Thank you for choosing our practice!  We are committed to the success of your medical treatment and care.  Please understand that payment of your bill is part of the treatment and care.

For your convenience, we have answered a variety of commonly-asked financial policy questions below.  If you need further information about any of these policies, please do not hesitate to contact our Billing Office at 248-474-5081.

How May I Pay?
We accept payment by cash, check, VISA, Mastercard , Discover or American Express.

Patient responsibility: It is your responsibility to be familiar with your insurance coverage. The doctor renders service to you, the patient, and not to the insurance company. The insurance policy is between you and the insurance company, not with the doctor. You, the patient or the legal guardian of the patient, is legally responsible for charges resulting form services provided by Tri County Orthopedics, P.C. regardless of the existence of insurance or other third party liability.

Do I Need A Referral?
If you have an HMO plan with which we are contracted, you need a referral authorization from your primary care physician.  If we have not received an authorization prior to your arrival at the office, we will contact your PCP to try to obtain it.  If we are unable to obtain the referral at that time, you will be rescheduled or pay the full fee at the time of service.

Medicare: We will bill Medicare and your secondary insurance for you. If you have Medicare only, you are expected to pay 20% of the Medicare fee schedule and/ or your yearly deductible.

Workman’s compensation or Auto-related injuries: We require your claim number, the adjuster’s name and address, the insurance carrier’s name and the date of injury. We also require an authorization letter/letter of intent to the physician from the insurance company. If you fail to produce the above information, you will need to reschedule your appointment or pay the full fee at the time of service. Any legal action must remain between you and your attorney. We do not wait for legal settlement.

For participating PPO insurance holders: You need to pay your co-pay and deductible at the time of service. We will bill the insurance for the remaining balance. However, if your policy does not cover particular services rendered, you will be responsible for the charges incurred.

For BCBS Master Medical patients: You are required to pay the full fee at the time of service. We will bill the insurance on your behalf and the insurance payment will be directly sent to you.

If you do not have insurance coverage, you will be responsible for all charges incurred. Please talk to us about our payment plan arrangement. We will be happy to assist you.

Our fees: We set our fees in alignment with the Medicare fee schedule and geographically adjusted for Orthopedic specialist in the Michigan region. We do not accept the insurance industry’s “usual and customary” fee schedule unless we participate with the insurance. For nonparticipating insurances, any dispute regarding the fees charged and their definition of “usual and customary” is between you and your insurance carrier. If you are not satisfied with the insurance payment, it is up to you to contact your carrier.

Please inform us of any insurance changes so we may bill the proper carrier. This is your responsibility.

As a courtesy to our patients, we will send either an electronic or paper claim to your insurance company.  After hearing from your insurance company, if there is a patient balance, we will send you a billing statement.  We request that payment for your services be remitted within 30 days.

If you are unable to pay in full, please contact our Billing Office to make arrangements for payment at 248-474-5081.