- Foot Surgery
- Fracture Care
- General Orthopaedics
- Hand Surgery
- Joint Replacement
- Pediatric Orthopaedics
- Physical Medicine
- Spine Care
- Sports Medicine
-
OUR PHYSICIANS:
- Kirk D. Clifford, MD
- Mary Beth Deering, MD
- Michael P. Dohm, MD
- Michael Dolecki, MD
- David P. Fisher, MD
- Robert L. Frazho, MD
- James S. Gebhard, MD
- Steven J. Heil, MD
- Michael J. Huang, MD
- Waqqar Khan-Farooqi, MD
- Mark G. Luker, MD
- Jeffrey M. Nakano, MD
- Richard J. Price, MD
- Michael T. Reeder, DO
- Michael D. Rooks, MD
- James K. Weaver, MD
- Thea A. Wojtkowski, MD
Rights regarding insurance pre-authorization and grievance procedures
Patients Quick Links
FOR PATIENTS: Insurance and Billing
Rocky Mountain Orthopaedic Associates will help in any way we can with your insurance requirements, physician referrals and payment for services. Please click on any of the links below for information.
- Insurance Plans That We Participate In
- Other Insurance Plans
- Co-pays and Deductibles
- Medical Discount Card Plans
- Referrals and Preauthorizations
- EOB's and Statements
- Billing Problems and MEDICARE Compliance
- Payment Plans
- Refunds
Insurance Plans That We Participate In
All of our physicians participate with MEDICARE, MEDICAID, and many private insurance plans (see plan list below - as of October 1, 2002 ). We will bill these insurance companies on your behalf and make every effort to resolve any billing problems that arise. Not every physician in our group participates with every plan listed. Our reception staff will be happy to provide you with more information when you call for an appointment.
PLEASE NOTE: Insurance plan contracts change frequently and it is possible that this list may not be 100% accurate. We try to update our website regularly, but it is always best to confirm that we participate with your insurance when making your appointment.
- Aetna
- Affordable Medical Networks
- America’s Health Plan
- Anthem BCBS of CO
- Assurant (Sloans Lake)
- Beech Street
- Champus/Tricare
- ChampVA
- ChoiceCare
- ChoiceNet
- CHP+ (through RMHP only)
- CIGNA
- CNIC
- Cofinity
- Colorado Contractors Trust
- Colorado Division of Vocational Rehab
- Concentra
- Coventry
- Definity Health
- First Health
- GEHA
- Great West
- Hartford
- HMO of CO
- Humana Employers Health
- Intercare
- Medicaid
- Medicare
- Metra Health
- Mountain Medical Affiliates (MMA)
- One Healthcare Plan
- Pacificare
- Primera
- Principal
- QMC3
- RailRoad Medicare
- Rio Grande Hospital Assoc
- Rocky Mountain Health Plans
- Secure Horizons
- Sisters of Charity
- Sloans Lake
- United Healthcare
- USA Managed Care
- U.S. Life
- Washington State Workers Comp
- Wausau
There are also many insurance plans that we do not contract with to be plan
providers. This may be because of unacceptable contract provisions, insufficient
"covered lives" in our service area, or it may be an "open plan" that does not
contract for services. As a courtesy to our patients, we will still bill these
insurance carriers on your behalf. However, if the insurance company does not respond
to the bill in a timely manner (60 days from the time the bill is properly
submitted), we will contact you for payment and provide you with the necessary
information to seek reimbursement from the insurance company.
Return to top
Many insurance plans require that we collect co-pays and/or deductibles from the
patient. By law we cannot waive these fees. MEDICARE has enacted tough penalties for
providers who do not make a diligent effort to collect these payments from the
patient.
Return to top
RMOA does not participate with any of the "Medical Discount Card" plans. Members
of any of these plans are personally responsible for payment at time of service. We
will provide you with copies of your bill to submit to the plan yourself.
Return to top
Referrals andPreauthorizations
Many private insurance plans require referrals and/or preauthorizations for some
types of services. Because of the multitude and complexity of plans, our office may
not be aware of the requirements of your particular health plan. We strongly advise
that you read your plan materials or consult with the plan's customer service
department to determine if there are any special requirements. If you do not
get the necessary referrals or preauthorization, the insurance company will often
refuse to pay the bill and you will be responsible for payment. In some cases it may
be necessary to reschedule your appointment until the required referral or
preauthorization is obtained. We will be glad to assist you in obtaining
these items and answering any questions that we can.
Return to top
In most cases you will receive an EOB (Explanation of Benefits) from your insurance carrier outlining what was billed and what was paid. The EOB should also provide an explanation of any amounts that you owe. There are many different formats and codes used by the various insurance companies. If you have questions regarding the information contained on your EOB, it is usually best to call the member services department at the insurance company. If you have questions about the services shown on the EOB, please call our billing department.
If you would like an itemized statement for your records we will be happy to provide you one on request.
If there are unpaid balances on your account, you should receive a statement from
us, even if we are billing your insurance company. Items pending from the insurance
company will show on your bill, but should indicate that we are waiting for payment
from them. If you have questions about your statement, please contact our billing
department.
Return to top
Billing Problems and MEDICARE Compliance
It is the policy of our organization and each of the physicians to comply with MEDICARE guidelines and other federal/state regulations regarding the provision of services and billing.
If you notice any discrepancy on your bill (such as an item or service that has
been billed that you did not receive) please contact our billing department as soon
as possible. If the problem is not resolved, please contact our operations manager or
CEO.
Return to top
If you are uninsured or are responsible for a portion of your bill, you will be
expected to make payment at the time of service. If you cannot pay for your care at
the time of your visit, please contact our billing office prior to
your appointment to determine if you qualify for a deferred payment plan. Our staff
will work with you to arrange a reasonable payment schedule for the services you
require.
Return to top
In the event that an overpayment or duplicate payment is made, we will make a
refund to the patient or insurance company as soon as possible (normally within 5
business days).
Return to top