Michigan Orthopaedic Surgeons Financial Policy

We would like to thank you for choosing Michigan Orthopaedic Surgeons (MOS) as your medical provider. To keep you informed of our current office and financial policies we ask that you read and sign our financial acknowledgement prior to any treatment. Please keep this document for future reference.


The patient is expected to present an insurance card at each visit. All co-payments and past due balances are due at time of check-in unless previous arrangements have been made. We accept cash, check or credit/debit cards.

Cancelled Appointments:

If you are unable to keep your scheduled appointment, please contact our office at least 24 hours prior to your appointment to reschedule your appointment. A fee for no-shows may apply.

Patient Balances:

After processing the claim, many insurances will transfer a portion of the payment responsibility to the patient in the form of a co-pay, co-insurance and/or deductible. Patients will receive statements in the mail as well as automated phone calls and texts. Payment is due upon receipt of that statement. Patients with questions regarding a balance or those who would like to establish a payment plan should call the MOS billing department at (248) 714-1625.

Patient Collections and Bad Debt:

Accounts with a patient balance more than 90 days past due, from date of patient responsibility, without a current “Payment Plan” are subject to collection activity. Patients are unable to schedule new services with MOS providers until the balance(s) are paid in full and the account is in good standing.

Elective Surgery:

MOS requires patients to pay 50% of their patient responsibility prior to scheduling elective surgeries. Patients will be provided with a real time estimate of their patient responsibility, including co-pay, deductible and/or coinsurance, per their insurance plan. This deposit will be applied to patient account after the claim is processed by the insurance provider. Patients will be billed for any outstanding balances or will be refunded for any overpayments. Please contact the MOS billing department with any questions or for a refund request at 248-714-1625.

Self-pay Accounts:

Patients requesting an appointment without active, billable medical insurance and/or open workers’ compensation or auto claims are to be designated as self-pay patients. If there is a discrepancy with insurance or claim information provided by patient, the patient will be considered self-pay until such time as information can be updated correctly. Self-pay patients are required to pay at time of service.   Self-pay patients receive a 40% discount on services. $150 will be due at check-in for office visits and the remaining amount for services provided will be due at check-out. Please contact our billing department at 248-714-1625 for additional information.


Please bring your insurance card with you at the time of your appointment. In order to properly bill your insurance company, we require that you disclose all insurance information including primary and secondary insurance, as well as any change of insurance information prior to each visit. Failure to provide complete insurance information may result in the patient being responsible for the entire bill. Patients are responsible for determining if their insurance provider considers MOS in-network. For insurance plans that we contract with, your carrier requires that all co-pays be paid prior to any services being rendered. The co-pay requirement cannot be waived by our practice, as it is a requirement placed on you by your insurance carrier. You are responsible for any co-insurance, deductibles or non-covered services as required by your insurance. You will receive a statement from our office indicating what your insurance has paid. Any remaining balance is due upon receipt of that statement.

Referrals: Certain health insurances (HMO,POS, etc.) require that you obtain a referral or prior authorization from your Primary Care Provider (PCP) before visiting a specialist.  If your insurance company requires a referral and/or preauthorization, you are responsible for obtaining it. Any services received without a referral or proper authorization will be your responsibility.

Auto Accident Injury: If your visit is related to an injury 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, MOS reserves the right to treat the third party as the primary payor. Payment for any services that we provide will ultimately be your responsibility if not paid promptly by another party.

Workers’ Compensation: If your visit is related to an injury due to an accident in your work place, please be sure to contact your employer and inform them of your injury. Failure to properly report this injury to your employer may result in your claims being denied. Denied claims will be the patients responsibility.

Medical Records:

Medical records will be provided upon request and a completed HIPAA compliant release. Requests can be completed through the MOS website or by calling the medical records department at (248) 929-9365. There is no charge on medical records for the patients 3 most recent visits. A charge will be assessed if additional information is requested.