Insurance Info
Prevention
The Hedley Orthopaedic Institute, a Physician Group of Arizona, Inc., practice, currently accepts the following health plans:
AHCCCS Plans
Acute Care Health Plans in Maricopa County
- Health Net Access
- Health Choice
- Maricopa Health Plan
- Mercy Care Plan
- Mercy Maricopa Integrated
- Phoenix Health Plan
- United Healthcare Community Plans
Long Term Care Plans in Maricopa County
- Bridgeway Health Solutions
- Mercy Care Plan - LTC
- United Health Care - LTC
Regional Behavioral Health Authority (RBHA) in Maricopa County
- Mercy Maricopa
- Mercy Maricopa Integrated
- Gila River Indian Tribe
Regional Behavioral Health Authority (RBHA) in Coconino County
- Health Choice Integrated Care
Acute Care Health Plans in Pima County
- University Health Plans
Aetna
- Aenta US Access
- Aetna QPOS
- Aetna PPO
- Aetna Medicare
- Aetna HMO
- Choice POS
- Aetna Select
- Managed Choice POS
- Open Access Aetna Select
- Aetna open Access Elect Choice
- Aetna open Access Managed Choice
- Open Choice PPO
- Aetna HealthFund PPO
- Aetna Healthfund POS
- Aetna Performance Network (ortho only)
- Aetna AExcel Plan (effective 1-1-2016, Ortho and Plastic only)
- AetnaChoice POS II
BCBS
- BCBS of AZ Workers Comp
- BCBS of AZ - Senior Preferred
- BCBS of AZ Par (Indemnity)
- BCBS of AZ and other BCBS – PPO
- BCBS of AZ HMO
- BCBS Select Exclusive Network
Bridgeway
- Medicare Advantage
- Medicaid
Cigna
- Cigna Healix
Health Choice
- Health Choice Preferred
- Health Choice Arizona - Medicaid
- Health Choice Generations - Medicare
- Health Choice Insurance Co.
- Health Choice Integrated Care - RBHA in Northern Arizona
Health Net
- Health Net PPO
- Health Net PPO/HAS
- Health Net Commercial – IFP and SBG
- Health Net Direct HMO
- Health Net POS
- Health Net Community Care HMO
- Health Net AHCCCS
- Medicare Through AZPC
Hawaii Mainland Network (HMN)
Humana
- Humana Community HMO
- Humana Community HMO Diabetes and Heart (HMO and SNP)
- Humana Gold Plus HMO
- Humana Gold Choice PFFS
- Humana Choice PPO Commercial
- Humana Premier
- Humana HMOx
- National POS - Open Access
- Choice Care PPO
- Humana One
Medicare
Mercy Care
- Mercy Care Advantage
- Mercy Care Plan
- Mercy Care Acute
- Mercy Care Long Term Care
- Mercy Care DDD
- Mercy Care GMHSA
Mercy Maricopa Integrated Care (MMIC)
- Mercy Maricopa integrated
- Mercy Maricopa GMHSA
UnitedHealthcare
UnitedHealthcare Medicare Advantage Plans
- Triccare
- Commercial HMO
- Commercial PPO
- Commercial Compass
- Commercial Navigate
- Medicare
- Community Plan AHCCCS
- Community Plan DDD
- Community Plan LTC
- Community Plan Dual Complete
The list above represents the health plans accepted by most physicians affiliated with Physician Group of Arizona, Inc. Please note that the listing of a health care plan does not guarantee coverage. If your managed health care plan is not listed, please contact your insurance provider. Some affiliates may not be listed.
Insurance Verification
You must provide our office with your insurance verification card. Should you change your insurance coverage, please contact our office with any updated insurance information. We also recommend that you contact your insurance company prior to surgery to determine the extent of your coverage, including:
- Anesthesiology
- Diagnostic testing
- Hospitalization
- Physical therapy
- Recovery
- Rehabilitation (needs, equipment)
- Second opinion requirements
- Surgeon fees
- Surgery
Please note, verification and/or pre-certification is not a promise of payment from your insurance company. You are still responsible for payment of the bill. To assist, we will submit a claim for any services to your primary insurance carrier and provide you with the information you may need for secondary insurance. If you have additional questions, please contact us.
Payment Policy
You are personally responsible for payment of your account regardless of your medical insurance coverage. Our policy requires that all office visit charges be paid at the time of service. We accept cash, personal checks, Mastercard and Visa for payment of charges. You will receive a monthly statement itemizing charges and your current balance. Any arrangements for extended payments must be addressed with our business office at 602-553-3113. If your account is past due and you have not made payment arrangements with the business office, we will need to take additional collection measures.
Surgery Deposit
A deposit may be required prior to your surgery, depending on your type of insurance coverage. If a deposit is required, you will be contacted by the business office prior to surgery.
Postoperative Charges
Office visits following surgery are included in your surgery fee for a specified period of time (usually up to 90 days), depending on the type of surgery performed. X-rays and other services or supplies provided after surgery are not included in the surgery fee and are your responsibility to pay..
Medicare
We accept Medicare. Medicare will pay us directly for 80 percent of the allowed charges. You are responsible to provide payment of the remaining 20 percent of Medicare’s allowed charges, if your deductible has been met. We will provide you with the information you may need for your supplemental insurance carrier.
Workman’s Compensation
On your first visit for an industrial injury, you must complete a 102-Form. If you have not completed this form, please speak with the practice’s industrial account representative. Information and forms must be submitted to the receptionist at the time of check-in.
HMO/PPO Plans
We are contracted with certain managed health care plans to accept their established fee schedule amounts. The various plans have different deductible, co-payment and co-insurance requirements, which you must pay at the time of service. Please familiarize yourself with your plan’s financial requirements as well as protocol requirements for referrals, preauthorization and second opinions.
Indemnity Plans
Indemnity insurance plans pay according to their reasonable and customary fee schedules. We are not contracted with these insurance companies. You are responsible for paying the difference between the practice’s charges and the insurance plan’s reimbursement.
For more information or to schedule an appointment, please contact us.
