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Billing & Insurance

Specialty Orthopaedics accepts most major insurance plans; however, some insurers offer specialized plans that may not be in-network. We encourage all patients to confirm coverage directly with their insurance provider. To verify our participation with your health plan, please reference our NPI number: 1477652139.

Please note that while Specialty Orthopaedics providers may participate in certain health plans, surgical facilities and members of the surgical care team—such as anesthesiologists—may have separate participation agreements with insurance companies.

Insurance Plans

Below is a sample list of the major medical plans we accept. While this list is updated regularly, we cannot guarantee participation with all plan products.

  • United Healthcare
  • Medicare of GA
  • Medicare Advantage
  • Medicaid of GA / Peach State/ Amerigroup/ Caresource
  • Anthem BCBS
  • Aetna
  • Cigna
  • Humana
  • Multiplan/ PHCS
  • Tricare
  • Alliant

Financial Assistance

For uninsured or underinsured patients, we offer financial assistance through Care Credit as well as discounted self-pay rates. Our team is committed to providing high-quality care and will work with you or your loved one to find solutions that make treatment accessible when you need it most.

Connect with our Team

For more information about insurance and financial assistance or for questions regarding a bill, please use the following contact information to connect with the department who can best assist you.

Pre-Cert Department
P: 470-634-5803
E: specialtyprecert@smiga.org
Work Comp Department
P: 470-634-5804
E: workerscomp@smiga.org
Billing Department
P: 470-634-5806
E: specialtybilling@smiga.org
Billing & Insurance FAQs
What to Expect: Surgery Costs, Copays, and Insurance Questions
Do I have to pay a copay at every doctor visit?

Yes, your specialist copay is typically due at each visit. The only exception is during an insurance-defined global period after a procedure, when certain follow-up visits may be included.

Why did I receive multiple bills after my surgery?

It is common to receive multiple medical bills for one surgery because different providers bill separately. You may receive bills for:

  • Surgeon (physician) fees
  • Surgery center or facility fees
  • Anesthesia services
  • Implants or medical devices (if applicable)

Each bill reflects a different component of your care and is processed separately by your insurance. You can expect receive a bill from Specialty Orthopaedics for the physician’s services and a separate bill from Specialty Orthopaedics Surgery Center for the facility fee if your procedure is performed there.

Why is my insurance asking if my injury was caused by an accident?

Insurance companies often send an accident or injury questionnaire to determine if another party may be responsible for your medical bills.

You must:

  • Complete the form or
  • Call your insurance company to provide the requested information

Important: Your claim will not be processed until you respond. Failure to respond may result in you being responsible for the full balance.

What is Coordination of Benefits (COB)?

Coordination of Benefits (COB) is the process insurance companies use to determine which plan pays first when you have more than one insurance policy (such as primary and secondary coverage).

How do I update my Coordination of Benefits (COB)?

Keeping your COB updated helps prevent claim delays, denials, or billing issues.

  • Medicare: Call the Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627
  • Other insurance plans: Call the Member Services number on your insurance card

You should update your COB if you:

  • Have multiple insurance plans
  • Recently changed coverage
  • Have a workers’ compensation claim
Why did I receive a bill for my brace (DME) if it was covered by insurance? Why am I receiving this bill?

“Covered” means your insurance approves the item, but it does not guarantee full payment. You may still owe out-of-pocket costs, such as:

  • Deductibles
  • Copays
  • Coinsurance

Your final cost depends on your specific insurance benefits and plan coverage.

How long do I need to keep the brace (DME) provided by my doctor?

Most insurance plans cover a replacement brace every 5 years if it is the same or similar type. To avoid out-of-pocket costs, we recommend keeping your brace for at least 5 years.

Why Choose Specialty Orthopaedics?

Our vision is to provide excellent, patient-focused, comprehensive orthopedic care to patients of all ages across North Georgia. With more than 20 years of experience, Specialty Orthopaedics has grown to become a pillar of the North Georgia medical community with four convenient locations in Gainesville, Dawsonville, Braselton, and Duluth. A leader in orthopedic care, our Fellowship Trained and Board Certified, physicians specialize in offering the latest and most advanced surgical and non-surgical treatment options.

Contact Us
Today

To schedule an appointment or for information about the treatment options offered at Specialty Orthopaedics, contact us today.
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