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525 St. Mary Street, Thibodaux, LA 70301
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Call Us: (985) 446-6284
(800) 521-2847
Email: office@thibodauxorthopaedic.com


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    FAQ:

    What insurances do we accept?

    We accept most all insurances and participate with the majority of major health care plans. Below is the list of the current healthcare plans that we do accept.

    If you do not see your health plan listed below, please call our office at 985.446.6284 to confirm that your plan is accepted.

    • AETNA
    • BCE EMERGIS
    • BEST CARE
    • BLUE CROSS
    • CIGNA
    • COMMERICAL HEALTH PLANS
    • EVOLUTIONS
    • GISLBAR 360 ALLIANCE PPO
    • HUMANA
    • LWCC (OMNET)
    • MEDICARE
    • MEDICARE ADVANTAGE PLANS
    • PPO PLUS
    • STATE GROUP EMPLOYEES
    • PRIVATE HEALTHCARE SYSTEMS
    • RAILROAD MEDICARE
    • UNITED HEATLHCARE
    • VERITY
    • WORKERS COMPENSATION

    Please note that this insurance list is subject to change.

    What are Guidelines for Prescription Refills?

    1. Our office requests a 24 hour notice for prescription refills. Because Monday and Thursday are surgery days, we may not be able to honor your request for a refill until the next day.

    2. We ask that you contact your pharmacy for the refill and they will contact us.

    3. Medication will be refilled between 9 am and 4 pm on Tuesday, Wednesday and Friday.

    4. No refills will be done on the weekends or holidays. The “on call” physician will not refill your medications.

    5. If you are receiving a similar pain medication from another physician, we may not refill your prescription.

    6. Be aware of the effect of other medication that you may be taking. Always check with your pharmacist or doctor whether you can take them with other medication.

    7. DO NOT drink alcoholic beverages or drive while taking pain medication. Obey warning regarding sedation of certain medications.

    8. Follow the prescribed dosage. Do not give your medications to other people and do not take medication from others.

    What are the Office and Financial Policies?

    Cancelled Appointments: We request a 24-hour notice if you are unable to keep a scheduled appointment so that we may offer that time to another patient. Please call our office so that we can reschedule your appointment. TOSMC reserves the right to charge a no-show fee. Excessive no-shows will result in possible termination from the practice.

    Insurance: Please bring your insurance card with you at the time of your appointment. Insurance plans with which we contract require that all co-pays be paid prior to any services being rendered. The co-pay requirement cannot be waived by our practice as it is a requirement placed on you by your insurance carrier. If you do not have your co-pay at the time of your visit, your appointment may be rescheduled.

    You are responsible for any co-insurance, deductibles or non-covered services as required by your insurance. You will receive a statement from our office indicating what your insurance has paid. Any remaining balance is due upon receipt of that statement.

    Workers’ Compensation: Workplace injury care requires authorization from your employer’s workers’ compensation carrier before we can file any of your medical claims. Failure to properly report this injury to your employer may result in your claims being denied. Denied claims will be your responsibility.

    Referrals: Many insurance plans with which we participate require a referral from your Primary Care Physician (PCP) before receiving services. Please bring the referral with you. Any services provided without a referral or proper authorization will be your responsibility.

    UCR (Usual and Customary Rate): We are committed to providing the best possible care for our patients and we charge what is usual and customary for our area. If we do not have a contract with your insurance company, you are responsible for payment in full regardless of any insurance company’s arbitrary determination of UCR rates.

    Delinquent Accounts: Delinquent accounts may be assigned to a collection agency. All collection costs will be added to your outstanding balance. Failure to pay a delinquent account will result in refusal to schedule appointments for you and/or possible termination from the practice.

    Return Checks: A $25.00 charge will be added to your account for any checks returned or ACH withdrawals rejected by your bank for any reason. This is in addition to any fees that your financial institution may charge you.

    Disability or Insurance Forms: There will be a charge of $5.00 per page for the completion of medical disability forms. Payment is due at the time that you deliver the forms. Forms are only completed on Thursdays.

    Medical Records: We will provide you a copy of your medical records upon request. A signed letter of release will be required at the time of pick-up. Please allow 7-10 days for us to copy your records. If you wish for your records to be mailed, there may be an associated fee to cover the mailing costs. You may be charged for additional copies of your medical records. Rates charged are within Louisiana state statutes.

    X-Rays: We will provide a copy of your x-rays upon request. A signed letter of release will be required at the time of pick-up. Please allow 48 hours from the time of your request. We reserve the right to charge for copies which is payable at the time of pick-up.

    Fracture Care: Fracture Care is billed-out as a “packaged” service, which includes the following:

    • Evaluation
    • The first cast or splint application
    • 90 days of postoperative follow-up care from the date of the fracture

    Services that are billed separately include: x-rays, all casting supplies, replacement cast applications, evaluations for any additional problems or injuries and treatment of complications. Your insurance carrier requires that we report our services using the coding system known as the Current Procedural Terminology (CPT). The codes for fracture care can be found in the Surgery section of the CPT book. This is not to imply that you will have or had surgery or that you will be or were taken to the operating room. This is how the CPT book was set up by the American Medical Association (AMA) for user-friendly purposes by both the insurance companies and physicians. Please note your insurance company may cover these services for fracture care differently than office visits. Therefore, your services may be paid as a surgical procedure, with deductible and co-insurance guidelines applied.

    If you have any questions or concerns, please contact our office at 985.446.6284 or 1.800.521.2647.

    Thank You for choosing Thibodaux Orthopaedic & Sports Medicine for your Orthopaedic care!

    Links:

    American Medical Association
    http://www.ama-assn.org/ama/pub/patients/patients.shtml

    American Academy of Orthopaedic Surgeons
    http://www.aaos.org/

    American Orthopaedic Society for Sports Medicine
    http://www.sportsmed.org/tabs/membership/finddoctor.aspx

    Stop Sports Injuries
    http://www.stopsportsinjuries.org/

    Arthroscopy Association of North America
    http://www.aana.org/Home/tabid/36/Default.aspx

    American Society of Surgery of the Hand
    http://www.assh.org/Pages/Default.aspx

    Patient Forms:

    You should have with you the following when arriving for your appointment:

    • Photo ID (i.e. driver’s license)
    • Your current insurance card(s)
    • Your co-pay as indicated in your insurance contract .
    • Any previous x-rays or medical records that pertain to your treatment
    • A list of your current medications
    • Referral from your Primary Care Physician, if your insurance requires.

    Click Below for Downloadable Forms (PDFs):

    1.) Patient Registration Form
    2.) Form for Clinic to Obtain Your Records
    3.) Form for Clinic to Release Your Records

    Other Downloads:

    1.) Patient Privacy Information
    2.) Office and Financial Policy Information