Payment Policy & Insurance
We make every effort to decrease the cost of your medical care and request payment for all office services at the time they are rendered, except in the case of:
- Insurance plans that require a patient copay at each visit
It is the goal of Southern Bone & Joint Specialists to provide quality assistance to our patients throughout the billing process. We have patient representatives and a financial counselor available in our insurance department to assist with any questions or billing issues that may arise.
Our physicians are participating providers with:
- Blue Cross & Blue Shield of Alabama PMD
- Blue Advantage
- Blue Cross & Blue Shield PPO
- All Kids
- Medicaid of Alabama and Georgia
- Well Care of Georgia
- Peach Care for kids
- Workers’ Compensation
- Tricare – Standard, Prime, VA and Champ VA
- Ala Med
- Aetna Medicare
- Viva Health
They also participate with several provider networks, including:
- United Healthcare
- Three Rivers
- Coventry Network
- One Call Medical
- Perdue Employee’s Plan
Because these provider networks often add or delete insurance companies, we suggest that you contact your insurance company to verify their participation. Also, be sure to check your plan to see if a referral/authorization is required by your insurance company. Some plans require a Primary Care Physician (PCP) to approve all visits. Some plans require the authorization to be submitted electronically by the PCP. It is the member/patient’s responsibility to confirm the referral/authorization has been obtained. Otherwise, they may not pay for the services. This will result in the patient being responsible for the bill and can delay medical treatment if test or surgery is required.
Any co-payments are expected at the time of service.
If our physicians are not participating members in your insurance plan, payment in full is expected at the time of service. As a courtesy, our insurance department will file your insurance claim for you if all insurance information is received. Payment in full is still expected at the time of service.
For patients without insurance coverage, payment in full is expected at the time of service.
For patients requiring surgery all co-payments, deductibles, and payments for non-covered surgical procedures are due prior to your surgery. SB& J offers alternative payment plans if needed. Please contact our office representative prior to your surgery.
We accept Alabama and Georgia Medicaid for patients referred by a primary care physician.
We accept Tricare Standard, Prime, VA and Champ VA. Patients who have Prime or VA are responsible for obtaining their referral/authorization from their Primary Care Manager prior to scheduling their appointment. Standard patients are required to pay their co-pay at the time of service.
Southern Bone & Joint Specialists will not get involved in cases under litigation. Patient is responsible for payments at the time of service. As a courtesy, we will file the claims for you if all required information is received. Payment in full is still expected at the time of service.
For patients who have Medicare but are enrolled with a Home Health Agency or in a nursing home please notify our receptionist at the time your appointment. For patients who have Medicare or Medicaid but appointment is made due to an auto accident or other liability accident Medicare or Medicaid cannot be filed. Payment in full will be expected at the time of service. As a courtesy, we will file the claims for you if all required information is received. Payment in full is still expected at the time of service.
Workmen’s Comp and Disability
We accept Workmen’s Compensation when authorization is received by a patient’s employer prior to appointment or receiving medical treatment.
We have close relationships with many employers in the area and will guide you through the workmen’s compensation process. We can help you to obtain and complete the proper work release forms and any other forms required for reimbursement.
Likewise, we are familiar with the disability process and can help you with obtaining and completing both short- and long-term disability forms. There is a $10.00 pre- pay fee required on completion of the forms.