Patient Information

Our primary goal is to serve the orthopaedic needs of our patients by providing excellent, cutting-edge orthopaedic care. The physician-patient relationship is an important association of mutual trust. We understand the importance of maintaining the dignity of each patient and the protection of the privacy of every patient’s private health information. We value your trust in us and continue to work diligently to maintain the highest standards in medical care.

Pre-Surgery Preparation

  • Nothing to eat or drink 8 hours prior to surgery
  • Wear loose-fitting clothing
  • Arrange for a ride home after surgery
  • Arrive 1 to 2 hours before surgery (depending on surgery)
  • Follow the instructions on your physician’s instruction sheet
  • Some surgeries require a “pre-surgery” class – check with your doctor
  • Some surgeries require donation blood – our office will assist you in making arrangements to donate your own blood prior to the surgery should you choose to do so.
  • Post-Op Information
  • Be prepared to pay any applicable insurance, copays, or co-insurance amounts in full

Read the instructions and information packet given to you from the hospital or surgery center.

Depending on your surgery, you may need postoperative physical therapy. If your surgery is outpatient, your physician’s assistant will assist in obtaining the necessary referral and authorization for outpatient physical therapy. If your surgery is inpatient, the discharge planner at the hospital will assist you in making arrangements for outpatient or in-home physical therapy before you are discharged.

 

Billing and Insurance

Synergy Specialists Medical Group is contracted with many insurance carriers including the following:

  • Aetna
  • Blue Cross
  • Blue Shield
  • Cigna
  • Coventry
  • Department of Labor
  • HealthNet
  • Medicare
  • Tricare
  • United Health Care

We are happy to bill your insurance carrier as a courtesy. We require a copy of your insurance card and a picture identification card prior to services being rendered. If services are denied by your carrier or if you are ineligible to receive benefits, you are financially responsible for all incurred charges. Please be prepared to pay your required co-payment or deductible at the time of service.

Health plan coverage varies significantly by carrier, by employer, and/or by contract. We cannot know the benefits and exclusions of each patient’s health plan. It is the patient’s responsibility to know and understand his or her health plan coverage and benefits.

Please be prepared to pay for all patient due amounts at time of service. This includes:

  • Co-payments
  • Deductibles
  • Outstanding Balances

For your convenience we accept cash, checks, debit cards, MasterCard, and Visa. If payment is not made at the time of service there will be a $15.00 fee added to your account to cover our costs associated with preparing, sending and processing patient statements.

Thank you for your cooperation and helping us to keep our cost to patients at a minimum.

Fees

If you have questions regarding our fees, we encourage you to discuss them with our Billing staff. Our fees for professional services are consistent with those in the community. An estimate for proposed services may be obtained upon request, and in many instances are given routinely. We suggest you contact your insurance prior to services being rendered so that you are aware of your potential financial responsibility.

Statements

The billing statement will itemize services as well as any payments, deductibles, or co-insurance amounts applied by your carrier. If you do not understand your statement or have questions regarding your balance, please feel free to contact our Billing Department for clarification. If your insurance delays processing or processes your claim incorrectly, you will need to contact them directly. If you cannot meet your financial obligation, please contact our Billing Department.

MasterCard and VISA are accepted.

Medicare

If you are covered by Medicare (Part B), Synergy Specialists Medical Group will bill them for services rendered. We will bill your supplemental insurance upon request. This may not apply to some patients under supplement HMO plans. We require a copy of all insurance cards for billing.

Questions?

For all billing questions and inquiries please contact the Billing Office at (858) 412-6080

 

Referrals and Authorizations

 

If your insurance company requires a referral from your primary care physician (PCP) for an orthopaedic consultation, please make sure you obtain the authorization number before calling for your appointment. Our office must be in receipt of the referral from your PCP before booking your appointment, if your insurance requires it. If our office has not yet received your referral, you will be asked to contact your PCP’s office to have them fax the referral to us.

Referrals for additional orthopaedic services that your orthopaedic physician may require such as MRI, physical therapy, ultrasound, CT scans, etc., will be ordered by our office.

Please allow 5 to 7 working days to process your referral in most cases.

 

Prescription Refills

For routine refills contact your pharmacy directly.

Please allow 72 hours for most refill authorizations.

 

Workers Compensation

Synergy Specialists Medical Group works with many industrial medicine entities, including Worker’s Compensation and the Department of Labor.

If you are injured on the job or feel that your problem may be work-related, please make sure you have informed your employer.

For more information, please visit the website for the State of California Department of Industrial Relations or visit the U.S. Department of Labor (http://www.dol.gov/owcp/dfec/)