PATIENT FORMS

Disability Forms

Carolina Regional Orthopaedics, PA will be glad to assist you with your Disability, FMLA, Attending Physician Statements, and Handicap Placard Applications. You may bring these forms with the patient part completed to have your physician complete their part of your form. All forms must be signed by the patient prior to provider completion. Our office will be glad to call you to pick the form up, mail it to you or fax to your disability/FMLA company upon completion.

We will complete your form at $10 per form unless you have had surgery. This completion fee must be paid in advance for us to complete your form. The form must be signed by you giving us permission to complete it. If you have had surgery at our facility, we will waive the $10 fee during your global period (anywhere from 15 to 90 days). The global period depends on what type of surgery you are having or have had. There will not be any charge to have your FMLA form completed.

All forms can take up to 10 business days to be completed. After your form is completed, we will fax or mail it to your insurance company, then mail it back to you, or you may pick it up from our office. You are welcome to call our office at any time to check the status. We understand how important this is to you, and we will do everything we can to get this done quickly.

FRACTURE CHARGES

Insurance companies dictate how a physician’s office should charge for the care and treatment of broken bones.

Broken bones are treated under a “flat fee” system. This means that a fixed amount is charged to take care of the fracture and no extra visit charges will be made for the follow-up visits. Even if you have to come back more times than normal, there will not be an extra visit charge.

On the first day, you might be surprised by the charges, but it is important to realize that follow-up care is normally included. There will be either 30, 60, or 90 follow-up days, depending on the type of fracture.

If during fracture treatment other things are done such as x-rays or cast changes, then additional charges will be made.

Several insurance companies, including MEDICARE, will write on the Explanation of Benefits that they send you, that you were treated with “Surgery”. It is important you are aware of this. Medicare uses the word “Surgery” for whatever a surgeon does, even though with most fractures no true surgery and no knives were used. Medicare and some other insurance companies will still call the treatment “Surgery”. Please be aware of this misleading statement on your Explanation of Benefits.

Please contact our office if you have further questions.

PRESCRIPTION REFILLS

Please try to have your prescriptions refilled on your appointment days, and avoid letting your medications completely run out before calling for a refill.

We will accept medication refill telephone requests Mondays through Thursdays, 8:00 am to 4:00 pm. Requests will not be accepted or processed on Friday, so please plan ahead. The clinical staff will take your information and contact your doctor for you. We cannot call in medications at any other time, including at night or on weekends, so please ask the physician to refill your prescription while you are in the office.

MONTHLY STATEMENTS

Carolina Regional Orthopaedics, PA sends out monthly statements each month. Your statement will show all activity on your account over the past 30 days, the amount billed to your insurance company, and your outstanding balance. Monthly payments are due each month.

If you cannot pay your outstanding balance in full 90 days from the date of service, your account will be transferred to Prince Parker & Associates. Prince Parker & Associates will be contacting you to discuss payment options.

Prince Parker & Associates Phone: 1-800-276-2423

We do not mail statements with a balance of $5.00 or less. If you have a balance of $5.00 or less, your balance will be on your account the next time you visit our office.

WORKER’S COMPENSATION

If you are injured on the job, you must immediately report your injury to your supervisor. Your supervisor or human resources department will then contact Carolina Regional Orthopaedics, PA to make you an appointment.

If you have seen another physician or have gone to the emergency room about this problem, then you must bring all notes and x-rays to your appointment to see our doctor. If your employer authorizes us to treat you, all of your medical bills for this problem will be sent to your employer or worker’s compensation company. By law, we must send a copy of your office note with the medical bill to your employer or worker’s compensation company.

If you still have questions please contact our office and we will be glad to assist you. Please bring your claim number with you.

VETERANS

At Carolina Regional Orthopaedics, PA, we appreciate the dedication our servicemen and women provide to keep our country safe. That is why we gladly accept TriCare insurance plans for our veterans and active-duty military. As one of the few local practices Down East to do so, we provide the medical support our military so justifiably deserves.