Fees and Insurance

(Updated 5/22/2008)

II. Quick Reference for Insurance Coverage

C. Government Plans:

I no longer participate with Medicare, Medicaid, Tricare, or workers compensation government plans. This means that if you wish to purchase my services, we must enter into a private contract. The discounted fee schedule (see section IV E ) applies. All fees for surgical services must be paid in advance. Office based services can be paid at the time of service.  Most supplemental Medicare or Medicare replacement policies won’t pay anything to a provider who is opted out of Medicare.

Hospital payments and other services that are not provided directly by my office will still be handled in the usual fashion by Medicare. These costs are typically the largest portion of any surgical procedure.

Example:

My fee for primary hip or knee
replacement including the assistant fee:                    $6000

Hospital fees 20% of approximately $9000:                $1800*

Anesthesiologist, radiologist and
pathologist fees:                                                                 $1250*

Supplemental Medicare policy covers some
Percentage of the $3050  (depends on your policy):    ?

*these are not under my direct control and are therefore estimates.

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