Our Financial Policy

Thank you for choosing Heartland Orthopaedic & Sports Medicine Clinic. The following is a statement of our financial policy. All patients must accept our financial policy before receiving treatment. Full payment of your bill is considered part of your treatment.

Method of Payment: We accept cash, check, Visa, Mastercard, Care Credit, and American Express.

Regarding Your Insurance

As a courtesy to you, we will submit medical claims to your insurance company. Any balance after processing of our claim by your carrier is your responsibility. Your insurance policy is a contract between you and your insurance company. You are responsible for verifying if providers are in-network with your insurance company. We cannot bill your insurance company unless you give us your complete insurance information for commercial insurance, Medicare, and Nebraska Medicaid. It is your responsibility to know your insurance benefits as it may not cover all of the services provided to you. Interest, at an annual rate of 16% may be charged to your account if full payment is not received by the statement due date.

Definitions

Co-Payment: A fixed dollar amount set by your insurance contract that is required to be paid at the time of an office visit. This amount is usually between $15.00 and $60.00. Regarding insurance plans where we are a participating provider, all co-pays are due prior to treatment.

Deductible: An annual dollar amount established by your insurance plan that is deducted from insurance benefits. This amount is your obligation and must be paid prior to having surgery.

Co-Insurance: A percent set by your insurance plan that is deducted from your insurance benefits. This percent usually ranges between 10% and 30% and is your obligation to pay.

Self-Pay: A patient that does not have any valid health insurance. You will be asked to pay a $300 deposit before you will be seen for your first visit and $150 for subsequent visits. 

*Over payment will be refunded at the end of your treatment.

*Overdue accounts are defined as any balance over 60 days old from the date of service.

When Surgery is Recommended

For individuals with a commercial insurance plan, a financial representative will check your benefits and may contact you prior to surgery to inform you of your out-of-pocket expenses. Financial arrangements will need to be made to meet your financial responsibility prior to the surgery in accordance with the financial policies of our physician practice.

Motor Vehicle Accidents (MVAs) and Third Party Insurance Policies

Heartland Orthopaedic & Sports Clinic may bill your motor vehicle insurance but will not bill someone else's insurance; however, we are contracted to submit bills to BlueCross BlueShield of NE for MVA claims and in most cases BCBS of NE will collect from your motor vehicle insurance. Otherwise, you will be asked for your personal health insurance should your MVA coverage become exhausted. If insurance has not paid this claim within 60 days of the date of service to you, you will become personally responsible for the amount due.

Regarding Personal Injury

We require a financial arrangement be established for payment in full at the time of service for personal injury cases. We are not a party to any litigation suits being filed for personal injuries.

Regarding Work-Related Injuries

We will file workers' compensation claims with your employer's workers' compensation insurance carrier. Written or telephone authorization is required from your employer and/or insurance company prior to treatment. If prior authorization is not obtained, you are responsible for full payment at the time of service If your company's workers' compensation carrier has not paid your account in full within 60 days of your date of service, the balance will be transferred to your account and it is your responsibility to pay in full by the statement due.

Completion of Forms

You will be asked to pay $10.00 to receive completed forms, i.e., AFLAC, FMLA, return to work, disability.

Returned Checks

A $20.00 service fee will be added to all checks returned for insufficient funds. If your check is returned, you will be required to prepay in full by cash or credit card for additional services.

Overdue and In-Collection Accounts

Patients with past due accounts will be asked to make payment in full before being seen at Heartland Orthopaedic & Sports Medicine Clinic. Patients with accounts sent to collection will not be allowed to schedule appointments, at Heartland Orthopaedic & Sports Medicine Clinic until the account is paid in full. Any patient that files bankruptcy will be on cash for service terms. We reserve the right to forward your account to a collection agency if it is determined to be uncollectible.

Accepted Insurance Policies

For current health insurance information, please call your health insurance administrator to verify provider enrollment with the physicians of Heartland Orthopaedic and Sports Medicine. With constant changes in health insurance coverage and plans merging and restructuring, we may not be enrolled as providers with all plans.

Our most common insurance companies are:

• Blue Cross
• Medicare
• United Healthcare
• Midlands Choice
• Coventry
• Aetna
• Principal
• Cigna