Business Services

Message to our Patients:  Thank you for choosing Rothman Orthopaedic Institute for your care.  The Business Services Department is here to assist with your financial concerns related to your treatment.  The changes of healthcare, coverage and benefits has become more of a challenge and the need for clarification is important to understanding exactly what is covered by insurance and what is paid for by the patient.  This purpose of this brochure is to summarize our departments and services available to you. 

Insurance Plans: Rothman Institute participates with most commercial insurance plans including Medicare, Blue Shield, Horizon, Personal Choice, Keystone Health Plan East, Amerihealth, Cigna, Aetna, United, Oxford, etc. If you have any questions about insurance, please contact our Patient Registration department at 267-339-7855 .

Patient Registration: Rothman Institute participates with most commercial insurance plans. If you have any questions about insurance or your plan’s coverage with the Rothman Institute, please contact our Patient Registration department at 267-339-7855.

Referrals: If you have an HMO plan and a referral is required, we ask that you contact your Primary Care Physician (PCP) and request a referral for evaluation and treatment (CPT code 99499). This will cover all services during the approved time period. The Registration department will attempt to locate a referral; however, if you do not have an active referral on the date of your appointment, you will be required to pay out of pocket or reschedule after a referral is obtained. Please see list of NPI provider numbers. Your PCP will need this information to issue a referral. If you have questions about your referral, kindly contact your insurance company or our Registration Department at 267-339-7855.

Worker’s Compensation/Auto Department: If you have a work related injury of an injury that is the result of an auto accident or other accident, kindly contact the worker’s comp/auto department with any questions. In order to treat at the Rothman Orthopaedic Institute, you will be required to provide all claim information, including date of injury, approved body part, insurance company and adjuster/nurse case manager contact information. All claims have to be verified and approved prior to the appointment. Auto claims need to be verified and benefits assessed prior to scheduling an appointment. We will also ask for your medical insurance as a back-up for non covered services. The direct number is 267-339-3776.

X-Rays:  An x-ray will be performed at the time of your appointment if warranted.  If you are capitated for radiology services, we ask that you please bring an x-ray on the day of your appointment.  If you would like us to provide an x-ray, we can do so at a discounted rate.  You can discuss this with the Front Desk Representative when you arrive. 

Pre-Certification/Financial Counseling:  Most surgical procedures and epidural injections require pre-certification through the insurance company.  Our pre-certification department will contact your insurance company and obtain your benefits.  This will include your deductible, co-insurance and approval/authorization number.  The information we provide to you is what we have been given from your insurance company.  We encourage you to reach out to your insurance company with any questions you may have about your specific plan and financial responsibility.  In the event you have a responsible portion, a financial counselor will attempt to contact you to provide detail and explain your out of pocket costs prior to your procedure. It is our goal to provide you with important information about your benefits and patient responsibility. 

Visco Supplement Injections:  Prior to your visco supplement injections (Orthovisc, Euflexxa, Monovisc, etc.) our central pre-certification department will contact your insurance company to obtain an authorization, as well as co-insurance and deductible amounts.  Insurance plans have preferred medications and we will contact your insurance company to obtain this information.  In the event you have a responsible portion or deductible, a representative will attempt to contact you to explain your benefits and financial responsibility. 

Patient Accounts Department/Statements:  During the course of your care, you will receive a statement with your patient responsibility for services rendered.  Our patient accounts department can be reached during the hours of 9:00 a.m. to 4:00 p.m. Monday through Thursday.  Friday hours are 9:00 a.m. to 12:00 pm.  Due to the volume of calls, we recommend you consider using our convenient online bill pay system as well as submitting any inquiries via our website at www.rothmaninstitute.com, where you can submit an online billing inquiry.  You will receive a response within 24-48 hours. 

Provider ID Numbers:

IBC (Personal Choice, Keystone, Amerihealth) Group Provider Numbers

PA – TIN 23-2856880
Provider # 0052411000 - Rothman-Recon Ortho. Assoc. (Multi-specialty Group)
Provider # 0457538000- Rothman -Recon Ortho. Spine
Provider # 0781362000- Rothman-Recon. Ortho. Podiatry 
Provider # 0035576000 - Rothman-Recon Ortho. Physical Therapy
Provider # 0002740000 -Rothman-Recon Ortho-DME
NJ - TIN 22-3700669
Provider # 0088890000 –Rothman Orthopaedic Institute NJ (Multi-specialty Group)
Provider # 2282582000- Rothman Orthopaedic Institute NJ –Physical Therapy
Provider # 2640452000 - Rothman Orthopaedic Institute NJ-Occupational Therapy
Provider # 0005209000 - Rothman Orthopaedic Institute NJ –DME

Rothman Orthopaedic Institute Provider Numbers

Aetna – PA Group Provider # 5085455
Aetna – NJ Group Provider # 7002166
Cigna – PA Group Provider # 23-2856880
Cigna – NJGroup Provider # 22-3700669
Horizon HMO PA - 78022328568800
Horizon HMO NJ - 78022237006690
PA TIN# 23-2856880
NJ TIN# 22-3700669