Participating Insurance Plans
Insurance Information
Ortho Illinois participates with most national and local insurance plans. It is the responsibility of you, the patient, to understand your insurance policy, benefits and limitations. We highly encourage you to contact your insurance provider at the phone number on the back of your card to verify Ortho Illinois is in-network for your plan. As a courtesy to you, we will file a claim with your insurance company for benefits. Updated insurance information is required at the time of your visit. If you do not provide us with a current/active insurance card Ortho Illinois will ask you to reschedule your appointment. Based on your coverage, you will be responsible for any co-payments, co-insurance, out-of-network, or other amounts due.
Insurance and Patient Responsibility
- Please understand that insurance coverage is an arrangement between you and your insurance company, and that your insurance company may not provide full payment of your medical costs.
- Prior to making an appointment, check with your carrier to verify we participate in your plan.
- If your insurance plan requires you to obtain a referral from your primary care physician, it is your responsibility to obtain this referral prior to your scheduled appointment.
- If your insurance plan requires a co-payment, this payment is expected at the time of service.
- If you are scheduled for diagnostic testing or surgery, please check with your insurance company to determine if it requires you to obtain a pre-authorization or second opinion.
Aetna
- Commercial HMO, PPO, POS
- Aetna – State of Illinois
- Medicare Advantage – HMO, PPO, POS
The Alliance
Blue Cross Blue Shield
- Choice
- PPO
- HMO Site:
- Advocate
- AMITA
- Northwestern
- Physician Care Network #098
Cigna
- Open Access PPO Plans
Claim Doc
Corvel (Workers’ Compensation Only)
Coventry (Workers’ Compensation Only)
Dean Healthcare (Winnebago & Boone Counties Only)
Dean Advantage (Winnebago & Boone Counties Only)
ECOH
First Health PPO
- Commercial
- Medicare Advantage
Health Alliance Medical Plan
- Commercial
- Medicare Advantage
Healthlink
- State of Illinois plan
HFN
- Commercial – PPO
- Workers’ Compensation
Humana/Choice Care
- Commercial – EPO, HMO, POS
- Medicare Advantage – HMO, PPO, POS
PHCS/Multiplan –
*PHCS must be primary network
Provider Network of America
Quartz
- Excludes State UW Plan – Dane County Members
Trilogy Workers Compensation
United HealthCare
- Commercial – EPO, HMO, PPO, POS
- Medicare Advantage – PPO, AARP Medicare Complete
- VA CCN – Veterans
Government Plans
- Medicare
- Clear Springs Medicare Advantage
- Illinois Department of Public Aid
- WI Public Health / Forward Health
- Zing Medicare Advantage
*Participating providers in Advocate Physician Partners (APP) plans:
- Amrit, Anand, MD
- Frank Bohnenkamp, MD
- Robert Bohnenstiehl, APRN
- Kevin Carlile, MD
- Jeffrey Earhart, MD
- Christopher Faubel, MD
- Scott Ferry, MD
- Michael Finigan, PA-C
- Brian Foster, MD
- Kristian Green, PA-C
- Michael Harvey, MD
- Rolando Izquierdo, MD
- Jacqueline Kannan, MD
- Jeffrey Kazaglis, MD
- Francois Kelso, PA-C
- Amanda Kroymann, PA-C
- Donald Kuick, PA-C
- Cort Lawton, MD
- Stephanie Leverentz, PA-C
- Valerie McCannon, PA-C
- Sabrina Miller, PA-C
- John Moore, PA-C
- Scott Mox, MD
- Shawn Palmer, DO
- Pradeep Raju, MD
- Marie Rivers, PA-C
- Trevor Schott, MD
- Husna Siddiqui, MD
- Tom Stanley, MD
- Geoffrey Van Thiel, MD
- Jon Whitehurst, MD
- Marc A. Zussman, MD
Aetna
- Commercial – PPO, POS
The Alliance
Blue Cross Blue Shield
- PPO, Open Access, POS
- HMO: Physician Care Network #098 (only this specific site number)
Cigna
- Open Access PPO Plans
Claim Docs
Corvel Workers’ Compensation
Coventry
- Commercial – PPO, POS
ECOH
First Health PPO
Health Alliance Medical Plan
HFN
Humana/ChoiceCare
- Commercial – PPO, POS
Quartz Health ASO.HMO
- Swedish American Health System employees or dependents
- Fully insured or self-insured groups effective 7/1/2018
- Medicare Advantage effective 7/1/2018
- Quartz HMO plans do not require referrals
United Healthcare
- Commcercial – PPO, POS
- Medicare Advantage – PPO, AARP Medicare Complete
Government Plans
- Medicare
- Medicare Replacement Plans – PPO, POS, Open Access
* Not accepted at Injury Express: Self pay patients or the following insurances:
- Advocate Accountable Health
- Aetna Better Health
- Medicare Advantage
- Any BCBS HMO Plan except for site 098 (Physicians Care Network)
- Any HMO insurance plans that require a referral authorization from the PCP unless the authorization is brought to the appointment
- BCBS Community Family Health
- Harmony Health Plan
- Illinicare Health Plan
- Illinois Public Aid
- Meridian Health Plan
- Tricare Prime
- UMR Health Smart Preferred
- United Healthcare Navigate
- Veterans Association
- Wisconsin Public Aid (BadgerCare)
Aetna
- Commercial – HMO, PPO, POS
- Aetna – State of Illinois
- Medicare Replacement – HMO, PPO, POS
The Alliance
Blue Cross Blue Shield
- PPO
- HMO: Physician Care Network #098 (only this site number)
ClaimDOCs
Cigna
- Open Access PPO Plans
Clear Spring Health
- Medicare Advantage
Corvel (workers’ compensation only)
Coventry
- Commercial – HMO, PPO, POS
- Medicare Replacement – HMO, PPO
- Workers’ Compensation
ECOH
First Health PPO
Health Alliance Medical Plan
- Commercial
- Medicare Replacement
Healthlink
- State of Illinois
HFN
- Commercial – PPO
- Workers’ Compensation
Humana/Choice Care
- Commercial – EPO, HMO, POS
- Medicare Replacement – HMO, PPO, POS
PHCS/Multiplan –
PHCS must be primary network
Quartz Health ASO/HMO
- SwedishAmerican Health System Employees or Dependents – excluded from using OISC
- Fully insured or self-insured groups effective 7/1/2018
- Medicare Advantage effective 7/1/2018
Trilogy Workers’ Compensation
UIC Campus Care
must have referral from University of Illinois
United HealthCare
- Commercial – EPO, HMO, PPO, POS
- Medicare Replacement – PPO, AARP Medicare Complete
Government Plans
- Medicare
- Medicare Complete
- Wellcare Medicare
- Community Care Alliance of Illinois (Medicare Replacement)
- Illinois Department of Public Aid