Mercer-Bucks Orthopaedics
Mercer-Bucks Orthopaedics
Mercer-Bucks Orthopaedics

Frequently Asked Questions (FAQs)

Do you offer early morning or evening appointments?

Early morning or evening appointments are subject to availability.

Do you offer weekend hours?

Yes. We offer Saturday hours 8:00am–12:00pm. Locations may vary.

What can I do to prepare for my appointment?

Sign up for our patient portal.

What is the patient portal?

The patient portal offers our patients online health services including secure communication with your healthcare provider, appointment requests, and anytime access to your health records and test results.

Email to request an email that will include a registration link and code. Once you sign up for the patient portal you will receive another email 1 week prior to your appointment that will include your pre-appointment paperwork.

If you prefer to download and print your paperwork, you can obtain those forms below.

If you are coming in for a problem related to the spine, please fill out your physician’s form below instead of the New Patient Package:

What should I bring to my appointment?

  • A form of ID and your insurance card.
  • A written list of medications, both over-the-counter and prescriptions, vitamins, and herbs.
  • Copies of recent testing and studies with reports such as X-rays, Cat Scans, MRI's, EMG’s, Bone Density Scans, Ultrasound.
  • Second opinion appointments please bring any clinical notes, therapy notes, OP notes.
  • Bring written questions. Sometimes there is a lot of information being exchanged and we can get off track. If you have a list of questions, we can ensure that all of them get answered.
  • If you can, bring someone with you. It is good to have a second set of ears listening to the information and will be able to better help you process it after the appointment.

What types of payments are accepted?

We accept all major credit cards online, over the phone, as well as in office. In addition, cash, checks, and money orders are accepted at the front desk of each of our offices.

Can I pay my bill online?

Credit card and checking account payments can be made online here or through our patient portal.

Where can I mail my payment?

Our lockbox address is:
PO Box 8095
Lancaster, PA 17604-8095.

Please include the patient name and account number on your correspondence.

How can I contact the billing office?

The billing office can be reached:
Phone: 267-212-0300
Fax: 267-212-0318
Mail: PO Box 8095, Lancaster, PA 17604-8095

Where can I get a copy of my billing records?

All requests for billing records can be made to the billing office at (267) 212-0300 or by fax at (267) 212-0318.

What do the comment codes on my statement mean?

We use a variety of statement comments to help explain your balance. Some common codes are:

DA – Deductible Applied – A health plan with a deductible means the patient is responsible to pay out of pocket, up to a certain limit, before the health plan begins to cover costs. Please consult with your health plan to determine your specific deductible amount.

NP – Not Covered by Plan – The services rendered are not covered by your health insurance plan. It is the patient’s responsibility to understand the coverages of their health plan. Please contact your insurance to review what services are covered.

PC – Patient Coinsurance – Coinsurance is a percentage of the bill that is the patient’s responsibility to pay out of pocket. Please consult with your health plan to determine if your plan has coinsurance and the coinsurance percentage.

COB – Coordination of Benefits – Your health plan is requiring a call from the patient to confirm coverage details. Please call your health insurance to review your insurance coverage.

DECO – Deductible/Coinsurance Applied – A combination of deductible and coinsurance allowance has been applied.

TERM – Insurance Terminated – The health insurance plan billed by the practice is no longer active. Please call the billing office with updated insurance information.

Why am I receiving a statement when I paid my bill?

Statements are generated every other Friday and patients will receive no more than one statement per month. It takes approximately two weeks from the statement generation date until it is received at the patient’s home. Please check the date on the statement to determine if your payment crossed in the mail.

I am a Medicare patient, why am I receiving a bill?

The Medicare program has a yearly deductible that needs to be paid by the patient prior to Medicare paying for services rendered. The yearly deductible is set by Medicare. Please contact Medicare to review your benefits. After the deductible is met, the patient is responsible for a 20% coinsurance. If you have a secondary insurance, please consult with the carrier to determine specific coverage in regards to deductibles and coinsurance.

Can I have a discount on my bill?

Medicare guidelines and commercial insurance contracts strictly prohibit the practice from discounting a patient bill. If you believe your benefits have been applied incorrectly, please contact your insurance carrier to review your deductible, coinsurance, and current benefits before calling the practice.

Can the codes on my bill be changed?

The Current Procedural Terminology (CPT) codes on the bill are assigned by the provider based on what most accurately describes the services rendered at your visit. We are unable to modify these codes as Medicare and commercial insurance carriers require us to accurately report the services we provide to their members.

What is fracture care and a global period?

When a patient is diagnosed with a fracture, a fracture care CPT code is billed. A global period is the subsequent 90 days from the initial fracture care billing. During this 90 day period, a patient is entitled to follow up at the practice without being billed for evaluation of the fracture. Any services provided such as an X-ray, DME, injection or evaluation of another body part are not covered in the global period and will result in a billable event.

How is money applied to my account?

Unless specifically instructed by the patient, money is applied to the patients account from oldest date of service to most current.

Why do I need a referral?

Specific health plans, such as HMOs, require patients to obtain referrals when accessing care from a specialist. Your primary care provider can issue a referral to you or directly to the practice prior to your visit. If a patient is seen without a referral and your insurance plan requires one, you will be responsible for the cost of the visit.

How much will my visit cost?

The cost of your visit will vary based on your insurance and the services rendered. The gross charge for Evaluation and Management codes can be found on our Patient Cost page. Please consult with your insurance provider to request specific costs for services provided.

I was injured in a motor vehicle accident and need to be treated by an MBO doctor.

What information do I need from my auto insurance company in order to schedule an appointment?

We will need the name of your auto insurance carrier, your claim number, date of accident, and the PIP or medical adjuster's name and number. We will authorize your treatment with the PIP or medical adjuster.

What does PIP mean and what is a PIP Adjuster?

PIP stands for Personal Injury Protection which is an extension of your auto insurance policy covering medical expenses. Pennsylvania and New Jersey both require PIP coverage but not all states do. Your PIP adjuster handles your medical claims and not the collision damage to your vehicle.

I need to see a doctor for injuries due to a Motor Vehicle Accident. Why are you requesting my personal health insurance information?

Auto insurance medical coverage varies from policy to policy and if your medical benefits under your auto insurance policy are exhausted we will then submit the bill to your personal health plan as a secondary insurance.

I am being treated under my Motor Vehicle Insurance policy, why do I need a referral to see a specialist?

In the event that your medical benefits are exhausted under your auto insurance policy we will then submit to your personal health insurance plan. If under your health insurance plan you normally need a referral to see a specialist, we will need this referral on file in order to submit your bill to the insurance carrier.

I gave you my auto insurance information for authorization of my treatment but I am being told that my health insurance is primary. How is that possible?

Under your auto insurance policy you may have selected an option that designates your health insurance as the primary for your medical coverage. Under this option your own personal health insurance plan will be placed primary insurance over your auto insurance policy. Check with your auto insurance carrier to see if your coverage selected the health insurance primary option.

I was hit by someone else and they are claiming fault over my accident. Why do you need my auto insurance information?

The medical treatment rendered in lieu of your accident will be authorized under your own auto insurance policy.

I scheduled my first visit with an MBO doctor under my Motor Vehicle claim. What do I need to bring to my appointment?

Photo ID, health insurance card with referral if needed, auto insurance information and claim number. Also if you had radiology studies such as an X-ray, MRI, or CT performed in lieu of your accident please bring copies or a disk of the report. Lastly, if you were treated by another medical provider for injuries sustained in a MVA please bring a copy of the last office visit note or discharge instructions for the doctor to review.

Do you accept my insurance?

A member of our staff will call and verify your benefits prior to your first visit.

How many times can I be seen?

The number of therapy visits allowed depends on your individual plan. Our therapists and staff will work together to submit paperwork required by some insurance companies to have visits authorized.

Do I have to pay a co-pay each visit?

If your plan has a co-pay, you are required to pay that amount at each visit.

Are splints covered?

Each plan is different and for that reason, we must contact your insurance provider to find out what your plan covers. If you are coming right over from seeing the doctor, we will try to call prior to making the splint. If we are unable to get through to the insurance company, the patient has the choice of scheduling an appointment to come back after the benefits have been verified or accepting responsibility for the cost of the splint without knowing what insurance will cover.

Will I see the same therapist every time?

We do our best to keep patients with the same therapist each visit to maintain continuity of care. There may be some exceptions for vacation coverage or to accommodate a patient’s schedule.

How long are therapy sessions?

Treatments usually last somewhere between 45-60 minutes.

Do you have a Certified Hand Therapist (CHT)?

We do have CHT’s on staff.

Do you treat children?

We treat patients of all ages who are experiencing limited hand and upper extremity function due to an orthopedic problem. We are not set up to treat children with sensory integration issues or those having trouble with hand writing.

Do you accept patients from outside doctors?

We are happy to treat patients from outside doctors with appropriate prescriptions and diagnosis!

How often do I have to come to therapy?

The frequency of your treatment depends on several factors including: diagnosis, prescription from doctor, progression in therapy and adherence to home exercise programs.

Do I have to see a physician at MBO to go to therapy there?

No, as long as we accept your insurance you can come for therapy at MBO with a prescription from any physician.

Do I need a prescription at all for physical therapy?

Not necessarily, in New Jersey physical therapy is by law "direct access", meaning you can be evaluated and treated by a physical therapist without a physician prescription. However many insurances require a doctor's prescription to authorize therapy, if you are interested please call the number on the back of your insurance card and ask them if you can see a therapist without a physician's prescription.

Do I have to go to MBO therapy if I saw an MBO physician?

No, you can go anywhere your insurance allows you to go. Reasons you may want to see an MBO therapist is:

Therapists have direct communication to your physician regarding your care, there is availability of medical staff in the event you need urgent attention and our therapists are highly skilled and experienced in orthopedic care.

How long does it take to get an MRI pre-certified?

Almost every insurance company requires 15 business days to authorize surgery unless it is emergent.

What happens if an MRI is denied?

Denial goes to physician who decides to appeal or follow recommendations of insurance company. The physician is notified of denial and the physician assistant will contact the patient.

How long does it take to get visco supplementation injections pre-certified?

Verification of benefits is sent to your insurance company. Each insurance company has its’ own procedures. It usually takes 1 week to verify benefits. Once approval is obtained you will be contacted by Mercer-Bucks Orthopaedics to schedule appointments for the injections.

How long does it take to get a prescription authorization?

We don't know if a prescription requires authorization until notified by the Pharmacy. If a prescription needs authorization, it usually takes 72 business hours from the time the insurance company is contacted.

Where do I need to go to get Pre-Admission Testing prior to surgery?

Patients having surgery at a hospital must go to that hospital for Pre-Admission Testing.

If you have had a recent EGK or bloodwork you should take a copy of those results with you to the hospital for your Pre-Admission Testing appointment.

If you are going to an Ambulatory Surgical Center, you can get the testing done at the lab your insurance requires you to go, but we must be notified of where the testing took place so we can obtain the results.

Some insurance companies require 15 business days to authorize surgery unless it is emergent.

What information do I need in order to schedule an appointment with an MBO doctor under my Workers' Compensation claim?

You need the date the incident happened, the name of the Workers' Compensation Insurance Carrier, your claim number, and the name and phone number of the adjuster assigned to your claim. We will then contact the Workers' Compensation Insurance Carrier to authorize your treatment.

Do I need to tell my boss if I was hurt on the job?

Yes, inform your supervisor immediately if you were injured during the scope of work.

Does Pennsylvania and New Jersey have different Workers' Compensation Laws?

Yes, each state has specific laws. You can access each state website at the following:

How do I know if my claim is a New Jersey or Pennsylvania Workers' Compensation claim?

Contact your employer with this question as they will advise you accordingly.

I scheduled my first appointment with a MBO doctor under a Workers' Compensation claim. What do I need to bring with me for my first appointment?

Photo ID. Also if you had radiology studies such as an X-ray, MRI, or CT performed in lieu of your accident please bring copies or a disk of the report. Lastly if you were treated by another medical provider for injuries sustained due to a work related incident please bring a copy of the last office visit note or discharge instructions for the doctor to review.