Patient Information

Workers’ Compensation Policy

Not all of our physicians accept workers’ compensation. Advise the office staff prior to making your appointment if your injury is a work related injury. We will assist you in making an appointment with a physician who accepts workers compensation.

When you call to make an appointment, please be certain to have available the name of your employer, the date of injury, the claim number and the insurance adjuster’s name and phone number if you have it.

We will verify the workers’ compensation claim and get an approval for your visit, prior to scheduling an appointment.

Liability/Auto Accident Policy

We do not accept third party payment. Patient is responsible for payment at the time of service.

We will give you a receipt upon completion of your office visit so that you can turn the bill in to the insurance company for reimbursement.

Out-of-Network Policy

Please call the office and we will be happy to answer your questions and assist you in choosing and in network provider.

In-Network Policy

We will be happy to file your insurance if the doctor that you are seeing is an in-network physician. Your copay will be collected at the time of service.

Appointment Paperwork

For your convenience, we allow our patients to go online to complete all necessary forms. Your chart will be prepared prior to your appointment with the completed forms ready for you upon check-in.

Be certain to bring your insurance card and a picture ID to your appointment. Some insurance policies request a referral from your primary care physician. Check with your insurance carrier and if a referral is necessary, it is the responsibility of the patient to obtain the referral prior to being treated in our office.

If you have had recent x-rays or MRI’s, please bring your films and report with you to your appointment.

You can also request an appointment online or download your documents for printing.

Payment Methods

Payment is expected at the time of service. For your convenience, we accept cash, checks, money order, Debit cards, VISA, MasterCard, Discover and American Express. We also offer online bill pay and Care Credit.

To pay your bill online go to: orthopedicassociates.org.  Click on the Patient Resources Tab and then the Online Bill Pay icon.  You will be prompted for your account number which can be found on your statement below the description and next to the patient name.  The account number is listed in parenthesis.

Financial Policy

At Orthopedic Associates we are committed to making patient care and satisfaction our number one priority. As part of that commitment, we want to communicate our financial policies to alleviate any financial surprises. Our staff is available to answer any questions. Please call our billing department at 214.222.6612 or 214.222.6616 and let us help answer your financial questions.

• Photo Identification and Insurance Card, if applicable: Any patient over the age of 16 will be required to present a photo ID prior to being seen. We regret that anyone unable to provide a photo ID will be required to reschedule his/her appointment. We also require a copy of your insurance card if applicable.
• Payment: Payment is expected at the time of service.
  • We will collect any applicable deductibles, copays and co-insurance during each visit. We will be happy to file your insurance if your doctor is an in in-network physician.
  • Not all physicians are part of the same networks. We will be happy to assist you; however, it is the patient responsibility to make an appointment with an in-network physician.
  • For your convenience we accept cash, checks, debit cards, VISA, MasterCard, Discover and American Express. We also accept Care Credit.
  • For those patients who are not covered through insurance: we will collect a $200 deposit at check in. Any remaining balance will be collected at check-out. If your medical charges fall below $200, a refund of the balance will be given to you at check-out.
• Automobile Accident or Third Party Payers: We do not bill third party insurance companies such as Auto or Liability Insurance. Payment for these services is due in full and we will provide you with a statement which will include procedure codes and diagnosis codes and proof of payment.
• Children of divorced parents: The parent who seeks treatment for a child will be financially responsible for paying for the child’s medical bills. We will honor divorce decree instructions if presented and appropriate arrangements are made prior to the visit.
• Durable Medical Equipment (i.e. splints, walking boots, etc.): Some durable medical equipment (supplies) are not payable by your insurance carrier. Most of these items will be identified and collected when dispensed. Others will go toward a patient deductible leaving the supply cost as the patient responsibility. We have no way of knowing the language in all insurance plans. In the event you are given a supply and it is denied by your insurance company, we regret that we will be unable to take back the medical supply and refund your money. If you prefer, notify the staff at check-out and ask that we call the insurance company while you are in the office for payment clarification.
• Work Related Injury: If we are not aware prior to your patient visit that you were injured on the job, we will need to reschedule your appointment until we can get approval by your workers’ compensation carrier to see you as a work related injury. A first report of injury will need to be completed by your employer and prior approval by the insurance carrier is required.
• Surgery Payment:
  • Insured Patients: A surgery deposit will be collected prior to your surgery.
  • Self-Pay Patients: A 50% discount is given off of billed charges if paid PRIOR to surgery. If not paid prior to surgery, you will be responsible for the billed charges. Payment arrangements can be made for up to 4 equal monthly payments.

Self-Pay Policy

Payment is due at the time of service. If you have any questions, please call the billing department and Becky or Tiffani will be happy to assist you:

• Becky (214) 222-6616
• Tiffani (214) 222-6612

For your convenience, we also offer Care Credit.

Prescriptions are filled during office hours only. You can request a medication refill by contacting our office at 972-420-1776 or by contacting your pharmacy.

We require all refill requests to be called in prior to 4:00 P.M. Monday – Thursday and 3:00 P.M. on Friday. Any requests after these times are subject to being refilled the next business day. A change in medication or dosage may require a follow-up visit with your physician.

Where can I get my medical records?

NEW MEDICAL RECORDS REQUEST

A Medical Records Release Form must be completed.  This can be done in two ways:

• In Office:  Request a Medical Release Form from the front office staff.  You can complete the form in-office and asked that it be given to the medical records department or fax the completed form back to 214.222.6660.  NOTE:  It takes 3 – 7 business days to complete your request.
• Website:  This form can be downloaded from our website under the Patient Resources Section.  Click on Patient Forms and go the General section.  By clicking on Forms in this section, you will see the Medical Records Release Form.  Print out the form, complete it and either drop it by the office or fax it to 214.222.6660. 

FOLLOW-UP OF PREVIOUSLY REQUESTED MEDICAL RECORDS

To follow up on the status of a request previously made, please contact HealthMark Group directly at 800-659-4035, or email them at status@healthmark-group.com

We send most record requests to HealthMark Group. It takes 3-7 business days to complete, no matter if records are mailed or picked up in our office. Please note on the form how you want to receive your records. If we are sending records to a doctor’s office, please include their address, phone and fax #s – plus your appointment date.

How long will it take to obtain my records?

The Texas State Board of Medical Examiners governs the laws regarding medical records and the release of those records. Medical Records Chapter 165.2 states (b) Deadline for Release of Records. The requested copies of medical and/or billing records or a summary or narrative of the records shall be furnished by the physician within 15 business days after the date of receipt of the request and reasonable fees for furnishing the information.

Although the Texas State Board of Medical Examiners allows a medical facility 15-days to release records, it is our policy to make every effort to release records in 3-7 business days.

Is there a charge for my medical records?

Texas State Board of Medical Examiners

165.2 Medical Record Release and Charge

(e) Allowable Charges.

(1) The physician responding to a request for such information shall be entitled to receive a reasonable, cost-based fee for providing the requested information. A reasonable fee shall be a charge of no more than $25 for the first twenty pages and $ .50 per page for every copy thereafter. If an affidavit is requested, certifying that the information is a true and correct copy of the records, a reasonable fee of up to $15 may be charged for executing the affidavit. A physician may charge separate fees for medical billing records requested. The fee may not include costs associated with searching for and retrieving the requested information.

It is our office policy to furnish the first copy of the medical record to our patients free of charge. Each additional copy is charged at the rate defined by the Texas State Board of Medical Examiners.

Are all my records available?

Only the records created by this office and tests ordered by your physician at Orthopedic Associates will be provided. You will need to contact your primary care physician, other doctor or testing facility for any records or tests that were not ordered by our physicians.

What if my records are from several years ago?

Medical State Board of Medical Examiners

165.1 Medical Records

(b) Maintenance of Medical Records

(1) A licensed physician shall maintain adequate medical records of a patient for a minimum of seven years from the anniversary date of the date of the last treatment by the physician.

(2) If a patient was younger than 18 years of age when last treated by the physician, the medical records of the patient shall be maintained by the physician until the patient reaches age 21 or for seven years from the date of the last treatment, whichever is longer.

We maintain all required records. It may be necessary to retrieve some records from our archives; therefore, it may require more time to handle your request. In these special circumstances, we ask for your patience; however, we will continue to make every effort to fulfill your request within 10 working days.

Is a Release for Medical Records form necessary?

Yes, you will need to complete and sign a Release for medical records. This is a HIPAA requirement and necessary for the release of all records. For your convenience, you may print out the Release form and mail it or drop it off at the office.

Who retains ownership of the MRI records?

Legally we are bound by law to obtain your MRI and your x-ray images as part of your medical record. If you would like a copy of your MRI or x-ray images, please call 214.222.6658 and ask a member of the x-ray staff to make you a copy of your images.

Who may pick up my records?

Only the patient and parties listed on the HIPAA form (which was previously completed by you) will be eligible to pick up records. If you have any questions, please contact our office.

If my child is over the age of 18, am I entitled to the medical records?

Any person over the age of 18 is legally considered an adult regardless of whether the child lives at home with you or at school. As long as your child listed your name on the HIPAA form, you will be able to obtain the medical record.

After Hours Policy

We have physician on call for emergencies 24 hours per day, 7 days a week. If you are experiencing an emergency, call 911 or go to the nearest emergency room. If you are not experiencing an emergency but feel you need to leave a message for a doctor or staff member, call 972-420-1776 and the answering service will assist you.

Elderly Relatives Policy

Our office policy requires a caregiver to remain with an elderly patient during his/her office visit. If a patient is brought to the office via ambulance or transport service, a caregiver is still required to attend the appointment. This policy allows explanation of the treatment plan and ensures the welfare of the patient.

Underage Children Policy

A parent or legal guardian must accompany children and young adults under the age of 18 to his/her appointment.

Disability/FMLA Paperwork

Please allow 7 – 10 working days for your form to be completed. There is a $15.00 charge for the completion of a disability form.

MRI Results

MRI images are sent digitally from our office directly to the radiologist. The radiologist reads the images and sends a written report back to your physician within 48 hours. When scheduling the MRI the medical assistant will inform you whether you will be reached by telephone or ask you to make a follow-up appointment to obtain your results.