Forms, Office Policies and Accepted Insurance
Patient Information Forms...
In order to
your visit less time consuming, we ask that you fill out the
mailed to you when your appointment was
scheduled. If you did not receive the forms, you may access and print
them from the above Online
Forms link. Please bring the
completed forms with you when you come for your appointment. Filling
out these forms in advance of your appointment will enable us to serve
you better and faster.
Office Financial Policy:
courtesy to our patients, we submit claims to all insurance companies
provided we have complete and accurate information. To ensure your
claim is submitted in a timely fashion, please make sure the following
insurance information has been included in your registration process.
It is our commitment to assist you in getting your claim processed, but
it is still your responsibility to ensure that all services rendered by
Strait Orthopedics, on your behalf are paid in full.
Your full name and address
* A copy of your
Complete name, address
& telephone number of insurance company
Secondary insurance, if
* Name and
birth date of the policyholder
* Social Security
Employer's name, address and phone number
Date of work-related
* Name and
address of your
Worker Compensation Carrier Insurance
Co-pays are due at time of service.
Billing statements are mailed once a month unless there is insurance
pending and in that case, you will not receive a statement until we
have been reimbursed by your insurance company. However, if after 60
days we have not received payment from your insurance company, we look
to you, our patient, for assistance in getting your account paid.
We recognize that health care costs can, at times, create a financial
hardship, therefore, we are willing to visit with you to set up a
payment plan to ease the financial burden of satisfying an account
balance. There will be times when we ask you to produce financial
statements to determine a financial hardship. Our billing department
will be happy to assist you and review the details with you.
3. Accepted Insurance Plans
Aetna US Healthcare
Blue Cross Blue Shield
addition, we accept many other insurance plans. We may accept your plan
even if it is not listed here. Please call us to verify if you are
Prescription Refill Policy
your pharmacy for refills and they will fax us your request.
request received after 3:00 pm on Thursdays will not be processed until
the following Monday.