Patient Financial Policy FAQ

Thank you for choosing Optim Healthcare. We are committed to the success of your medical treatment and care. Please understand that payment of your bill is part of this treatment and care.

For your convenience, we have answered a variety of commonly-asked financial policy questions. If you need further information about any of these policies, please ask to speak with a billing specialist or a billing manager.

 

Q: What are my payment options?

A: We accept payment by cash, check, VISA, MasterCard, and Discover. A photo ID or two other forms of ID is required for all third-party checks. We do not accept post-dated checks.

 

Q: Do I need a referral?

A: If you have an HMP plan with which we are contracted, you need a referral authorization from your primary care physician. Our staff will inititate the request for a referral. If we have not received an authorization prior to your arrival at the office, you will be rescheduled or you may sign a waiver which states that you will be financially responsible for all services required.

 

Q: Which plans are contracted with Optim?

A: See list below

  • Aetna
  • Ambetter
  • Amerigroup
  • BCBS PPO, HMO, POS
  • Cigna
  • Conventry
  • GA Medicaid
  • Medicare
  • Peach State
  • The Care Network
  • Tricare Standard
  • Tricare Prime
  • United Healthcare

Our patients are responsible for verifying our participation in their insurance plan. Plan contracts with Optim Orthopedics are subject to change at any time and without notice.

 

Q: What if I need surgery?

A: If your physician recommends surgery, you will be escorted to his Medical Assistant (MA). The MA will answer specific questions about the surgery scheduling process.

The MA will refer individuals who only have one insurance policy or do not have insurance coverage to our billing department. The Surgical Financial Specialist will request a pre-surgical deposit, the amount of which depends on the cost of the proposed surgical procedure, co-insurance payment, and/or unmet deductibles. You will also be required to pay any outstanding balances prior to having your procedure. A cost estimate which shows your financial responsibility will be explained by the billing specialist and given to you for your records.

 

Q: What if my child needs to see the physician?

A: A parent or legal guardian must accompany patients who are minors on the patient’s first visit. The accompanying adult is responsible for payment of the amount, according to the policy outlined under “What is my financial responsibility for services.”

 

Q: What if I’ve been involved in an accident?

A: We will file either your auto med-pay insurance or health insurance coverage as primary if your plan is listed under the “Which plans are contracted with Optim.” If you choose to have us file your claims under a TPL/MVA policy, we will file any health insurance as secondary once the med-pay benefits have been exhausted. You will be required to pay $350.00 prior to being seen. This excluded Medicare patients as we are required to file auto med-pay and third-party liability policies before submitting the claim to Medicare.

 

Q: What is my financial responsibility for services?

A: Your financial responsibility depends on a variety of factors, explained below. Please contact our billing department at 912.644.5353 if you have any questions.

Download the Patient Financial Policy