Insurance & Billing

Participating Medical Managed Care Plans

It is patient responsibility to verify if we participate with your specific insurance carrier and 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 Health Care Exchange Plans

If you are enrolled on one of the state’s health care exchange programs, please advise our office of this when you schedule your appointment.

Connecticare Exchange Network
Healthy CT Exchange Network
United healthcare Exchange Network

Managed Medicare Plans

Many of the Managed Medicare Plans require a referral.

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.

Aetna Managed Medicare
Connecticare Exchange Network
United healthcare Medicare

Workers’ Compensation Managed Care Plans

We participate in most Connecticut 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.

Insurance for Therapy Services

Insurance claim processing and billing for Therapy Services is a service of OrthoConnecticut. We participate in most Connecticut provider plans, however, physician participation in a plan does not ensure Physical Therapy/Occupational Therapy provider participation. We will ask you, prior to your visit, details about your policy so that we may verify and authorize your visits prior to your first visit. We will need a photocopy of your insurance card and your photo ID. When you come for your first visit, we will inform you of your plan details, as they affect PT/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.

Billing

We are happy to answer any questions you may have about your bill or about processing your claim with your insurance company. It is patient responsibility to verify if we participate with your specific insurance carrier and plan. If you have questions about benefits or eligibility, please call the member services number listed on you insurance card. For other questions, please call our Billing Department at 203-743-3505. 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. OrthoConnecticut accepts cash, checks, MasterCard, Visa, American Express and Discover.