Patient Forms

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 at 717-299-1928 to find out if we accept your insurance plan.

To schedule an initial appointment with a doctor at Orthopedic Associates of Lancaster, call our schedulers at 717-299-4871. They will take your insurance information and get you scheduled for your visit. Follow-up visits are then scheduled by our exit staff when you leave at the end of your appointment.

Everyone’s insurance plan is different. It is essential that you are familiar with the requirements of your 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.

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.

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.

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.

The amount you pay for covered healthcare services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself. After you pay your deductible, you usually pay only a copayment or coinsurance for covered services.

The percentage of costs of a covered healthcare service you pay (20%, for example) after you've paid your deductible. Let's say your health insurance plan's allowed amount for an office visit is $100 and your coinsurance is 20%. If you've paid your deductible: You pay 20% of $100, or $20.

A copayment, or copay, is a fixed amount for a covered service, paid by a patient to the provider of the service before receiving the service.

A health maintenance organization (HMO) is a type of network health insurance plan which focuses on prevention and coordinated care by a primary care physician (PCP). The PCP coordinates members’ care with in-network specialists, so members must receive a PCP’s referral to see any specialist. Out-of-network care generally isn’t covered at all, except in an emergency.

The process of determining which of two or more insurance policies will have the primary responsibility of processing/paying a claim and the extent to which the other policies will contribute.