Financial Policy

At Orthotic & Prosthetic Lab, Inc. we make every attempt to provide you with the most accurate estimate of cost to you. We understand that financially and physically the services we provide can be a huge decision. We want you to make the most informed decision possible. We ask that you realize that Orthotic & Prosthetic Lab, Inc. can, in no way, guarantee coverage. Benefits are determined by your insurance at the time your claim is processed. All benefit calculations are only an estimate, based on information obtained from your insurance company. The actual final Total Patient‘s Responsibility may be different than what was previously calculated by Orthotic & Prosthetic Lab, Inc.

Proof of Insurance

All patients must complete our patient information form before seeing our practioner. We must obtain current valid insurance information to provide proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you may be responsible for any balance due on the claim. If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim due to unreported changes, you will be held responsible for the unpaid balance.

Minor Patients

The adult accompanying a minor is responsible for payment. If the minor is unaccompanied he/she should have a payment with them, or prior arrangements should be made.

Private Insurance

We participate with most insurance plans and bill both primary and secondary insurance. We request that half of the estimated balance due which includes non-covered items, copay, coinsurance and deductibles be collected prior to work being started. The remaining balance is due at delivery of the device.

Medicare/Medicaid

In the majority of cases we accept assignment for Medicare and Medicaid claims. If we feel the service will not be covered by the carrier we will inform you of the cost and why we feel the services will not be covered. At that time you will be required to pay half down to start the work and the remaining amount will be due at delivery for the device.

Worker’s Compensation

You are responsible for knowing what coverage you have and what is offered through your plan. We will need, prior to your appointment, the contact information for your Worker’s Compensation case manager. No items will be dispensed until all needed authorizations or referrals are received. If we are unable to verify coverage for our service we will expect of half down to start the work and remaining balance at delivery.

Veterans Health Administration

We are happy to contact the appropriate parties at the Veteran’s Administration to see if authorization will be given for the services needed.

Motor Vehicle

We do not accept auto insurance claims. If you have been in an accident and auto insurance must be billed before any private payer, you will be responsible to pay us in full unless we can confirm with your private pay carrier that you have completed the required subrogation forms for them to pay as primary on your claim without billing the motor vehicle insurance.

Litigation

If you are involved in litigation of any kind that affects the payment of our services, we hold you responsible for payment of our fees.

Financing

We partner with CareCredit when financing is needed. If you would like more information about CareCredit or would like to apply for CareCredit please visit their website at www.carecredit.com.

Self-Pay

Payment of half down on the balance due at the time service is started is required and the final half at the time of delivery.

Returned Checks

All returned checks are subject to a service fee. Should a check be returned the account must be resolved prior to any future services being started.

Payment Options

We accept Visa, MasterCard, Discover and American Express. Debit cards with the Visa or MasterCard logo are also accepted. Payments may be made by coming into one of offices, via our website at www.oandplabinc.com, by phone to one of our office locations or our billing office.

Returned Items/Abandoned Items Policy

Products that have come in direct contact with the skin may not be returned once you leave nor will refunds be made. Custom fitted or custom fabricated items may not be returned nor any refunds made. If you cancel an order you will be financially responsible for the services performed, materials purchased and fabrication performed to that point, these fees are not billable to your insurance carrier. If an item is fabricated/special ordered but you refuse delivery, (i.e.. Abandon) you will be financially responsible for the item. Due to insurance billing policies we cannot bill your carrier.

Nonpayment of Balances Due

We outsource our unpaid account to Accounts Receivable Tracking/Wakefield and Associates 30 days after invoice for further invoice and payment arrangement needs. If your account becomes delinquent with them, it may be forwarded to their collection agency. If this happens, you will be responsible for all costs of collection, including, but not limited to, interest, refilling fees, court costs, attorney fees and collection agency costs. Any account that has an unresolved balance will be required to do so prior to any future services being started.

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