Orthopedic Associates of Lancaster, LTD.

In most cases, yes, just as other medical practices do. Forms take skilled staff time to complete accurately. When a form is not required by your health insurer, we typically charge a prepaid fee of $15.

Many types of treatment require preauthorization, for example, MRI, physical therapy, injections, etc. If your insurance company denies any of these services, you can appeal the decision by contacting your insurance company’s customer service department and asking for appeals. If you are denied authorization for a procedure and you choose to continue with treatment, be prepared to pay all charges in full.

To obtain an out-of-network referral you need to contact your primary care physician (PCP). Ask them to write an out-of-network referral to our office. Be specific. Tell them the date of your appointment and what you are being treated for. Present your referral at our front desk when you arrive for your appointment.

As a patient, you may decide which doctor(s) you would like to provide your treatment. If your primary care physician refers you elsewhere, you may ask them to write a referral to our office. You will want to double check, though, to make sure that our office participates with your insurance company.

Everyone’s insurance plan is different. It is essential that you are familiar with the requirements of your particular plan. If you choose to come to our office and we do not participate with your insurance company, it is your responsibility to contact your primary care physician (PCP) before the visit to obtain an out-of-network referral. It is important to remember, however, that even if we participate with your insurance you may need a referral. Some plans allow you to come to a specialist without a referral with the understanding that if you come without one, you may have to pay more than you would if you do have a referral. Ultimately, it is your responsibility as a patient to know whether a referral is required.

Call your insurance company and give them our tax identification number: 23-187-9220. They can use this number to verify whether we are a participating provider. Or you can call our business office to find out if we accept your insurance plan.