Newport Orthopedic Institute
(949) 722-7038
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Insurance

 

 
An Important Notice for our Aetna PPO Patients

Attention Greater Newport Physicians (GNP) Patients

During the current open enrollment period, you have multiple hospital networks available to you within Greater Newport Physicians. To continue seeing your NOI providers, you must select the Hoag Hospital network.

If you have any questions, please contact Becky Hepler at 949-722-5077.

 Newport Orthopedic Institute’s Financial Policy

Thank you for choosing us as your health care provider. We are committed to your treatment being successful.

Please understand that payment of your bill is considered a part of your treatment. The following is a statement of our Financial Policy, which we require you read and sign prior to any treatment.

All patients must complete our Patient Information and Insurance form before seeing the doctor.

WE ACCEPT CASH, CHECKS, or VISA/MASTERCARD and DISCOVER.  We do not accept AMEX.

Regarding Insurance Billing

We will bill your insurance company as a courtesy. Your insurance policy is a contract between you and your insurance company. It is your responsibility to know your benefits and how they will apply to your treatment by the doctor. We are not a party to that contract. If your insurance company has not paid your account in full within 60 days, the balance will be transferred to you and/or the guarantor listed on the Patient Information form. If unable to make payment in full, contact the billing department immediately to make payment arrangements.  If the account is referred for collections, you will be responsible for the balance of your account plus a collection agency charge of 25% of the balance and reasonable attorney’s fees.  If your account becomes delinquent or is referred for collections, your provider and/or any collection agent of your provider has authorization to obtain your credit report to assist them in the collection of your bill.

HMO Plans (with which we are contracted): All co-pays must be satisfied at every visit. There can be no exceptions due to contractual and uniform compliance issues with your insurance company. You are responsible for obtaining prior approval with your Medical Group or PCP prior to treatment.

PPO Plans (with which we are contracted): We have agreed to take a discount from your insurance company. Your co-insurance is your responsibility and is due at time of treatment. In the event your insurance coverage changes to a plan where we are not a participating provider you will be responsible for any out-of-network deductible or coinsurance amounts.

Medicare: We accept assignment with Medicare. Medicare pays 80% of their allowed amount after satisfaction of the yearly deductible. You are responsible for 20% of Medicare’s allowed amount. We will bill your secondary insurance as a courtesy.

Usual and Customary Rates

Our practice is committed to providing the best treatment for our patients and we charge what is usual and customary for our area. You are responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates.

Cash Patients

All services must be paid in full at time of treatment.

Returned Checks

A $25.00 fee will be charged for any returned checks. We will be unable to accept your check for any services thereafter.

Thank you for understanding our Financial Policy. Please let us know if you have questions or concerns. You can reach the Business Office Manager or Chief Operations Officer at (949) 722-7038.

Accepted Insurances

Our specialists participate with most insurance plans including Medicare. Prior to making an appointment we recommend that you contact your insurance carrier to verify that the doctor you wish to see is contracted with your plan. At this time we do not accept auto insurance or third party insurance.

PPO Agreements

  • Aetna US Healthcare
  • Beech Street
  • Blue Cross
  • Blue Shield
  • CIGNA HealthCare
  • First Health / Coventry Health
  • Great West Healthcare
  • Orange County PPO
  • PHCS / Multiplan
  • Physicians Care of California
  • United Healthcare

HMO Agreements

Provided through Greater Newport Physicians (Hoag Hospital) and Edinger Medical Group (IPAs)

  • Aetna
  • Blue Shield
  • Blue Cross
  • Cigna
  • Great West Healthcare
  • Health Net
  • PacifiCare
  • United Heathcare
  • Universal Care

Medicare HMO Advantage Senior Plans

Provided through Greater Newport Physicians and Edinger Medical Group (IPAs)

  • Blue Shield 65+
  • OneCare
  • Secure Horizons, AARP, United Heathcare
  • SCAN