BILLING & INSURANCE

We want you to get the care you need.

Every patient, regardless of financial means or social status, is treated equally with kindness and compassion. It is our aim to help you get the orthopaedic treatment you need. Our support staff is here to help you understand everything related to billing and insurance.

 

If you are uninsured, or unable to pay your portion at the time of service, we will make every effort to arrange a reasonable payment schedule for the services you require. However, arrangements must be made prior to your appointment, otherwise, your appointment will be rescheduled.

 

Please send all payments to:

 

Vail-Summit Orthopaedics PO Box 3199 
Grand Junction, CO 81502

 

Questions and Claims:

(866) 358-0202 (toll -free) or (970) 241-0202

 

Business Office Hours:

 

Monday - Friday, 7:30 a.m. - 5:00 p.m. MST

 

Contracted Insurance Plans

 

Insurance plan contracts change so frequently that it is best to confirm our participation directly by contacting your insurance company or by calling our business department at (866) 358-0202.

 

Other Insurance Plans

 

There are many insurance plans that we are not contracted with. As a courtesy to our patients, we will bill these insurance carriers on your behalf; however, if the insurance carrier does not process the claim in a timely manner (60 days from the time the bill is properly submitted), we will contact you for payment on your account.

 

Co-pays and Deductibles

 

Many insurance carriers require that we collect co-pays and/or deductibles from the patient. Federal laws, as well as our individual agreements with the insurance carriers we are contracted with, prohibit us from waiving these fees.

 

Referrals and Pre-Authorizations

 

Many insurance plans require referrals and/or pre-authorization for certain services and/or procedures. While we make every effort to ensure your services will be covered, it is ultimately your responsibility to ensure the terms of your insurance plan are met.

 

Explanation of Benefits and Statements

 

In most cases, you will receive an EOB (Explanation of Benefits) from your insurance carrier. The EOB will generally outline what was billed, what was paid and what we can or cannot bill to the patient. These forms vary greatly from plan to plan and contain a lot of terminology you may not be familiar with. If you should have any questions regarding an EOB you have received, please contact our business department at 866-358-0202. We would be happy to assist you. You will receive a statement for unpaid balances on your account. Items pending from the insurance company will NOT show on your bill. If you have questions about your statement, please contact our business department at (866) 358-0202.

 

Payment Plans

 

If you are uninsured or are responsible for a portion of your services, you will be expected to make payment at the time of service. If you are unable to pay your portion at the time of your visit, please contact our business department prior to your appointment to discuss payment options. Failure to do so may require us to reschedule your appointment. Our business department will make every effort to arrange a reasonable payment schedule for the services you require.

 

Refunds

 

In the event that you or your insurance company has overpaid on an account, we will process a refund check for the appropriate payee in a timely manner.

 

Transparency in Health Care Prices

 

Vail Summit Orthopaedics is required by Senate Bill 17-065 to post the most frequent codes/procedures billed to patients.  In order for VSO to comply with this bill we are providing our patients with a list of the 15 most billed codes.  

 

All Healthcare pricing is an estimate and the actual charge for services is dependent on the circumstances at the time that the service rendered.

 

If you are covered by health insurance you are strongly encouraged to consult with your health plan to determine the accurate information about your responsibility for a particular service provided by VSO.  If you are not covered by health insurance you are strongly encouraged to contact our billing office at 866-358-0202 to discuss paypayment options and potential self pay discounts available to you prior to receiving any services from VSO.