Frequently Asked Questions

As an ambulatory surgery center, there is no hospital red tape. Our limited paperwork makes your preoperative registration and postoperative discharge as efficient as possible. Furthermore patients experience less stress because our center offers a warm atmosphere and our staff pays particular attention to their needs. With all its advantages, outpatient surgery at the Carolina Bone & Joint is a practical and convenient alternative to hospital-based surgery, providing the quality care you and your family deserve.

Our orthopedic specialists treat a wide variety of disorders involving all areas of the musculoskeletal system—bones, joints and connective tissues. We provide care for degenerative diseases like arthritis, sports injuries, fractures, sprains, ligament tears, structural abnormalities, sciatica, herniated disc, degenerative disc disease and many other types of orthopaedic conditions.

If it is necessary to cancel or change an appointment, please try to notify the office at least 48 hours in advance so that we may make the appointment time available to other patients.

Do you accept my insurance?

We are in network with the following insurance plans:

• Aetna
• Aetna Medicare Advantage
• Blue Choice Health Plan
• Blue Choice HIX
• Blue Cross Blue Shield
• Blue Cross Blue Shield HIX
• Blue Cross Blue Shield State Health Plan
• BlueCross Federal
• Blue Cross Medicare Advantage
• Cigna
• CHAMPVA
• First Choice Select Health Medicaid
• Humana (Commercial PPO and POS plans)
• Humana Medicare Advantage (HMO, Network PFFS, POS, PPO)
• MedCost
• Medicare
• Planned Administrators (PAI)
• SC Medicaid
• Tricare (Prime requires referral from Primary Care Physician)
• United Healthcare (HMO, PPO)
• United Healthcare Medicare Advantage

We are out of network with the following. We will verify patients’ out of network benefits and bill the insurance carrier. Patient responsibility varies depending on their benefits:

• Cigna Medicare Advantage Plans**
• Coventry
• First Health
• MultiPlan**
• PHCS**
• Supermed

**We check and verify benefits for these insurances and will notify the physician if we are unable to perform a procedure here. This may apply to patients with very high out of network deductibles or if their plan does not have out of network benefits.

We do NOT accept the following:

• Affordable Healthcare Plans (Only the BCBS HIX mentioned above)
• BCBS Medicaid
• Molina Medicaid
• Wellcare Medicaid

If you do not have insurance coverage from the above lists, or if your plan is not accepted, you will be expected to pay the bill in cash or by credit card at the end of your consultation. The original receipt, the signed copy of the credit card bill, the medical report in English, and the results of tests performed will be provided to you for submission to your private or state insurance for reimbursement.

If you have private insurance with an affiliate, the referral can be sent from your insurance company to us by fax or e-mail. We suggest that you contact your insurance in order to obtain this referral before your visit to our offices.

If you don’t have an insurance coverage, feel free to come to our Medical Centre. The billing procedure is as explained above.

Your anesthesia will be prescribed by a Board Certified Anesthesiologist after he reviews your records and discusses any medical problems or concerns you might have. Your anesthesia will be administered by either a Certified Registered Nurse Anesthetist or by a Certified Anesthesiologist’s Assistant. Both CRNAs and AA-Cs are licensed by the State of South Carolina and work under the medical direction of an anesthesiologist.

All patients having anesthesia will be interviewed by an anesthesiologist prior to their procedure.  Your medical history will be reviewed and the choices of anesthesia appropriate for your procedure will be explained and agreed upon. Any special concerns you might have, such as the possibility of nausea and post-operative pain issues will be discussed before your procedure. You will also meet your anesthetist and the operating room team scheduled to care for you at this time.

You will most likely receive two bills for your services, depending on your insurance plan. This is because some plans require separate billing and some require a single combined bill.  One bill will be from Carolina Bone & Joint Surgery Center, and one bill be will be from Lookaway Anesthesia, LLC. Depending on your insurance you may see one or two claims on the EOB. You may see one for the anesthesiologist and one for the anesthetists.

So we can better serve you, please bring the following items to your office visit:

• Photo identification
• Your health insurance card and co-pay
• A list of your current medications and their doses
• A list of any known drug allergies and symptoms you have from taking these medicines
• Your insurance referral, if needed
• Any x-rays, MRIs, CT or bone scans related to your orthopaedic condition / injury
• A list of your questions and concerns
• Your claim number if it is a worker’s compensation injury