If you are unsure of your plan, or to verify if we participate with your plan, please call the number on the BACK OF YOUR INSURANCE CARD prior to calling for an appointment.
If your insurance plan requires a referral, it must be in place prior to your appointment.
Co-pays are required at the time of service.
Participating Medical Insurance Plans:
- Anthem Blue Cross/Blue Shield
- MuliPlan / HMC, PHCS
- Rail Road Medicare
- United Healthcare
Participating Health Care Exchange Plans:
- ConnectiCare Exchange Network
- Healthy CT Exchange Network
Participating Managed Medicare Plans:
- Aetna Managed Medicare
- ConnectiCare Medicare Advantage
- Oxford/UHC Managed Medicare (Oxford/UHC Managed Medicare is all under the UHC Medicare Advantage/AARP Medicare Complete)
If your insurance is a managed Medicare plan also known as a Medicare advantage plan your insurance dictates that you must obtain a referral for all specialist visits. If you do not have an active referral your insurance will not cover the cost of the visit. Please contact your primary care physician to generate a referral.
Participating Workers’ Compensation Plans:
When calling to schedule an appointment please advise our office that this is a WORK-RELATED injury. We will need to have a “contact person” at your place of employment.
- CHAWCT – Medical Car Plan
- GAB Robbins
- Kimberly Clark
- US Department of Labor
Insurance for Therapy Services
Insurance claim processing and billing for Therapy Services is a service of Coastal Orthopaedics. We participate in most Connecticut provider plans; however, physician participation in a plan does not ensure Occupational Therapy provider participation. We will ask you details about your policy so that we may verify and authorize your visits prior to your first visit. When you come for your first visit, we will inform you of your plan details, as they affect OT: co-pay, number of visits allowed, and re-certification process. This is not a guarantee of payment – ultimately you will be responsible for payment. Many insurance companies now require frequent reauthorization for visits, and we monitor your visits and submit updated progress notes when necessary to ensure there is no interruption in your care. These updates must address the skilled care that is provided and medical necessity for continued care. We make every effort to help facilitate this process so your treatment program is optimized.
Please present your insurance card at every visit. This helps to ensure that your claim is processed correctly. As with all medical offices, co-payments are required at time of service. Coastal Orthopaedics accepts cash, checks, MasterCard, Visa, American Express and Discover. Patient balances will be mailed to you as a Patient Statement and are due upon receipt. Patients are responsible for payment of co-payments and co-insurance deductibles. For patients who have signed up for our Patient Portal, you can view and pay your balance on-line.
We are happy to answer any questions you may have about your bill, the status of your insurance claim or the explanation of benefits (EOB) paid by your insurance company.
- If you have questions about benefits or eligibility, please call the member services number listed on you insurance card.
- For account balances and other billing questions, please call our Billing Company, toll-free at 855-346-1594. You will be greeted by an Auto-Attendant
- Press 1 – “If you would like to hear your account balance or make a credit card or check payment.”
- Press 2 – “If you would like to speak with the next available patient account representative.”