschedule an EMG. A “no show” fee of $200.00 may also be applied for failing to call at least 3 business days in advance to cancel/reschedule a surgery/procedure. Patients are solely responsible for all fees as they will not be charged to insurance.