Billing & Insurance

Insurance

Newport Orthopedic Institute participates in most major insurance plans.

Prior to making an appointment we recommend that you contact your insurance carrier to verify that the doctor you wish to see is ‘in-network’ with your specific plan or to obtain an estimated out of pocket cost.

• We do not accept Motor Vehicle policies for visits related to auto-accidents.
• We do not accept Personal Injury/Lien/Attorney cases. These appointments would be self-pay; please click here to go to our self-pay pricing list.

PPO Plans

• Aetna
  • We do not take Aetna Whole Health EPO
• Alignment Health Plan
• Anthem Blue Cross (Large & Small Group Plans)*
  • We do not take High Performance Network (HPN prefix) plans
  • We are Out of Network with Blue Cross Exchange plans all levels (Bronze, Silver, Gold, Platinum). PPO patients will require a referral from their PCP-we are Tier 2 providers.
• Blue Shield
  • We do not take Blue Shield Medicare PPO or Blue Shield Medicare Advantage PPO plans
• ChampVA
• CIGNA including CIGNA Oscar
• HealthNet
• Noridian-Medicare Part B
• PHCS / Multiplan/Beech Street
• SCAN Direct
  • Tricare Companies
• United Healthcare

HMO Plans

• Greater Newport Physicians (GNP) including Edinger
• Hoag Physician Partners

Transparency in Coverage Rule (CMS-9915-F)

The Department of Health and Human Services (HHS) issued a rule which requires most group health plans, and health insurance providers in the group and individual market to disclose price and cost-sharing information to participants, beneficiaries, and enrollees. Health plan price transparency helps consumers know the cost of a covered item or service before receiving care. This ruling was effective July 1, 2022 and the link below will take you to the CMS Fact Sheet.

https://www.cms.gov/newsroom/fact-sheets/transparency-coverage-final-rule-fact-sheet-cms-9915-f