The primary rule in today's health care environment is  CALL YOUR INSURANCE COMPANY/HEALTH PLAN and ask questions.

 Health Maintenance Organizations or HMO's/Health Plans, in general, need referrals to be brought to us by you, the patient. Only in very rare instances are they allowing faxes or phone calls to replace a referral in hand. In most cases you will need two referrals at the time of your initial visit, one for the physician's visit and one for x-rays. These must be on two separate referrals. One referral should be in the doctor's name and the other made out to Good Samaritan Hospital Radiology Department.

 Under most other insurances you will be required to pay the professional fee at the time of service and collect reimbursement directly from your insurance company. The professional fee ranges anywhere from $57.00 to $290.00 depending on the complexity of your case as well as the reading of x-rays. We are prepared to accept cash, check and MasterCard, Visa or American Express.

 If you have Medicare and are now enrolled in a Managed Care Program, you must now obtain prior authorization from your new Primary Care Physician before your scheduled visit. Your Primary Care Physician's telephone number will be located on your new card.

If you have Medicare, are not enrolled in a Managed Care Program but have a secondary insurance, you will not be required to pay anything up-front initially. We will submit your insurance claims to Medicare and your secondary insurance(s) for you.

 If you have only Medicare, are not in a Managed Care Program and have no secondary insurance, you will be required to pay the standard 20% associated with Medicare which would be somewhere in $11.00 to $58.00.

For anyone on Medicare in Maryland there is a toll-free hotline to answer any and all questions you may have, regardless of whether you are with a managed care program or not. Their number is 1-800-444-4606 and they are available Monday through Friday 8:30 AM to 4:30 PM.

If this is a Workman's Compensation Case, please bring a copy of all billing information with you. If you have no insurance you will be asked to pay in full for your visit at the time of service.

Under any cases where referrals are needed, and if not provided, you will be either asked to pay in full at the time of your visit or to reschedule.

All the above information relates to clinical visits. If it is determined that you need surgery, someone will be able to assist you with getting authorizations, knowing what expenses to anticipate, and when payments will be expected.

We are sorry that this has become so complex and laborious, however, these are rules imposed on you and us by the insurance industry. We are here primarily to care for your orthopaedic needs.

Together we will work to navigate through the complexities of insurance requirements to the maximum benefit for both you the patient and our office.