FARMINGTON VALLEY ORTHOPEDIC ASSOCIATES, P.C.

860.677.0079

FVOA

Patient Information

Insurance Plans

 

Farmington Valley Orthopedic Associates, P.C. participates with most insurance companies, including those listed below.  If you have any questions regarding your plan’s coverage we encourage you to contact your insurance plan or agent directly for a complete list of benefits and services covered.

 

Aetna

Anthem Blue Cross Blue Shield

Cigna

ConnectiCare

Medicare

 

What to bring to your appointment

 

Before your first visit with our office, please fill out the following forms and bring them with you to your appointment.

·   Patient Information Form

·   Medical History Form

·   Summary of Notice of Privacy Practices Form

·   Acknowledgment of Privacy Practices Form

 

Also, please bring along with you to your appointment:

·  Insurance card(s)

·  Photo ID

·  Referral, if required by your insurance carrier.

·  X-ray, MRI, CT Scan reports or medical records pertaining to your injury.

·  Copay

 

* If Worker’s Compensation claim, please bring the following information to your appointment:

 

·  Authorization for treatment

·  Worker’s Comp Carrier Name

·  Billing Address

·  Claim number and date of injury

·  Claim Adjuster’s Name and Phone number

 

Referrals

Many insurance plans require a referral from your primary care doctor prior to treatment by a specialist.  If you are unsure if your insurance requires a referral to see a specialist, please contact your insurance carrier directly.

 

Copays

Insurance copays are collected at the time of service.  We accept MasterCard, Visa, personal checks or cash.

 

Payment Policies

Patients are responsible for all balances not paid by their insurance

company.  Balances are due upon receipt. If you require a special arrangement, please contact our office and ask for the billing department.  We accept MasterCard, Visa, personal checks or cash. — All returned checks have a processing fee of $30.00.

 

Cancellations

We understand that situations arise in which you must cancel your appointment. It is therefore requested, if you need to cancel your appointment with one of our physicians, we would appreciate at least 24 hours notice. Early cancellations give other patients the opportunity to utilize the available time slot. Please feel free to call our office and we will be happy to reschedule your appointment. Patients who do not show up for their schedule appointments without a call to cancel their appointment will be considered a “no show”. Patients who “no show” 2 or more times may be subject to a $50.00 fee.

 

Disability Forms

All disability forms will be completed within 7-10 business days of receipt. There is a charge to process the non-worker’s compensation forms.

 

Request for Medical Records

If you would like a copy of your medical records, please download our Authorization for Medical Records Release Form.  Once we receive the form it takes approximately 5-7 business days to complete the request.

 

Please note: all x-ray films taken in our office are considered part of your medical record. It is our policy to LOAN ONLY the most recent x-ray films to the patient or the physician on the patient’s behalf with the full understanding that it is the patient’s responsibility to return the loaned films to our office.

Notice of Privacy Practices

Click here for the Notice of Privacy Practices

Emergencies

If you have an orthopedic emergency after hours, please call our office    phone number and our answering service will contact the physician who is on call to assist you. For a serious or life threatening situation, CALL 911 immediately.

 

Prescription Refills

We will be happy to refill appropriate prescriptions that have been originally provided by our office.  However, it is our policy not to fill prescriptions during evenings and weekends.  We do not believe it is good patient care to fill a prescription if the provider does not know the patient or have the medical record at the time of the call.

 

Prescriptions will not be refilled during nights or weekends, therefore please anticipate your medication needs and make arrangements for refills according to the following schedule.

 

Monday – Thursday 9:00 am  – 3:30 pm

Friday 9:00 am – 12:00 pm

 

Prescription refill request called in after 12:00 pm on Friday will not be processed until Monday morning.

 

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  Multiplan

  Northeast Health Direct

  Oxford

  United HealthCare

* Worker’s Compensation

 

LOCATIONS:

34 Dale Road

Suite 208

860.677.0079

100 Hazard Avenue

Suite 205

860.677.0079

18 East Granby Road

First Floor

860.677.0079

620 Norwich-New London Turnpike

860.677.0079

1060 Day Hill Road

Suite 201

860.683.1108