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  • Most insurance plans are welcome. If you are unsure of your insurance benefits, please contact our office and we will be more than happy to contact your insurance company on your behalf. For more information, please call 201.567.5700.
     

    School insurance can be primary or secondary coverage.

     

    Workers’ Compensation Insurance (work-related injuries) requires prior authorization.

     

    Auto medical (PIP) insurance requires pre-certification to facilitate your claims after the first 10 days of injury.

  • To make a secure, contactless payment to Englewood Sports Medicine Orthopaedic Surgery, P.C., please call 201.567.5700 for instructions, while we upgrade our online payment portal. MAKE A PAYMENT.

  •  If your insurance plan requires you to pay a co-payment, co-insurance and/or deductible, it will be necessary to pay at the time of your visit.


     Payment will also be required for all non-covered services. For your convenience we accept cash (preferred), checks, Visa, MasterCard, American Express and Discover. A % charge will be added for credit card use.


     If you do not have insurance, we can arrange a payment plan for you.


     A fee of $30.00 will be charged to your account for returned checks.

  • Please arrive 15 minutes before the scheduled appointment and bring the following:
    Insurance card.
    Driver’s license or picture ID.
    List of current prescriptions and/or over-the-counter medications, including dose and frequency.
    Information about patient’s medical and surgical history.
    Recent test results, including x-rays, MRI’s, CT Scans and the medical reports for each.
    Any questions you may have for the doctor.

    • DOWNLOAD FORM

  • You must also provide:
    Name, address and telephone number of the workers’ compensation insurance carrier.
    Date of accident.
    Workers’ Compensation claim number.

    DOWNLOAD FORM

  • You must also provide:
    Name, address and telephone number of insurance carrier.
    Claim number.
    Attorney name and phone number.

    • DOWNLOAD FORM

  • You must also provide:
    Name, address and telephone number of school’s insurance carrier.
    Injury form provided by the school nurse, coach or trainer.

  • You must also provide:
    Attorney name and phone number.
    Date of accident.

    DOWNLOAD FORM

  • If your insurance plan requires you to pay a co-payment, co-insurance and/or deductible, it will be necessary to pay at the time of your visit.
    Payment will also be required for all non-covered services. For your convenience we accept cash, checks, Visa, MasterCard, American Express and Discover.
    If you do not have insurance, we can arrange a payment plan for you.
    A fee of $30.00 will be charged to your account for returned checks.

  • Medical records requests must be in writing, accompanied by a signed medical release. Allow 5-7 business days for your records to be processed. Payment for copying services will be due prior to the release of medical records. There will be no fee for records sent to another provider office.

    DOWNLOAD FORM

  • If you request copies of your X-rays, allow 24 hours for your request to be honored. A fee of $10.00 per film will be due upon pick-up.

  • Please provide the pharmacy name, phone number and the medication that you are requesting. Upon Physician approval, our staff will refill request within 24 hours.

    DOWNLOAD FORM

  • To comply with federal regulations (HIPAA), our office has established procedures to make your identity and medical records secure. Your personal information is for proper medical treatment and billing purposes only. We must have on file the names of people to whom your medical information may be released (i.e., spouse, son/daughter).

    DOWNLOAD FORM

  • If you are unable to keep your appointment or are going to be delayed, please call our office. As a courtesy, we request that you provide 24-hour notice for cancellations.

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