Our staff will gladly assist you with any questions you have regarding your bill. Contact the Billing Department at 800.824.9861 or 937.415.9166, Monday – Friday, 8 am – 5 pm.

Insurance

Please bring your insurance card with you at the time of your first appointment. Your insurance carrier requires that all co-pays be made prior to any services being rendered. You are responsible for any co-insurance, deductibles or non-covered services as required by your insurance. You will receive a statement from our office indicating what your insurance has paid. Any remaining balance is due upon receipt of that statement

View insurances accepted

This list is not all encompassing but if claimed through one of the networks listed, OA should be considered in-network (exclusions listed in notes column).

Workers Compensation

If your injury occurred while on the job, please contact our Workers Compensation Department at 800.824.9861 or 937.415.916. We have specialists available to help you file the proper forms in order to receive care in a timely fashion.

Returned Checks/Rejected ACH Withdrawals

A $25 charge will be added to your account for any checks returned or ACH withdrawals rejected by your bank for any reason. This charge is in addition to any fees your financial institution may charge you.


Disability or Insurance Forms

There will be a charge of $20 for completing medical forms. Payment is due prior to the forms being completed. This charge is per occurrence, not per number of forms. You will also need to fill out a Medical Records Release so that we may include required medical documentation. Please allow 7 to 10 days for completion.

Medical Records

We will provide you a copy of your medical records upon request. You will need to sign a letter of release at the time of pick-up. Please allow 30 days for us to copy your records. If you wish for your records to be mailed, there may be an associated fee to cover the mailing costs. You may be charged for additional copies of your medical records.

Please note all charges for copies for Medical Records follow the Current fees allowed by the Ohio Revised code sections 3701.74, 3701.741, and 3701.742, any actual cost of related postage incurred by the health care provider or copy service will also be charged at actual cost as allowed by law.

MEDICAL RELEASE FORM