UnitedHealthcare PPO – Frequently Asked Questions
Q: Are you still seeing UnitedHealthcare PPO patients?
Yes - we are happy to continue seeing patients with UnitedHealthcare PPO. However, as of October 2025, we are no longer in-network providers with UHC PPO.
Q: What does this mean for my visits and surgery?
All clinic visits (new and follow-up) will now be billed as out-of-network. You will pay at the time of service, and we’ll provide a superbill for you to submit to your insurance if you want to seek reimbursement.
Q: What if I recently had surgery with you while you were still in-network?
If you are still within the standard 90-day postoperative global period, we will continue to honor that period without charging for follow-up visits, even after our UHC contract ends.
Please note: Supplies such as imaging, splinting, or braces may still carry a fee.
Q: Will future surgeries still include a 90-day global period?
Yes. If you have surgery with us after we are out-of-network, your surgical fee will still include a full 90-day global period of follow-up care.
Q: What parts of my care might still be covered by UHC?
Even though we are out-of-network, many parts of the surgical episode may still be covered in-network, including:
- Hospital or surgery center facility fees
- Anesthesia services
- Many implants and surgical supplies
- Intraoperative imaging
Q: Does this change affect UnitedHealthcare HMO plans?
No. If you have an HMO plan through UnitedHealthcare and we are a participating provider, this change will not affect you. We are out of network for UnitedHealthcare PPO plans only.
Q: Will you bill UnitedHealthcare for me?
No. Since we are out-of-network, we do not submit claims to UHC. However, we will provide a detailed receipt (superbill) with all necessary codes to help you file for reimbursement.
Q: How do I know if I’ll be reimbursed?
We recommend calling the number on the back of your UHC insurance card and asking:
- “What are my out-of-network benefits for orthopedic care?”
- “What’s my reimbursement rate for an office visit or surgical procedure?”
- “Will reimbursement be sent directly to me?”
Q: Why are you leaving the network?
UnitedHealthcare PPO’s reimbursement rates are not sustainable for our practice. This shift allows us to continue delivering excellent care, maintain transparent pricing, and reduce administrative delays for our patients.