The following forms may be printed and completed prior to your visit to University Orthopedics. Please complete those applicable to your appointment to the best of your ability. If you have any questions about the forms, or are unable to print a copy, please call 423-267-4585 and ask to speak to an Appointment Scheduler.
Click here to access our Patient Portal to fill out your patient history information.
Authorization for Release of Information Form
Patient Health History Form
New Patient Consent for The Use and Disclosure of Health Information for Treatment, Payment & Healthcare Operations
Patient Request for Confidential Disclosure of Protected Healthcare Information
NOTE: Please do not FAX these forms to the office. Bring them with you at the time of your visit unless you have been instructed otherwise by a University Orthopedic representative.
During the past ten years the healthcare has experienced tremendous change with new technology, innovative and alternative treatments and improved access to care. Today’s healthcare consumer is more informed, educated and aware of these improvements, and eager to access an abundance of health-related topics which are now available with a tiny "click".
The sites listed below have been recommended by the physicians of University Orthopedics as good sources of reference for a variety of topics related to orthopedic issues. Some sites may be more difficult to navigate than others or may require computer technology not available within your system. In addition, articles, booklets and other printed information related to your care are available in the group’s offices. Please ask your surgeon or a member of our staff if you are unable to obtain information about a specific issue or event and we will be happy to assist you.
Our physicians participate in the area’s major healthcare insurance plans and physician networks including:
- BlueCross Blue Shield
- United Health Care
- CIGNA Healthcare
- The Beech Street Networks
- Cariten Health
- First Health
- Assured Care Network
- Humana Networks
Please call our business office at 423-267-4585 to obtain more detailed information regarding network participation, or contact your health insurance or physician network representative.
We request that you bring your insurance card with you at each visit, which allows us to insure that all information is up to date and accurate. If you are covered by more than one plan, please bring those cards with you as well.
While our well-trained business staff makes every effort to be familiar with healthcare services covered by the various plans, it is impossible to stay abreast of the many variations and contracts offered by these health insurance companies. Each insured patient is responsible for knowing which services are covered under their plan.
Co-payments (“co-pays”) and any portion of charges you may owe through the “deductible” portion of your health insurance plan will be payable at the time of your visit. The University Orthopedics business office will file insurance claims on your behalf for those health insurance plans or networks in which the group participates. Patients with health insurance from a plan or network the group does not participate in may schedule appointments and receive services, but usually will have a greater “out-of-network” co-payment, or higher deductible to pay. The University Orthopedics Business Office will also file insurance claims on behalf of patients whose health insurance plans are in these categories, but the patient will be responsible for any unpaid charges.
If your health insurance plan requires that you obtain a "referral" from your primary or family physician, or from another physician, before you are seen by a surgeon at University Orthopedics, the "referral" must be received prior to your visit, or your visit will have to be rescheduled.
For your convenience, we accept cash, check, Visa, MasterCard and American Express.