Thank you for choosing us for your Orthopaedic care. Our primary goal is to provide quality health care to all our patients. It is necessary, however, to establish policies to avoid misunderstandings. We would like to clarify the following policies that are followed by our practice.

Orthopaedic Specialists of Austin participates in many health insurance networks to make our services as accessible and affordable as possible. To get a current list of the networks we're in, click here. This list is subject to change without notice. Please contact your insurance company with any questions and to verify your coverage.

As a courtesy to our patients, we do file insurance for most insurance types. We do not file automobile or other third party liability claims (accident policies, litigations, etc.). Please understand that your insurance policy is a contract between you and your insurance company. We are not a party to that contract. We cannot accept the responsibility for collecting an insurance claim or for negotiating a disputed claim. Our practice is committed to providing the best treatment for our patients and we charge what is reasonable and customary for our area. You are responsible for payment regardless of the insurance company's determination of usual and customary. If, after 60 days, your insurance company has not issued payment, we will expect you to make payment in full.

Payment is expected at the time services are rendered. Any co-payments are due at the time of check in. Unpaid deductibles and co-insurance percentages will also be due upon checking with our front office staff.

The costs for medical record copies (including x-ray film duplication, disability forms, etc) are not covered services by insurance carriers. The patient is responsible for these fees in the event a request is made for such services.

We do accept cash, checks, and credit cards. In the event that your bank returns payment made by a personal check, a service fee of $25.00 will be billed to your account. If payment is unable to be made in full, payment plans can always be arranged. In the event costs and/or fees are incurred in connection with the collection of your account, the patient will pay all such costs and fees. These fees may include, but are not limited to collection costs, attorney's fees, court costs, and bank fees.

If any questions or concerns arise regarding our payment policy, feel free to ask anyone in the front office.

Health Insurance 101
If you have never used your health insurance benefits or done so infrequently, you may not understand terms like co-insurance or deductible. Below, we explain some of the more common elements of health insurance.

Deductible is the initial portion of a covered expense that must be paid by the patient before the insurance policy pays its part of the expense. (For example, if the deductible is $500, then the patient must pay the first $500 of the covered medical costs before the insurance company will pay anything at all.)

Co-insurance is where the patient and the insurance company share the covered procedures under a policy in a specified ratio. Example: (80 percent paid by the insurance company and 20 percent by the patient).

Co-pay is an arrangement where the patient pays a specific amount for services and the insurance company pays the remaining charges.

Out of Pocket Max (OOP) is the total amount a patient will have to pay out of pocket in one year. After the OOP Max has been met, typically the insurance company will cover the patient at 100%.

Frequently Asked Questions

What insurance plans do you accept? Orthopaedic Specialists of Austin participates in many health insurance networks to make our services as accessible and affordable as possible. To get a current list of the networks we're in, click here. This list is subject to change without notice. Please contact your insurance company with any questions and to verify your coverage.

What does ‘in-network’ or ‘out-of-network’ mean? HMO and PPO plans generally have provider books or lists that show you which doctors are in network for your plan (meaning which doctors have contracts with your insurance plan). By choosing a provider from your insurance list, you will obtain the highest benefit your policy offers. If you choose to see an out-of-network physician (one that does not appear on their list), generally the benefit is less (maybe none), meaning higher patient financial responsibility. Every insurance plan is different, so we encourage you to check your insurance before your appointment.

Will my insurance pay for my visit? Only your insurance company can answer that. We make every effort to verify your benefits prior to your visit and ask that you do the same so that you are informed of your coverage.

I have no insurance. How much will my visit cost and when am I expected to pay? If you call us prior to your visit and let us know why you are coming in, we can ESTIMATE the cost of your visit. We cannot guarantee any fees until after you have had your appointment. Payment is expected at the time of service.

Do you offer any discounts for self-pay patients? Yes. If you pay in full at the time of service, a 20% discount will be applied.