Insurance & Payment

Out-of-Network PPO Plans

Triumph Ortho & Spine is an out-of-network practice. Most PPO plans include out-of-network benefits that can help cover the cost of your care with us.

• Benefits check before your visit: Before your first appointment, our team verifies your out-of-network benefits and gives you a written estimate of what you may owe.
• Your share under your plan: You are responsible for any deductible, coinsurance, and other amounts your plan assigns to you for out-of-network care.
• Self-pay patients: If you are uninsured or choose not to use insurance, you have the right to a Good Faith Estimate of expected charges under the No Surprises Act. We provide one when you schedule or any time you ask.
• Workers’ compensation & auto accidents: We handle workers’ comp and motor vehicle accident claims. Learn more about workers’ comp & auto accident care.

Questions about coverage or cost? Contact us or call 1-877-215-PAIN.

Medicare Non-Participating Provider

Triumph Ortho & Spine is a Medicare non-participating provider. We accept Medicare patients, but our financial relationship works differently than a participating practice.

• Limiting charge: Our fees are capped at 115% of the Medicare-allowable amount for covered services.
• Balance billing: Patients are responsible for the difference between the limiting charge and what Medicare reimburses.
• Direct reimbursement: Medicare reimburses the patient directly (not the practice) for covered services.
• Payment at time of service: Patients pay the practice at the time of service and submit to Medicare for their share.