Billing & Insurance
We understand billing and insurance can feel complicated, and we are committed to providing clear information and helpful support. Whether you need details on coverage, authorizations, or payment options, we are here to assist.
Insurance: Understanding Your Coverage
HMO
Golden State Orthopedics & Spine is contracted with various HMO groups. Please make sure that you have a valid referral or authorization prior to being seen. Please note that in certain situations, reauthorization may be required.
PPO
We contract with most major PPO insurance plans. Depending on your plan’s benefits, you may be responsible for a copay, deductible, or coinsurance at the time of your visit. Please check with your insurance provider to confirm coverage.
Medicare
We accept Medicare and participate in the assignment program. Patients are responsible for applicable deductibles, copayments, and any non-covered services. Supplemental insurance may be billed for secondary coverage.
Out-of-Network Plans
If Golden State Orthopedics & Spine is not in your insurance network, you may still receive care from our specialists. Out-of-network benefits vary, and patients are responsible for any balance not covered by insurance.
Billing: Payment Options & Financial Policies
Self-Pay
For patients without insurance or those choosing to pay directly, Golden State Orthopedics & Spine offers self-pay options. Payment is due at the time of service, and estimates can be provided in advance upon request. Currently, the self-pay prices are applicable to the East Bay locations only.
Surgical & MRI Charges
Certain services, such as surgery or imaging, may involve separate charges for the facility, doctor, and anesthesia provider. Our team will help verify coverage and estimate your financial responsibility before scheduling.
Statements
Patients will receive statements for any balances due after insurance has processed their claim. Payment is expected upon receipt unless prior arrangements have been made with our billing department.
Payment
We accept major credit cards, checks, and electronic payments. Payment plans may be available for qualifying balances. Please contact our billing office to discuss available options.
Overdue & Collection Accounts
Accounts not paid within the agreed timeframe may be subject to collection procedures. We encourage patients to contact us early if financial difficulties arise so we can work together to find a solution.
Workers’ Compensation
We work closely with employers and insurance carriers to provide timely, coordinated care for work-related injuries. Please ensure your claim is properly filed and that we receive the necessary authorization before your visit.
Motor Vehicle Accident (MVA) & Personal Injury
If you are being treated for injuries sustained in a motor vehicle accident or personal injury case, our staff can assist in coordinating billing through the appropriate insurer or attorney. Verification of claim information will be required prior to scheduling.