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What should I know about how my insurance is processed?

We must have complete and accurate information to file claims for you.  Please be prepared to present your insurance card whenever asked by our staff.

Please note that even if your insurance company is "In Network" with our physicians, you should also check to see if Roanoke Memorial Hospital is "In Network", as all of our physicians do their surgeries there.  If Roanoke Memorial Hospital is not In Network, you should check for "Out of Network Benefits" to reduce your total out of pocket payment.

  • Copays     You are responsible for paying copays on the day you receive services.  Copay amounts vary by insurance plan and group contracts.  If you are unsure about your copay amount, contact your insurance company to find out what portion, if any, you will be responsible for.
  • Referrals  HMO's, PPO's and other types of managed care plans require authorization from your primary care physician to receive services from a specialist.  You are required to obtain a referral, if required by your insurance plan, and bring that referral with you at the time of your visit.  If a referral is not obtained, your insurance company may pay less (or not pay at all) on the claim, increasing the amount of your "out of pocket" expense.
  • Workers' Compensation     When you provide verification of injury from your employer, we will file workers' compensation claims for you.  Therefore, you must bring the name of the insurance company handling the claim, the address of that company, name of the contact person, telephone number, claim number and the date of injury.  Your appointment will be rescheduled until this information is obtained.
  • Auto Insurance/Other Litigation or Liability     We do NOT bill auto insurance or other insurance companies under litigation.  You are responsible for prompt payment of all bills no matter fault, settlement or recovery.  Therefore, you MUST present your regular health plan card information.  You may receive an itemized statement for services rendered which YOU can submit to your auto insurance company for reimbursement.
  • "Self-Pay"     If you have no insurance, we do accept "self-pay patients".  Currently our fee for an initial office visit is $185.00, which is payable prior to your office visit.  This $185.00 is subject to change.
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