Patient Forms

Insurances 

We are formally participating physicians with:

• Medicare & most Medicare HMO
• Medicaid & most Medicaid HMO’s
• BCBS of Michigan
• Blue Care Network
• Aetna/Cofinity
• Tribal Insurance
• Priority Health
• Tricare Automobile & Workman’s Compensation

Payments

The patient is responsible for payment regarding medical services rendered including automotive, Workmens Compensation and liability claims.

To better assist you, please provide us with:

• Insurance Carrier Name and Address
• Insurance Adjustor’s Name and Address
• Valid Claim Number

It is our policy to only bill insurance carriers or the patient. Claims denied become the patient’s financial responsibility.

Co-Pays and Deductibles

Co-pays and deductibles are due at the time services are rendered. Non-insured patients are offered a 10% discount for a full payment at the time services are rendered.

Patient Education 

Orthopaedic Links

• American Academy of Orthopaedic Surgeons: Ortho Info