Fees and Insurance

(Updated 5/22/2008)

I. General Introduction

II. Quick Reference

A. “In Network” Plans
B. “Out of Network” Plans
C. Government Plans
D. Cash Paying Plan

III. Types of Plans

A. HMO
B. PPO
C. Indemnity plans
D. Health Savings Accounts
E. Government plans

IV.Explanation of Fees

A. “In network” vs. “out of network”
B. Conditions for standard fee schedule
C. Conditions for discounted prepayment fee schedule
D. Payment options “out of network”
E. Full fee schedule

V.Global Prepayment Option

VI.Cost of Joint Replacement and Cost Shifting

VII.Contracted Insurance Plans ( “In Network Plans”)

VIII.CPT Codes