Patient Information
Appointment Scheduling
Appointments can be made or canceled by calling (814) 443-1281. When making your initial appointment, it is important to give the scheduler adequate details of your condition so that we can properly schedule your first visit to the office. Please notify the scheduler of all diagnostic testing you have had done pertinent to the reason for your appointment. You will be asked to bring these test results and x-ray films with you. Please be sure to bring photo identification and your insurance information to your appointment.
When scheduling follow-up appointments, please call as far ahead as possible as we cannot always guarantee available appointment slots.
Our office has several providers seeing patients at one time. Each provider sees their patients in the order they are scheduled.
While emergencies do sometimes occur which demand our immediate attention and delay our schedules, we do our best to see each patient at the appointed time. We know your time is valuable. If you cannot keep your scheduled appointment, we would appreciate your notifying us at least 24 hours in advance to reschedule so that someone else can be treated during that time. Repeatedly missing appointments without notifying our office of the need to reschedule may cause dismissal from the practice. Please note that arriving late for your appointment will cause us to have to reschedule the appointment.
Office Hours
Our regular business hours are:
Monday-Thursday 7:30 a.m. to 4 p.m.
Friday 7:30 a.m. to 2 p.m.
Emergencies And After Hours Contact Information
If you have a true medical emergency, please call 911 or report to the nearest emergency room. We advise that if you are having uncontrolled pain that you go to the nearest emergency room. If you have an urgent need to speak with a physician after normal business hours, you may call the hospital at (814) 443-5000 and have the operator page the physician on call for the practice. For all non-urgent calls and prescription renewals, please contact our office during regular business hours when your chart is readily available to the provider to review. Prescription renewals requested at other times will not be filled.
Prescription Refills
If you need a refill on your prescription, please call our office at (814) 443-1281 during regular business hours, choose the prescription refill option and leave a message for the physician assistant. Be sure to notify our office at least 24 to 48 hours prior to needing a refill on your prescription. Prescriptions will only be refilled during normal office hours when your chart is readily available to the provider.
Billing Information
Payment Policy -- Co-pays and other payments for services being rendered are due upon check-in. Failure to make these payments upon check-in will result in the need to reschedule your appointment unless prior arrangements have been approved by our office. Our office accepts cash, checks, credit cards and debit cards in the form of Mastercard, Visa, American Express and Discover. As part of your new patient packet, you will be asked to sign and date a Patient Financial Obligation Policy which will be placed in your chart and a copy given to you.
Health Insurance -- Our practice participates with a large number of health insurance carriers, each with its own rules and regulation. It is your responsibility to supply our office with correct and complete insurance information. It is also your responsibility for knowing about referrals, co-pays, and other administrative issues relating to payment for services. If you are unsure if a service will be covered, you will need to contact your insurance company prior to your visit to our office.
Below is some information about specific insurance carriers.
UPMC For Life: In addition to your specialist co-pay, there is an additional $15 co-pay per x-ray taken in our office.
Managed Care: All managed care patients must obtain a valid referral from their primary care practitioner prior to receiving services, except for those services that can be accessed by self-referral. If you do not have your referral, your appointment will need to be rescheduled. Co-pays are expected upon check-in; please refer to our payment policy for further information.
Blue Shield and Commercial Insurance: Many commercial plans do not cover office visits, so payment is expected at the time of service. One exception is if you have PA Blue Shield with Major Medical. With this coverage, we will bill Blue Shield and you will be responsible for the portion they do not pay.
Supplemental and Secondary Insurance: Please inform our office staff upon registration if you have a supplemental insurance or a secondary insurance. We will need to copy these insurance cards along with your primary insurance.
Self-Pay Patients -- Self-pay patients are required to bring a $75 deposit which will be taken upon check-in. The remaining balance for services rendered will be due upon check-out unless prior arrangements have been made with our practice. Uninsured, self-pay patients receive a time of service cash discount for payment in full provided the same day as services rendered. Discounted fees are based on the current year Medicare Fee Schedule allowable amount rounded to the nearest whole dollar. To be eligible for discounted rate, payment in full is required at the time of service, and Somerset Orthopaedics, Inc. will not file a claim with any insurer.
Workers' Compensation -- If your injury is work related, you will be required to complete a worker’s compensation injury form. This form requires you to supply the following information: your employer’s name, worker’s comp insurance carrier, the claim number, the date of injury and the date your employer was notified of the injury. This information must be available at the time of your appointment or prior to your appointment in order for you to be seen. You need to obtain this information from your place of employment. If the information is not available upon your arrival to our office, your appointment will need to be rescheduled. As is usual in our practice, you will be asked to supply us with a copy of your regular health insurance card for your chart.
Automobile Accidents -- If your injury is due to an automobile accident, you will be asked to fill out an auto injury form. This form requires you to supply the following information: date of your accident, the claim number, the name, address and phone number of the insurance carrier and adjuster. As is usual in our practice, you will be asked to supply us with a copy of your regular health insurance card for your chart.
Billing For Medical Equipment -- It is our experience that many insurances do not pay for orthopaedic devices (braces, splints, etc.). We contract with a private company to provide devices in our office. If an orthopaedic device is given to you at your appointment, the outside company will submit a claim to your insurance carrier for the equipment; however, you may receive a bill from them for any balance of uncovered items. If your insurance company requires you to use a specific brace company, please notify us immediately upon being told you need a brace and we will give you a prescription to take to the supplier covered by your insurance carrier.
Insurance Forms -- There is a $5.00 fee for each insurance form that needs to be filled out by our office. Please allow at least three business days for the forms to be filled out from the day they are dropped off. Our staff will automatically mail or fax the forms in when they are completed if they have been paid for up front. A copy of the form will be scanned into your health record. If you are picking the form up, you may be asked to provide photo ID. If you are sending someone else to pick up the form in your place, you must provide a note stating the person’s name who will be picking the form up and that you give them permission to do so. The note must be signed and dated by you and will be scanned into your health record.
Litigation -- We realize that many injuries are associated with legal action. Financial responsibility to the doctor rests with the person who is injured and receives treatment, not with the person who is being sued. Therefore, you are personally responsible for all balances due regardless of the status of legal action. Our practice does not bill third party insurances.
Surgery
If surgery is required, we have a surgery scheduler and patient educator on site who can answer any questions you may have and assist you through the process of scheduling surgery. Patients scheduled for surgery may need to have a preoperative clearance appointment with their family doctor prior to having the surgery performed. In addition to this, patients are screened by our surgery scheduler and may be required to have additional testing such as lab work, EKG, or stress testing done prior to having surgery performed. Patients are required by Somerset Hospital to come back to our office within seven days of the scheduled surgery for a history and physical by the physician assistant and to sign consent forms for surgery.
Somerset Hospital will notify you of what time you need to arrive for your surgery on the day prior to the scheduled surgery. This information is not available to our office any sooner than that.
If you are scheduled for surgery and have a co-pay, co-insurance or deductible, you will need to pay this prior to any elective surgery being performed unless prior arrangements are made with our billing department. As a courtesy to our patients who do not have insurance coverage for services rendered by our office, we offer payment options for surgeries. All uninsured patients must make a $200.00 deposit on the day of your scheduled history and physical exam at our office, which is scheduled prior to your surgical procedure. If you are unable to make the deposit and your condition is not medically urgent, you will be required to reschedule your procedure.
Confidentiality
As a new patient, you will be asked to sign our practice HIPAA (confidentiality) statement. Your medical record is completely private. NO information regarding your condition or treatment will be disclosed without your consent. There is a section on the consent form that asks that you list those who you allow our office to communicate with regarding your condition. It is your right to remove any of those listed at any time. Please notify our office immediately in writing if this is requested. We understand that medical information about you and your health is personal. We are committed to protecting health information about you. Please review the Notice of Privacy Practice and how medical information about you may be used and disclosed and how you can get access to this information.
Requests to release protected health information to include insurance forms, test results, x-rays or other health information will be processed within three days. Due to confidentiality issues, you will be asked to pick these up in person. However, if you need to have someone else pick up this information for you, a written note must be provided to our office by you stating your permission to release this information to the individual who will be picking it up. The note must contain your signature and the date. It will be scanned and made a part of your health record.
Contact Information
Somerset Orthopaedics, Inc.
126 E. Church Street, Suite 2100
Somerset, PA 15501
Telephone: (814) 443-1281
Fax: (814) 443-3214
Click here for directions
Wendy Cable, Practice Manager
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Somerset Orthopaedics, Inc.
126 E. Church Street, Suite 2100
Somerset, PA 15501
Telephone: (814) 443-1281
Fax: (814) 443-3214
Regular Business Hours
