Patient FAQs

What are your hours of operation?
We are open from 7:30 a.m. – 5 p.m. Monday through Friday. Not all doctors are available during those hours as they have some surgery only days. For emergencies, we direct you to the Carlisle Regional Medical Center. Their phone number is (717) 249-1212.

How can I contact you?
Please see our Contact Information page for all phone numbers, email, mailing addresses, and fax number.

With which hospitals are you affiliated?
Appalachian Orthopedic Center is an independent practice offering the latest treatment options for bone and joint health and sports injuries, both surgical and non-surgical. If surgery is necessary to improve your quality of life, we perform operations at two locations. Our board-certified surgeons operate at OSI Outpatient Surgery Center - a state-of-the-art surgical facility and Carlisle Regional Medical Center where joint replacement patients participate in Joint Camp. Joint Camp is a special program within the hospital that provides individualized care for joint replacement patients.

How can I find out if I have a deductible, coinsurance, and/or co-payment?
Contact your insurance company. Deductible, coinsurance, and co-payment amounts are written into your insurance policy. It is in your best interest to know the specifics of your individual plan.

What is a deductible?
A deductible is a set dollar amount for which a patient is responsible in the course of a year according to his/her contract with the insurance company. For example, if a patient has a $500 deductible, he/she must pay $500 out-of-pocket on services for which the deductible applies before the insurance will make payment. A deductible amount generally applies for one year. Once the year is complete, the deductible must be met for the new year, again.

What is coinsurance?
Coinsurance is a percentage of each charge for which a patient is responsible. This amount is determined by the patient's
insurance policy and is non-negotiable. If a patient has 20% coinsurance, for example, he/she is responsible for 20% of each specific negotiated rate by charge code. Therefore, if the practice has a negotiated rate of $1,000 for a surgical charge code, the patient would be responsible for $200.

What is a co-payment (copay)?
A co-payment is a set amount that a patient is responsible for at each visit. A patient with a $15 copay will be responsible to pay $15 at each visit. It is important to be familiar with your individual plan. Some plans require a co-pay for office visits only while others require a co-pay for office visits as well as X-rays, physical therapy, etc.

Am I responsible to pay my co-payment at the time of my visit?
Yes. Appalachian Orthopedic Center's policy is to collect your copay at the time of service. (In the case of copays on X-rays, physical therapy, etc., most insurance cards do not document this copay; if that is the case, you may receive a bill for this amount.)

Do I need a referral?
Everyone's insurance plan is different. It is essential that you are familiar with the requirements of your particular plan. If you choose to come to our office and we do not participate with your insurance company, it is your responsibility to contact your primary care physician (PCP) before the visit to obtain an out-of-network referral. It is important to remember, however, that even if we participate with your insurance you may need a referral. Some plans allow you to come to a specialist with or without a referral with the understanding that if you come without a referral you may be responsible for a larger out-of-pocket amount. Ultimately, it is the patient's responsibility to know whether or not a referral is required.

How do I get an in-network referral?
To obtain an in-network referral you need to contact your primary care physician (PCP). Ask them to write a referral to our office. Be specific. Tell them the date of your appointment and the reason you are being treated. Present your referral at our front desk when you arrive for your appointment.

How do I get an out-of-network referral?
To obtain an out-of-network referral you need to contact your primary care physician (PCP). Ask them to write an out-of-network referral to our office. Be specific. Tell them the date of your appointment and the reason you are being treated. Present your referral at our front desk when you arrive for your appointment. Insurance companies are not required to give you an out of network referral in order to treat with providers that are not that in their network.

If I arrive at the office without a referral and my insurance plan requires a referral, what happens then?
It is your responsibility to get the referral from your PCP. We have a telephone in our reception area that you may use to call your PCP to request a referral be faxed to our office at 249-6235. The patient chart will not be put back for the doctor until the referral is received. Our reception staff can also reschedule the appointment if you do not want to wait for the referral. The only time our office can treat a patient without a referral is if it is truly an emergency, as determined by our nursing staff.

Are there any other resources available to help pay for medical services for self-pay patients?
Contact the County Assistance office for the county in which you live.

Cumberland County Assistance Office 800-269-0173
Dauphin County Assistance Office 800-788-5616
Perry County Assistance Office 800-991-1929
Franklin County Assistance Office 800-991-8839
York County Assistance Office 800-991-0929