Payment and Insurance

Our office participates with most commercial insurance plans, including, but not limited to, Aetna, BlueCross, Cigna, Meritain, MCA, UMR, and United Healthcare.  We make every effort to verify your eligibility and coverage prior to your visit; however, if your carrier denies payment of your claim due to lack of eligibility or for any other reason, the charges incurred will be your responsibility to pay.

We have voluntarily opted out of all government payers, but see many Medicare and Tricare patients on a private, fee-for-service basis.  Also, we gladly accept self-pay patients and workers’ compensation cases from Tennessee, Virginia, and many other states.

The patient’s portion of payments is due on the date of service (including, co-pays, co-insurance, and deductibles) and may be paid by cash, check, Visa, or MasterCard.  Returned checks are subject to a $40 fee.  For patients who are unable to pay their entire balance on the date of service, Care Credit and Parasail offer extended payment plans.

Carecredit and Parasail Financing

 

Further Information for Commercial Insurance Patients

It is YOUR responsibility to know your insurance benefits. You are given an insurance membership handbook and ID card at the time you become a participating member of your insurance plan. You need to look in your handbook for the following important information that affects your personal financial responsibility:

In-Network Provider; Specialist Co-Pay Amount; Individual and Family Deductible Amounts; Benefits for Routine Examination; Pre-Existing Waiting Periods

We collect all co-pays, co-insurance, and deductibles at each visit.  When surgery is necessary, your account balance must be paid-in-full and we will collect a pre-pay for the amount that is estimated to be the patient responsibility BEFORE the surgery is scheduled. Credit balances will be promptly refunded upon completion of your treatment.

Further Information for Medicare Patients

Since 2005, our office has chosen not to participate in Medicare Part B physician services. We welcome and treat many patients with Medicare on a fee-for-service basis, since neither the patient nor Trinity Hand Specialists can legally file the claim. Before you first visit, and annually thereafter, the government requires that you have a completed Medicare Private Contract on file with us. You may download this document from the Forms section of this website or request a copy from the receptionist.

Our Medicare patients are pleased to receive specialty care at Trinity Hand Specialists for their hand and wrist conditions. Because the care rendered is through a private contract, we can provide services not covered by Medicare, and Dr. Gorman will see you himself – spending ample time to examine you, explaining your problem and associated treatment options, and answering your questions.

Medicare Part A benefits may still be used for more costly outpatient surgery center and laboratory/testing services. Also, many patients have commercial insurance that can be used as the primary payer for physician services because we have opted-out of Medicare.

Please call to speak with a member of our staff if you need additional information or to schedule an appointment.

Further Information for Self-Pay Patients

Not everyone has insurance and, for various reasons, those who do sometimes prefer to be seen on a self-pay basis. Our office is committed to offering exceptional hand specialty care at a great value, and self-pay patients are always welcome. Not all surgeries can be done in-office, but for those that can, the availability of this option makes Trinity Hand Specialists a great choice.

Please call to speak with a member of our staff if you need additional information or to schedule an appointment.

About Our Fees

Your fee is based on the time we spend with you during your visit, the complexity of your medical condition, and/or any treatment that we provide. Proper attention to your care also requires that we spend much additional time beyond that which we spend with you in the office. Some of the things we may do for you are:

  • Verify your insurance eligibility – this can take a great deal of time on the phone with some companies
  • Create and maintain your permanent medical record
  • Review, interpret, and document all prior medical records, x-rays, MRI and other scans, and lab results relevant to your care and communicate those results – orally or in writing – to you and/or your referring physician
  • Scheduling surgery – also a time-consuming process, since we must coordinate your, our, and the surgery center’s schedules
  • Complete insurance applications, forms, claims, and short-term disability forms
  • Draft letters of necessity to obtain medical services, instruments, or prescriptions that you need
  • Fill out other reports and forms relevant to your care and that your insurance company might need to authorize your treatment
  • Consult via phone about your case with referring or consulting physicians and hand therapists
  • Prepare referral letters and arrange appointments to additional specialists, as needed
  • Complete return-to-work forms
  • Prepare patient educational materials
  • Communicate with pharmacies about your prescriptions
  • Conduct utilization review and re-credentialing negotiations with hospitals and insurance companies

All of these activities add significantly to our cost of doing business; however, we are committed to providing you with the best in value-added care. Hopefully, this explanation of our fees has been helpful and has given you some insight to all that goes on “behind-the-scenes” to achieve optimal results and satisfaction for our patients.