Jackson Orthopaedics &

Sports Medicine

Board Certified-

American Board of

Orthopaedic Surgery

150 South East Ave, Jackson, Michigan
   
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Office Visits
     
    Patient Information Forms
   

For your convenience, you may print, complete, and bring these forms with you:

* Patient History Form
* Medication Flowsheet
* Insurance Registration Form
* Release of Records
     
    When You Arrive
    Please have your insurance information ready and give it to the secretary when you check in. Also bring along any authorization and/or referrals required by your insurance. If you are a returning patient and any insurance or personal information has changed since your previous visit, please notify the secretary when you arrive.

In order to help your physician learn as much as possible about your condition, we ask that first time patients please bring the following:

* X-rays taken within 6 months

* MRI films/reports

* Complete medication list

* Pertinent medical information, including allergies

* Insurance cards

* Referral when necessary

* Workers Comp or auto claim information.

* New acute injury: Current films taken at the Hospital or an urgent care center or other physician's office

     
    Prescription Refills
    Please check your medication supply before each appointment so you can arrange for refills while at the office. If you run out of a routine medication between visits please call us Monday through Thursday between 8:00 a.m. and 4:30 p.m., or Friday between 8:00 a.m. and 3:00 p.m. Our office staff will check with your doctor and arrange for the refill upon his approval, after his review of your chart. Prescriptions are usually called in at the end of the day.

Please have available the following information:

  • pharmacy name& phone number
  • prescription number
  • medication type
  • dosage schedule

For your health's sake, arrange for refills at least 48 hours before they're needed, and remember, you'll need to call Monday through Friday.
     
    Insurance
    We participate with Medicare and will file all claims on your behalf. You will be responsible for all co-pays, deductibles, and any services not covered by Medicare.
     
    BCBS, HMO's, MANAGED CARE PLANS
     The individual physicians may have participation agreements with your plan. Please call the office for further information. Because we are a specialty practice we must have prior authorization for all HMO plans, including Medicaid HMO's. Please call your primary care physician first, even if you are referred by Foote Hospital's emergency room.
     
    Workers Compensation
    All workers compensation patients must have written authorization for treatment.
     
    Auto Insurance & Liability
    We require the name and address of the insurance company as well as the claim number referring to the injury. Auto insurance is always primary to Medicare or Medicaid. If there is a lawsuit associated with the problem you are being seen for please notify us prior to your visit.
     
    Minors
     All children under 18 must be accompanied by a parent or legal guardian for their first visit. The guardian who signs the authorization for the child is responsible for payment, unless previous arrangements are made.