Insurance & Billing

We understand that the insurance and billing process for health care services can be confusing. We will make every effort to work with you and your insurance plan. The information below provides general information and guidelines regarding insurance plans and our billing procedures. Prior to your first visit, you will be asked to review and sign our detailed, financial policy which contains all of the specifics regarding our billing procedures and payment terms.

Insurance Plans

Victory Sports Medicine & Orthopedics participates with most major insurance plans. Below you will find a list of the current insurance companies with which we participate. This list is subject to change so if you do not see your insurance plan listed please contact us at 315-685-7814 to verify if we participate.

Medicare

Medicare will pay 80 percent of Medicare-approved amounts (with the exception of certain services which will be paid at 100 percent of the approved amount). Typically, this leaves 20 percent that must be covered by supplemental insurance or paid by you. In addition, an annual deductible must be satisfied each calendar year, and some Medicare plans have additional co-pays or deductibles that must be paid by the patient. Under federal law, we are not allowed to write off these Medicare expenses.

Workers Compensation

If you have a work injury, please call our office with the date of injury, your employer’s name and workers’ compensation insurance information prior to making your appointment so that we may obtain approval for treatment. You will also need to complete our Workers Comp Injury Report form.

For additional information regarding the Workers Compensation services offered by Victory Sports Medicine & Orthopedics, please click here.

Know Your Benefits

Insurance coverage is an arrangement between you and your insurance company. It is important for you to understand the extent of your health insurance coverage and the responsibilities you have as part of that coverage. Many plans include co-payment and deductible requirements and may have limitations on how you can access services you may sometimes need.

Insurance plans specifically define what services are “covered” (paid for by your insurance carrier) and those that are “not covered” (will not be paid for by your insurance carrier). Dr. Pietropaoli and the health care team at Victory Sports Medicine & Orthopedics recommend treatment based upon the patients medical needs, not their insurance coverage. It is the patients right to choose which treatment they will receive.

We encourage you to review your coverage prior to a visit with the Victory Sports Medicine & Orthopedics. If you have any questions, please contact your health plan’s member services department. They are there to serve you and their number is usually listed on your insurance card and on their website.

Billing Your Insurance

After your appointment is completed, we will send an electronic claim (bill) to your primary insurance plan for services provided. Your insurance plan will then process your claim and mail you an Explanation of Benefits (EOB) summarizing their payment of the claim.

Once we receive payment from your insurance plan,we will then mail you a statement for the balance owed. The amount shown on your statement is the responsibility of the patient or guardian. Your statement summarize the services provided, the date(s), charges,and the amount your insurance carrier paid. Payment is due within ten days of receipt of your statement.

Co-Pays, Co-Insurance and/or Deductibles

You are responsible for paying any co-pay, coinsurance and/or deductible at the time of service. These fees cannot be waived as they exist under the terms of our contract with the participating health plans above.

We accept cash, check, MasterCard, Visa, American Express and Discover credit cards.

Other Bills

Victory Sports Medicine & Orthopedics only bills insurance plans and patients for services directly provided by our healthcare team and for other services provided in our office. Depending upon your care, you may receive bills from other medical facilities. For example, if your care required surgery, you will receive a separate bill from the hospital or surgery center.

Frequently Asked Questions

Billing & Insurance

How often will I receive a statement from Victory Sports Medicine?

A: Every month, you’ll receive a statement that lists what your insurance company still owes and what you owe. Statements continue until all payments are made.

Why did my insurance deny the claim?

A: One or more of the following may apply:

• The service you received was not covered under your plan.
  
• You did not provide the correct insurance information at the time of service.
  
• You were not covered by your plan at time of service.
  
• An authorization was not obtained prior to the services being rendered.

What does “adjustment” mean on my bill?

A: “Adjustment” refers to the portion of your bill that our office, your provider and your insurance company have agreed not to charge you.

Will you bill my primary and secondary insurance?

A: You will need to provide us with complete primary insurance information. As a courtesy to our patients, Victory Sports Medicine submits bills to your insurance company and will do everything possible to advance your claim. However, it may become necessary for you to contact your insurance company or supply additional information to them for claims processing requirements or to expedite payment.

When are co-payments and deductible payments due?

A: Co-payments and deductibles are not covered by your insurance and are your responsibility. We expect all co-payments and deductibles to be paid at the time of service. If you are uncertain as to the amount you will owe please contact one of billing specialists at 315-685-7814 or one of front desk representatives will help you during your appointment.

May I pay my bill with a credit card?

A: Yes, Victory Sports Medicine accepts Visa, Mastercard, Discover and American Express.