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