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Thank you for choosing Dr. Carl Talmo. We believe that good care starts with good communication. We have created this policy to help our patients understand the responsibilities that they have for payment of our fees. If at any time you have questions or problems with our fee or payment process, please do not hesitate to contact our Billing Department by phone at 800-927-0002.

CO-PAYMENTS

Your insurance plan determines your co-pay amount and they require that we collect your designated co-payment at the time of service. Please be prepared to pay the co-payment at each visit. Failure to pay co-payments upon check-in may result in non-emergent appointments being rescheduled.

REFERRALS

If you are a member of an HMO, it is mandatory that you get a referral from your Primary Care Physician to see a specialist, have injections/procedures, and have x-rays. Your insurance company will not pay for the visit without a referral. Please call your primary care physician in advance to ask for a referral. If possible, try to get a referral for multiple visits so you do not have to repeat this process every time you come to the office. If a referral has not been obtained and the claim is denied, you will be responsible for payment in full. If you do not have a referral at the time of your visit, you will be required to put a card on file. If the required referral is still not received, you will then be responsible for payment and the credit on file will be charged.

INSURANCE

Your health insurance policy is a contract between you and your Health Insurance Company or employer. It is important for you to be an informed consumer, who understands the specifications of your insurance policy (e.g., doctor visit coverage, referral/authorization requirements, radiographs, durable medical equipment, etc). If you are uncertain about your current health insurance policy benefits you should contact your plan to learn the details about your benefits, out-of-pocket fees and coverage limits. Dr.Talmo belong to many insurance plans. Before your appointment, please be sure your in-network and the services are covered under your plan. If your the doctor is out-of-network, you will be billed for the cost of care. As a courtesy to you, we will bill your insurance company directly for medical service rendered. If problems arise regarding coverage issues, we will attempt to work with your insurance company to help resolve them prior to making it your responsibility. However, please be advised that you are ultimately financially responsible for payment of medical services rendered by this office. If we receive payment at a later date, you will be reimbursed. If we contact your insurance carrier regarding benefits or authorization on your behalf, we are not responsible for inaccurate information provided to us by your carrier. The information about your plan that we relay to you is in good faith.

FAILURE TO PAY

We expect that each charge will be paid in full the first time it is presented to you. Once your insurance carrier processes your claim, we will bill you for any remaining patient responsibility deemed by your insurance carrier. For the most up to date balance information. Past due amounts may hinder your ability to have appointments scheduled and could result in possible dismissal from the practice. If you cannot pay in full we request that you contact our Billing Department to arrange an acceptable payment plan. Any balance over 90 days, without prior arrangements, may be sent to our collection agency. If you have a documented financial hardship, please contact our Billing Department. In every effort to assist you with meeting your obligations, we offer many payment options. We accept all major credit cards.

WORKERS COMPENSATION

Charges for services incurred as a result of a verified work-related injury will be treated as worker’s compensation, and we will bill the workers’ compensation carrier as a courtesy to you. You must provide us your date of injury, claim number, and case manager’s name and telephone number before making an appointment. If you make an appointment using your private health insurance and inform us at the time of the appointment that it is workers comp, we reserve the right to cancel your appointment until the claim can be verified.

Related Links

  • American Academy of Orthopaedic Surgeons
  • New England Orthopedic Society
  • aahks
  • North Atlantic Surgical Suites
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