My goal is to provide you with the finest personalized and complete care in my specialty.  It is my intention to help you resolve your complaint(s) on an enduring basis.  Frank and open communication is essential to achieving that goal in the most efficient and effective manner.  If at any time you have questions or concerns regarding my services and / or policies, please bring them to my attention.

1. Prior to your first visit please:

• Fill out, as completely as possible, sign and date the enclosed health questionnaire.

• Obtain any imaging studies ("x-ray", CT scan, MRI, bone scan) films along with copies of the radiologist’s reports and the results of other pertinent tests and/or consultations.  If providers require verification that you have an appointment with me, I will be happy to provide that verification by phone.

2. Please bring with you to the first visit:

   • the completed questionnaire

   • imaging reports / studies

   • pairs of shoes which you use frequently

   • shoe inserts / orthotics which you currently use

   • bite appliances / retainers which you currently use

3. Please wear loose fitting clothing for all visits.  Female patients should not wear girdles, dresses, or skirts.  They should wear slacks or shorts.

4. Patients under the age of eighteen must be accompanied by a parent or guardian throughout each visit.  They should be under the concurrent care of a pediatrician or family physician.

5. Please do not bring children requiring supervision to the appointment, as they are likely to significantly compromise the value of the visit.

6. My services are scheduled to enable both personal and time-intensive care.  Please notify me as soon as you know that you will be unable to keep an appointment.

7. Your initial visit will last approximately 85 to 115 minutes (1 1/2 to 2 hours).  Routine follow-up appointment times will last approximately 25 to 55 minutes (1/2 to 1 hour). Visit times will usually be less for pre-school and infant children.

Fees and billing 

1. Fees vary as determined by the specific services provided at each visit. 

2. For Medicare patients:  I do accept Medicare patients on a non-participating basis. (In other words, I do not accept assignment.)   My fees are what Medicare calls "limiting charges" and are the maximum amount allowed by law that can be billed and collected from a Medicare patient. It is anticipated that Medicare will pay 80%, less any deductibles, of the "non-participating amount" schedule for my services.  As required by Federal law, we will bill Medicare for you.  If you have secondary insurance and if you provide us with that information prior to our billing Medicare, then we will submit that to Medicare with our billing.  In that case, after processing and paying, Medicare will forward the residual claim to your secondary carrier.  Payment will be due, in full, to me as soon as you receive the payment from Medicare. Typically, we submit bills for Medicare covered services once every six months.
   *Initial visit at the request of and with a report to another physician.
       2009 estimated fee ranges for total due:  
              Consultation* -  from $228 to $446 (commonly ~ $397)
              New patient -  from $182 to $395 (commonly ~ $377)
              Established patient -  from $96 to $237 (commonly ~ $152)
       2009 estimated secondary insurance and / or out of pocket expense:
              Consultation* -  from $69 to $136 (commonly ~ $121)
              New patient -  from $55 to $120 (commonly ~$114)
              Established patient -  from $29 to $72 (commonly ~ $46)

3. For Tricare patients: fees are the same as for Medicare patients; however, payment in full is required at the time services are rendered.  Please pay by check.  Each Tricare patient must also sign a waiver agreeing to pay my bill in full, even if the Tricare administrator processes the claim in a manner inconsistent with my bill. A receipt will be provided which contains the codified information necessary for you to submit a claim to Tricare.

4. Due to the length of time spent with each patient and the specialized nature of my services, I do not contract with any private (HMO or PPO) insurance plans.  If you are not covered by Medicare insurance and have not made other arrangements as described below, payment in full is required at the time services are rendered.  Please pay by check.  A receipt will be provided which contains the codified information necessary for you to submit a claim to your insurance company.

5. If you have been in an accident, are covered under workman's compensation, or have HMO coverage, I will accept payment directly from the insurance company, if and only if I receive advance written notice from the insurer that they will promptly pay my bills IN FULL in accordance with my fee schedule.  I do not accept liens.

6. Estimated fee ranges for non-Medicare pre-school age and younger:
   Consultations* -  for approximately 45 - 60 minute visit: usually between $381 and $413 (commonly 99243-25; 98927).
   New patient -  for approximately 45 - 60 minute visit: usually between $281 and $313 (commonly 99203-25; 98927).
   Established patient -  for approximately 15-25 minute visit:  usually between $228 and $260 (commonly 99213-25; 98927).

7. Estimated fee ranges for non-Medicare greater than pre-school age: 
   Consultations* -  for approximately 2 hour visit: usually between $628 and $723 (commonly 99245-25; 99354-25; 98927; 97112).
   New patient -  for approximately 2 hour visit: usually between $528 and $623 (commonly 99205-25; 99354-25; 98927; 97112).
   Established patient -  for approximately 45-55 minute visit: usually between $248 and $343 (commonly 99214-25; 98927; 97110).

8. Itemized statements, medical records, and / or medical reports will be released to third parties only upon your written authorization and advance payment by the requesting party for each of these services. Each patient will receive, upon their signed authorization, one copy of their medical record for no charge.

9. I am available to consult with your attorney and to provide medical testimony.  Each of these services will be provided upon advance payment by your attorney.