Financial Policy

Thank you for choosing Dr Stark for your orthopedic needs. We are committed to your treatment being successful. The following is a statement of our financial policy which we require you read and sign prior to any medical services being rendered.

Participating Insurances
We participate with most insurance companies. Please verify that we are in your network prior to your visit. If you have health insurance we will file for you as a courtesy provided we are supplied with verifiable insurances information. The following insurance companies we are contracted with and we will automatically file:


Most Blue Cross Plans

Workers’ Compensation

Contracted Managed Care Plans


Commercial Carriers

Co-payments and Deductibles
Our health insurance contracts require us to collect payment of co-payments and deductibles at the time the services are provided.

Failure to pay a co-pay at the time of service will result in a $15.00 charge added to your account.

Accepted Types of Payment
Our office accepts cash and personal checks as payment for services.

Insurance Form Submission
As a courtesy to our patients, we will file your insurance forms at no additional charge to you. It is your responsibility to bring all of your insurance data to your appointment/visit. However, in the event of non-payment by your insurance company, payment is your responsibility.

Health Maintenance Organizations
A written or electronic referral from your primary care physician is usually required prior to your appointment/visit. Should you not have a referral on file or do not bring a referral with you the day of your appointment/visit, you will be asked to reschedule your appointment until a valid referral can be obtained. It is your responsibility to obtain a referral.

Auto and Third-Party Insurance
We will submit the claim for you, provided you have a claim number and appropriate insurance information with you. We do not bill attorneys for services provided. However, if you do not bring the necessary information with you the day of your appointment/visit, you will be responsible for payment at time of service.

Workers’ Compensation
You will need to bring your claim number, billing information and employers' information in order to submit an insurance claim form. If you do not bring this information with you, responsibility of payment is yours.

Should you require surgery, we will obtain authorization from your insurance company and our Billing Department will submit your insurance claim form. Of course, you are responsible for payment of any co-payment or deductible. Should you not have insurance coverage, our Billing Department will ask for payment prior to surgery. All surgeries will be pre-certified by our staff prior to service being rendered. Please be aware that “pre-certification is not a guarantee of payment.

Payment Plan Arrangements
Medical expenses are often not anticipated. We are willing to have our Billing Department work with you if you are in need of payment plan arrangements.

Missed Appointments
So that our office can run efficiently for all of our patients, we request 24-hour notification of cancellation of your appointment. If you are unable to keep your appointment and fail to inform us, you will be charged a “no show” fee of $25.00 not billable to your insurance.

Disability Insurance/FMLA Forms
There is a $10 fee for completion of each form/disability paperwork. Payment is expected at the time the paperwork is ready. Please allow seven (7) to ten (10) working days for completion.

We will not bill the fee for this service.

Returned Checks
Returned checks will be charged back to the patient’s account with a service fee of $35.00. Such checks not redeemed in twenty (20) working days may be assigned to a collection agency.

Resulting fees and collection costs are the responsibility of the patient and/or his financial representative.

Click here for Top Ten Ways to Make Your Visit Go Easily.

Thank you for understanding the necessity of our financial policy. If you need to make payment arrangements you must discuss prior to being examined. of page


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