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West Orange Orthopaedics & Sports Medicine

Office Information: Insurance


As a courtesy, we file most insurances. It is your responsibility to make sure we are providers for your insurance company's network and that you have the proper authorizations or referrals needed to meet your insurance carrier requirements. You will be responsible at the time of service for any monies your insurance company determines as your responsibility.

We DO NOT get involved with Third Party Liability. Payment would be required at time of service. Upon payment for office visits you will be given a receipt. If requested, we can mail you an itemized bill, which can be submitted along with your claim form for reimbursement from the Insurance company.

Your health insurance is a contract between the insured and the insurance company. We ask that you not lose sight of this fact. It is therefore necessary that you take the responsibility to follow-up a claim to your company if you feel it is not being paid promptly or properly. We will be happy to provide you with what information we can to help you substantiate your claim.

Please be aware that not all insurance coverage is the same. We cannot be responsible for the amount paid by your insurance company. Some have rate schedules that do not necessarily agree with the charges in our particular area.

Your office visit may include an X-ray, Fracture Care, Casting or an Injection. These are considered Radiology and Surgical Procedures. Depending on your Insurance, you may owe an additional Deductible, Coinsurance or Copay for these procedures in addition to your Specialist Copay.

Auto Related Injury

The Florida No Fault laws are very specific. If you have been injured in or on a four wheeled vehicle, you must call your Auto insurance first before seeking non-emergency medical care all within 14 days. Please complete this form and bring it with you to your appointment.

Helpful website

Work Comp Related Injury

The initial appointment must be scheduled by your Adjuster.

Helpful website

Medicare Patients

We are Medicare participating providers. If you have a Supplemental policy, you should make sure you are signed up with Medicare automatic crossover. If you have Medicare and are still employed or have insurance through a spouse who is still employed, make sure you have updated your COB with both insurances. Please complete this form and bring it with you to your appointment.

Helpful website

HMO Patients

If you have an Insurance Assigned Primary Care Physician, your insurance requires you to see that doctor first, for all medical care. The PCP will then determine if they want to take an X-ray, send you for an MRI or for Physical Therapy prior to sending you to an Orthopaedic Surgeon. If they do refer you to us, your insurance requires a specific Referral Process and some are only good for two visits. You should become familiar with your Insurances Member Website and monitor your Referrals. Many of these plans require an "Online" referral on the AVAILITY website. We must be able to access this referral through the Availity website prior to scheduling any appointments.

After 05/31/2024, we will no longer be IN-NETWORK with CarePlus. Either CarePlus or your PCP would need to issue an out of Network Referral or Continuity of Care Referral before we can schedule any services.

Participating Insurance List

(Network Participation is based on patient’s registration County or assigned PCP’s County)
  • Aetna PPO, POS & EPO (Medicare PPO & HMO)
    • We are not participating in BetterHealth OR AEXCEL
  • Allegiance Orlando Health
    • We are not participating in Advent Health
  • AVMED Open Access
    • We are not participating in Engage or Entrust
  • Cigna PPO, OAP, Local Plus, Network/HMO, Connect AOP & EPO
    • We are not participating in Medicare HealthSprings, SureFit, or Connect HMO
  • Devoted (Medicare PPO & HMO)
  • Employers Health Network (EHN)
  • FL Blue MyBlue, Bluecare Simply Blue, MyTime (Medicare PPO & HMO)
    • We are not participating in FL Blue Select or Truli
  • Humana PPO, POS (Medicare PPO & HMO)
    • We are not participating in Select or Premier
  • Orlando Health Network (OHN & EHN)
  • Tricare
  • United Healthcare PPO & HMO and AARP Medicare PPO & HMO
    • We are not participating in AARP Medicaid, NHP or HMO FL ONEX
  • Sunshine Medicaid HMO
  • Wellcare Medicare HMO
Serving the communities of: Altamonte Springs, Apopka, Astatula, Celebration, Clermont, Eustis, Ferndale, Gotha, Kissimmee, Leesburg, Longwood, Mascotte, Metrowest, Monteverde, Mt. Dora, Oakland, Ocoee, Orlando, Windermere, Winter Garden