Patient Info

In the event of an emergency, dial 911. An on-call physician can be reached by dialing (478) 745-4206.

We would be happy to answer any questions you have about your care and experience at OrthoGeorgia. Please view our frequently asked questions for more information about OrthoGeorgia, insurance and billing, and our surgery center.

Payment for office appointments is expected at the time of service. Hospital and surgery charges are discussed individually. For more information, visit our insurance page.

As a courtesy, claims may be filed directly to your insurance plan. Our staff is knowledgeable about current plan participation, but as a patient, you should also contact your insurance company to verify that our surgeons are covered providers. While our billing department can assist you with insurance issues, you, as the patient, are ultimately responsible for your bill in the event of non-payment from an insurance company. For more information about plans we participate with, please visit insurance information tab.

Patients’ requests for prescription refills are handled in 24 to 48 hours: requests for prescription refills received prior to 3:00 p.m. are addressed the same day; prescription refills received after 3:00 p.m. are addressed the following business day. For refills, please call our refill prescription line at (478) 745-4206, extension 3.

The Georgia Regional Academic Community Health Information Exchange (GRAChIE) is a big name with a big goal.

GRAChIE is a network that connects practitioners and healthcare settings across Georgia, all of whom have made the decision to participate for one reason – to improve patient care.

Across the country, networks like GRAChIE, known as Health Information Exchanges (HIEs), are being formed. Currently, GRAChIE links providers across Georgia from various care settings, including pediatrics, primary care, long-term care, home health and hospitals.

The purpose is to ensure that you and your family receive the best healthcare possible. GRAChIE will allow doctors, nurses and other healthcare providers to share vital information securely and electronically, reducing the need for patients to relay their medical information to every health professional involved with their care.

For additional information or to opt-out visit their website GRAChIE.org.

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an
in-network hospital or ambulatory surgical center, you are protected from
surprise billing or balance billing.


What is “balance billing” (sometimes called “surprise billing”)?


When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.


“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.


“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in network facility but are unexpectedly treated by an out-of-network provider.


You are protected from balance billing for:


Emergency services
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.


Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.


If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.


You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.


When balance billing isn’t allowed, you also have the following
protections:


•You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
•Your health plan generally must:
•Cover emergency services without requiring you to get approval for services in advance (prior authorization).
•Cover emergency services by out-of-network providers.
•Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
•Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
If you believe you’ve been wrongly billed, you may contact 1-800-985-3059
Visit www.cms.gov/nosurprises/consumers for more information about your rights under
federal law

Click here for more information on the Good Faith Estimate

Click here for information about your rights under Georgia’s state law.

Awards and Affiliations

Sports Injury Clinic: Saturdays 9AM - 11 AM, at the Macon Building A.

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