Insurance Info

Insurance

Below is the list of current insurance companies Longview Orthopedic Associates is contracted with. Please contact your insurance company for further information as it is the patient’s or guardian’s responsibility to know their insurance benefits, coverage and if they are being treated at an office in network with their insurance plan.

  • AARP
  • Aetna (Commercial and Medicare)
  • Care Oregon
  • Cigna (Commercial and Medicare)
  • Coordinated Care
  • Dept. of Labor and Industries
  • DSHS (WA Medicaid)
  • First Choice
  • Heath Net (Commercial and Medicare)
  • HMA
  • Humana (Commercial and Medicare)
  • Kaiser Permanente
  • Lifewise
  • Medicare and Railroad Medicare
  • Moda (Connexus Network)
    • NOT Synergy Network
    • NOT Beacon Network
  • Molina
  • OMAP (Oregon Medicaid)
  • Pacific Source (NOT the Legacy Health Network)
  • Premera Blue Cross
  • Providence (Commercial and Medicare)
  • Regence Blue Cross Blue Shield
  • Tricare
  • TriWest
  • UMR
  • US Dept. of Labor
  • United Healthcare (Commercial, Medicare, and Community Care)
  • Worker’s Comp. (Self-funded and L&I)
  • And other Misc. Insurances

Medicaid

Longview Orthopedic Associates requires a referral to be seen in our office as well as verified active insurance coverage at each visit. If we cannot confirm eligibility at the time of the appointment, you will be considered "Self Pay" and expected to bring a $100 deposit to your appointment and at that time meet with our billing department to discuss a payment plan. If you become eligible and or reinstated for that date of service we will then bill your insurance and refund you the amount you have paid out of pocket.

Insurance

THIRD PARTY CLAIMS: Longview Orthopedic Associates does not bill third party claims.

HMO PLANS: A referral is required from your primary care physician prior to each appointment and procedure. If we do not have a referral at the time of the appointment, you will be asked to reschedule or sign a waiver stating you will be responsible for all charges incurred during your visit.

WORKERS’ COMPENSATION: It is your responsibility to inform Longview Orthopedic Associates that the visit is for a work-related injury and will also need to provide your date of injury, employer name, claim number, claims manger's name, phone number and fax number. This is to your benefit so that we can get you treated in a timely manner and bill appropriately. If the claim is DENIED or CLOSED or if you fail to inform Longview Orthopedic Associates of the work-related nature of your medical problem, including appropriate claim information, you will be responsible for all charges.

PRIVATE PAY: Please see self pay requirements below and contact billing department prior to your visit in order to establish a payment agreement. Longview Orthopedic Associates can also give you information on Care Credit to help with payments for your medical services, please contact us for more information.

  • A $100 deposit is required prior to the New Visit to Longview Orthopedic Associates if you pay by cash, check, or credit/ debit card.
  • Longview Orthopedic Associates makes every effort to include all visit-related charges by the end of the visit for private pay patients. However, the charges are an estimate, and you may receive a bill for any remaining charges by statement.

CO-PAY: Copayment is due at the time of service.

  • Co-Pay: A flat rate applied to office visits and/or procedures pre determined by your health plan.

DEDUCTIBLE & COINSURANCE: You will receive a monthly statement showing itemized charges and the current amount due on your account. Payment in full is required within 60 days of the date on your statement. If you are unable to make payment in full within the 60-day period, you must notify the Longview Orthopedic Associates Business Office and make payment arrangements or utilize the Care Credit plan if you are unable to make the payment due in full.  Each statement will detail this information as well as the payment plan options. 

  • Deductible: The amount you must pay for services out of pocket to your provider before your insurance will begin to pay for your claims. This is outlined in your insurance plan.
  • Coinsurance: A percentage amount for which you are responsible for per visit or procedure. This is also outlined in your insurance plan.

AUTHORIZATION: Longview Orthopedic Associates will make every effort to pre-authorize services. However, in the event that prior authorization is not received, you will be responsible for the charges. It is the patient’s or guardian’s responsibility to know the benefit coverage, as well as to make sure there is a prior authorization in place prior to receiving care if needed.

REFERRALS: Longview Orthopedic Associates requires a referral from your primary care physician for certain insurance plans. However, in the event that a referral is not received and the insurance requires it, or you have not established care with your PCP, you will be responsible for the charges. It is the patient’s or guardian’s responsibility to know their benefit coverage, as well as to make sure there is a referral in place prior to receiving care. If you have a coinsurance and/or a deductible balance as determined by your insurance plan, Longview Orthopedic Associates will send you a statement after your claim has been processed with the insurance. You are required to pay this balance in full to Longview Orthopedic Associates.

DURABLE MEDICAL EQUIPMENT: Medical products may be recommended and/or dispensed to assist you with the healing process. In some instances, you will be required to pay at the time of your visit for non-covered DME. For insurance covered items, Longview Orthopedic Associates will bill your insurance as a courtesy; however, you will be responsible to pay for any amount not covered by your insurance. Some items may be billed through an external DME company.

SURGERY:In the event you require surgery or a procedure, our office will work diligently to get a pre-authorization prior to scheduling. A cost estimate is available upon request. In the event you undergo a surgery or procedure at a facility other than Longview Orthopedic Associates, you will be responsible for three separate billings. One from the facility where the procedure took place. The second, from the anesthesiologist that provided anesthesia during your procedure. The third would be from our Physician at (Longview Orthopedic Associates) for performing the procedure. Most surgeries include a 10, 60, or 90-day global period, meaning the related post-operative visit(s) will not be billed, as it is included in the global package. Anything additional will be billed to the insurance company and applied to your benefits at that time of service. (X-rays, Casting, DME,  injections, ect.)

RADIOLOGY: In the event you require an MRI, you may be responsible for two separate bills, one from the facility where the MRI took place, and the second from the radiologist that provided the interpretation of the MRI.

FORM COMPLETION: If you require a form be completed by your provider, a $15 fee will be due at the time the form is submitted to our office. Form completion turn around time is 7–10 business days.

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