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New Patient Forms

Your First Visit

We want your first visit to go as smoothly as possible. To assist us in providing the most appropriate treatment and to eliminate unnecessary delays, please bring the following information to your first visit:

  • New patient forms (please print and fill them out)
  • Records of other treatment you have received for this condition, including films (the actual images or CD) and reports for any diagnostic tests (Bone scan, EMG and nerve conduction studies, etc.)
  • The name, address and telephone number of your referring physician.
  • Your insurance cards and information

Identity Theft Policy

In order to comply with The Fair and Accurate Credit Act of 2003 and the recently enacted Federal Trade Commission “Red Flag” rules, South Orange County Orthopaedics (SOCO)is required to implement an Identity Theft Prevention Program effective November 1, 2009.

As part of this program, SOCO is now required by the Federal Trade Commission to obtain a copy of a valid photo ID from each patient or patient’s guardian presenting to our office.

If you are unable to provide a valid photo ID, SOCO cannot bill your insurance company, and you will be required to pay for your visit at the time of service.

We apologize for any inconvenience that this may cause; however, this is a federal regulation with which we must comply. If you would like more information, please go to this website:

http://www.ftc.gov/os/statutes/fcrajump.shtm.

Insurance, Billing, and Co-pays

Please ask about insurance coverage when you make your appointment. We participate with many PPO’S, workers’ compensation carriers, private insurance’s, Medicare, and selected HMO plans. For contracted insurance plans, we will file a claim with your insurance company for any fees related to care, surgery, or hospital services.

We will file claims for all services covered under these plans. You will be asked to pay for any non-covered services, co-payments or deductibles at the time of your visit. For non-contracted insurance plans, we will ask for payment of routine services at the time of your visit. We accept ATM debit cards, cash, personal check, Discover, Master, or Visa credit cards. When you make a payment, you will be given a complete and accurate statement that you may file with your insurance company for reimbursement.

A Message To Our Patients About Arbitration

We believe that the method of resolving disputes by arbitration is one of the fairest systems for both patients and physicians. Arbitration agreements between health care providers and their patients have long been recognized and approved by California courts. Lawsuits are something that no one anticipates and everyone hopes to avoid. By signing our arbitration agreement we are agreeing that any dispute arising out of the medical services you receive is to be resolved in binding arbitration rather than a suit in court.

Our goal is always to provide medical care in such a way as to avoid any such dispute. We know that most problems begin with communication. Therefore, if you have any questions about your care, please ask us.

Contact Address

  • 26730 Crown Valley Parkway
    Suite 200
    Mission Viejo, CA 92691
  • Tel: (949) 364-2154
  • Fax: (949) 364-2110
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