Your Appointment

YOUR APPOINTMENT

At the Charlottesville Orthopaedic Center, we make it easy for you to manage your own account with us. That means you can do everything from scheduling an appointment and paying your bill to coordinating the medical care we provide with your own insurance company.

Here’s all the information you need to get started.

APPOINTMENT REQUEST

Please complete the appointment request form and then click “submit.” We’ll call you back within 24 hours to schedule your appointment.

If you are already seeing a particular physician, please select from the “Requested Physician” list. If you do not have an assigned physician but would like to request an appointment, you may leave that selection blank.

Name:

Email:

Phone:

Patient's Date of Birth:

Address:

Patient's Insurance Company:

Patient's Insurance ID #:

Preferred Contact Method:

Description of Problem:

Requested Physician:

Additional Comments:

INSURANCE

Our practice accepts payments from most insurance companies, including many of those accepted by Martha Jefferson Hospital. We’re happy to file insurance claims for your plan if it’s not one of those on our list.

Charlottesville Orthopaedic Center participates with the following list insurance plans:

Aetna
Anthem
Cigna
Humana
Medicare
Optima Health
Tricare/Champus

United Healthcare
VHN
Worker’s Compensation (with advance approval from your worker’s compensation carrier)

And don’t forget: Always bring your insurance cards to your visit.

PAYMENT

Please bring your copayment with you at the time you are treated. We accept cash, check, Visa, MasterCard, and CareCredit.

REFERRAL

Check with your insurance company to determine if you need to obtain a referral to see one of our physicians. If you do, contact your primary care physician prior to making your appointment. You are responsible for your bill if you do not obtain proper authorization from your insurance.

QUESTIONS

We’re always available to answer financial and billing questions, so please call us at (434) 220-0335 when you have questions or need help.

WHAT TO DO BEFORE YOUR VISIT

INFORMATION FOR ALL PATIENTS

Insurance

Please bring your insurance card and referral from your primary care provider if required by your plan.

If you have no insurance or are otherwise paying with cash on your own, you will need to contact the office prior to your visit to set up payment options.

Payment

Copay is due at time of registration

Worker’s Compensation

Please bring your Worker’s Compensation information:

Employer’s name and phone number
Name of Worker’s Compensation Insurance Company
Address and phone number
Case manager’s Name
Claim number
Authorization notice from Worker’s Compensation that we can see you.

Children

Children under the age of 18 must be accompanied by a parent. A temporary guardian is allowed if there is written authorization from a parent or legal guardian.

X-ray and MRI

If you have had x-rays and/or an MRI outside of UVA or Sentara Martha Jefferson Hospital, please bring the films and the report with you for your initial visit.

Forms

To help make your office visit more efficient, please print and complete the following forms prior to your appointment.

New Patients to the practice: Form (PDF)
Established Patients last seen over a year ago but less than 3 years: Form (PDF)
Established Patients not seen in 3 or more years: Form (PDF)

Each document is in .pdf format and requires Acrobat Reader to open (click to download Acrobat Reader).