Billing & Insurance
Understanding your orthopedic bills and insurance costs is important to us. Continue reading to learn the answers to some of the most frequently asked questions about billing and insurance.
If your injury is due to an automobile accident, we request that you provide us with any information that will assist us in getting your medical claims paid. If your services are due to and/or are payable by a third party, MOR reserves the right to treat the third party as the primary payor. This information may include:
- a copy of the police report
- a copy of your auto insurance
- medical insurance
- names and information on other parties involved
Payment for any services that we provide will ultimately be your responsibility if not paid promptly by another party.
If your injury is a result of another party’s negligence, we request that you provide us with any information that will assist us in obtaining reimbursement for the services rendered to you. If your services are due to and/or are payable by a third party, MOR reserves the right to treat the third party as the primary payor. This information may include:
- a copy of the accident report listing claim number and responsible party
- medical coverage and/or attorney information
Payment for any services that we provide will ultimately be your responsibility if not paid promptly by another party.
If your injury is due to an accident in your workplace, please be sure to contact your employer and inform them of your injury. We will need to receive authorization from your employer before we can process any of your medical claims. Please have your employer contact our Workers’ Compensation Department at 708-236-2607. Failure to properly report this injury to your employer may result in your claims being denied. Denied claims will be your responsibility.
At the time of service, you will be responsible for all fees that are not covered by your insurance, including co-pays, co-insurance, deductibles and non-covered services or items received. You will receive a statement from our office indicating what your insurance has paid. Any remaining balance is due upon receipt of that statement. For your convenience we accept cash, checks, credit cards (Visa, MasterCard and Discover), and money orders.
For POS and HMO insurance plans that Midwest Orthopaedics at Rush participates in, your insurance carrier requires that you obtain a referral from your Primary Care Physician (PCP) before receiving services. It is your responsibility to obtain the correct referral for those services.
Bundled Payment Program / Self-Pay Program
What is a bundled payment program?
Healthcare bundled payments are fixed bundled pricing plans. These plans enable providers to reduce costs, improve value, and increase accessibility. In addition, they allow patients to understand the total cost of their care prior to initiation of treatment. The programs offer affordability and transparency, allowing our patients access to the highest quality sports medicine care.
How does a bundled payment program work?
For each package, the prices are non-negotiable, and payment is expected in full when Midwest Orthopaedics at Rush providers render the services. The patient pays Midwest Orthopaedics at Rush directly and third parties or insurance companies won’t be billed for services in the program.
What is included in the fixed bundled pricing plans?
- Surgeon fees – including initial consultation visit
- Facility fees
- Anesthesia fees
- Supplies and implants (if applicable)
- Uncomplicated follow-up care
What services may not be included in the healthcare bundled payments?
- MRI or X-rays
- Post-operative Rehabilitation
- Home health services
- Physical Therapy
- Durable Medical Equipment
- Post-operative medication
What are the orthopedic healthcare bundled payment packages available at Midwest Orthopaedics at Rush?
- Knee Arthroscopy: $6,000
- ACL Reconstruction (Autograft): $11,500
- ACL Reconstruction (Allograft): $12,500
- Hip Arthroscopy: $13,250
- Shoulder Arthroscopy: $11,000
- Rotator Cuff Repair: $12,500
At a Glance
Dr. Jorge Chahla
- Triple fellowship-trained sports medicine surgeon
- Performs over 700 surgeries per year
- Assistant professor of orthopedic surgery at Rush University
- Learn more