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Thank you for choosing us!

Thank You For Choosing Orthopaedic & Sports Medicine at Cypress. To keep you informed of our current office and financial policies we ask that you read our Financial Policy prior to any treatment. 

Questions about your statement?
Please call toll free at (877)-807-5163

Questions about our Financial Policy? 
Please call our Financial Counselor at (316) 219-4758 ext. 211

Thank you for allowing us to serve you.

Payments Accepted

Cash, Personal Check, Money Orders, Discover, Mastercard, Visa, and American Express.

Cancelled Appointments

If you are unable to keep your scheduled appointment, please contact our office at least 24 hours prior to your appointment to reschedule your appointment. 

Insurance

Please bring your insurance card with you at the time of your appointment. For insurance plans that we contract with, your carrier requires that all co-pays be paid prior to any services being rendered. The co-pay requirement cannot be waived by our practice, as it is a contractual agreement by your insurance carrier. If you do not have your co-pay at the time of your visit, you will be required to reschedule your appointment. 

You are responsible for any co-insurance, deductibles or non-covered services as required by your insurance. You will receive a statement from our office indicating what your insurance has paid. Any remaining balance is due upon receipt of that statement.

No Insurance?

Payment will be due at the time of service. If you are unable to pay your balance in full, you will need to make prior arrangements with our Financial Counselor. 

High Deductible Plans

High Deductible Health Plans (HDHP's) are consumer-driven health plans that have a minimum deductible and out of pocket limit that is set on an annual basis. If you have a HDHP, OSMC will schedule a time for you to visit with our financial counselor to receive a cost of care estimate in order to help you budget for your share of any of the following out of pocket expenses such as your deductible, co-insurance, co-pay and/or any non-covered service.

Payment Plan

For your convenience, OSMC offers our patients the flexibility to put down a deposit and make payments on large out of pocket expenses, relating to deductibles, co-insurance, co-pays and/or any non-covered services.

If you have questions about your payment plan, please call our Financial Counselor at 316-219-4758 ext. 211.

HMO or POS

For any POS and HMO insurance plans that we are contracted with, you are required to obtain a referral from your Primary Care Physician (PCP) before receiving services. Please bring that referral with you or have it faxed to our office at (316) 219-5899. Any services received without a referral or proper authorization will be your responsibility. 

Auto Accident Injury

If your injury is due to an automobile accident, we request that you provide us with any information that will assist us in getting your medical claims paid. If your services are due to and/or are payable by a third party, OSMC reserves the right to treat the third party as the primary payor. This information may include: 

  • a claim number
  • a claim mailing address
  • adjuster's name and phone number
  • medical insurance

Payment for any services that we provide will ultimately be your responsibility if not paid promptly by another party. 

Liability Injury

If your injury is a result of another parties negligence, we request that you provide us with any information that will assist us in obtaining reimbursement for the services rendered to you. If your services are due to and/or are payable by a third party, OSMC reserves the right to treat the third party as the primary payor. This information may include: 

  • a claim number
  • a claim mailing address
  • adjuster's name and phone number
  • medical insurance

Payment for any services that we provide will ultimately be your responsibility if not paid promptly by another party. 

Workers' Compensation

If your injury is due to an accident in your work place, please be sure to contact our office as we will need to review records prior to scheduling any appointment.  If you have any questions, please call (316) 219-4758 ext. 211.

Return Checks/Rejected ACH Withdrawals

A $30.00 charge will be added to your account for any checks returned or ACH withdrawals rejected by your bank for any reason in addition to any fees that your financial institution may charge you. 

Disability or Insurance Forms

There will be a charge of $25.00 for the completion of medical forms. Payment is due at the time that you drop off the forms. Please allow 7-10 days for the completion of these forms.

9300 E 29th St. North, Suite 205 | Wichita, KS 67226  | (316) 219-8299