Insurance and Billing
Authorizations
Authorization from your insurance provider is necessary for most tests and all surgical procedures. To obtain authorization, our staff will contact your insurance company and make a formal request. This process takes time and we ask for your patience. We request authorization within 3 working days following your appointment for routine requests and immediately for emergent requests. Each insurance company’s response time varies. If you do not hear from our office concerning a request for authorization within 5 working days, please call us to check on the status of the request.
Note that new conditions often require authorization before you can be treated. Please check with your insurance plan to see if you need one. Depending on your insurance plan, you may need to see your primary care physician prior to seeing a specialist.
Payments
Please remember that all co-pays are due at the time of your visit. For your convenience, we accept Visa and MasterCard. FORM Ortho offers cash and payment plans for qualifying patients. Our billing office is happy to answer your payment questions at (510) 505-1090.
Insurance Plans
Below is a list of the insurance that we currently accept at FORM Ortho. We accept all PPOs and most EPOs, auto insurance, Medicare and Workers’ Compensation. We will gladly accept most Palo Alto Medical Foundation plans. FORM Ortho is not currently contracted with HMOs. If you do not see your insurance listed below, please call our billing specialists at (510) 857-1000 and they can answer any insurance-related questions you may have.
| COMPANY | NETWORK | ACCEPTED |
|---|---|---|
| AARP | Y | |
| AdMar | PPO | Y |
| Aetna Aexcel | PPO | Y |
| Aetna Managed Choice | Y | |
| Aetna Open Choice | PPO | Y |
| Aetna Select Choice | PPO | Y |
| Alameda Alliance | Y | |
| Beech Street | Y | |
| Benesight | Y | |
| Blue Shield | PPO, EPO | Y |
| Blue Cross | PPO, EPO | Y |
| BPS Healthcare | PPO, EPO | Y |
| Carpenters Health & Welfare | Y | |
| Chubb | Y | |
| Cigna | PPO | Y |
| CCN | Y | |
| Coventry Health Network | Y | |
| ESIS | Y | |
| First Health | PPO | Y |
| Great West (One Health) | EPO, PPO | Y |
| Guardian | Y | |
| Health Managed Care | Y | |
| Healthnet | PPO | Y |
| Humana | Y | |
| Interplan | PPO | Y |
| Kaiser | WC | Y |
| Keenan | Y | |
| Medi-Cal | N | |
| Medicare | Y | |
| MultiPlan | PPO | Y |
| Nippon Life | Y | |
| One Call Medical | WC | Y |
| Pacificare | PPO | Y |
| Palo Alto Medical Foundation | Y | |
| Patriot Risk Services | Y | |
| Preferred Health Network | PPO | Y |
| Principle Life Insurance | PPO | Y |
| Pro America | PPO | Y |
| Private Healthcare Systems | Y | |
| Prudent Buyer | Y | |
| State Compensation Fund | WC | Y |
| Teamsters Benefit Trust | Y | |
| Three Rivers Provider Network | Y | |
| Tricare | Y | |
| TriWest | Y | |
| Unicare | Y | |
| United Healthcare | PPO, EPO | Y |
| Washington Senior Care | Y | |
| WAUSAU | Y | |
| Workers Compensation | Y | |
| York | Y | |
| Zurich W/C | Y |
