Wichman Orthopedics
Insurance & Billing
Out-of-network, without the surprise bills.
Choosing an out-of-network surgeon shouldn't mean paying more, or worrying about a bill you didn't see coming. Here's exactly how we protect you.
Choosing an out-of-network surgeon shouldn't mean paying more, or worrying about a bill you didn't see coming. Here's exactly how we protect you.
Before your visit, we send a secure payment link for only what you'd owe an in-network surgeon, typically just your plan's copay. No penalty for choosing us.
We will never send you a surprise bill for the difference between our fee and what insurance pays. Sorting that out is our job, not yours.
When surgery is needed, we operate at a facility that's in-network for you, so your facility and anesthesia costs stay at your in-network level.
When you see a doctor who is out-of-network, the thing most people worry about is a big surprise bill. A federal law, the No Surprises Act, exists to protect you from exactly that.
Here is the simple version. For care connected to an in-network facility, the law limits what you can be charged to your normal in-network amount, the same copay, deductible, and coinsurance you would owe an in-network doctor. If your insurance pays us less than we billed, sorting that out is our job to handle with your insurance company, not yours. There is even a federal process for it, called Independent Dispute Resolution, and it happens entirely between us and the insurer.
What this means for you:
A couple of things to know. These protections apply when your surgery is performed at an in-network facility and your plan includes out-of-network benefits (many plans do, and in this arrangement they simply sit in the background). Every plan is a little different, so we verify your specific coverage and walk you through what to expect before anything is scheduled. If your plan has no out-of-network benefits, call us and we will explain your options clearly.
Read the government's official overview of the No Surprises Act
The same copay, deductible, or coinsurance you would owe an in-network doctor, nothing extra for choosing us. We send a secure payment link before your visit, so there is nothing to handle at the front desk.
A careful exam, any imaging you need, and a clear diagnosis, with the full range of options laid out. Surgery only if you truly need it.
So your hospital and anesthesia costs are billed at your in-network rate, just like any in-network surgery.
If your insurer pays us less than we billed, we resolve it with them directly through the federal process. Nothing more falls to you, no claims to chase, no surprise bills.
You will never owe more than you would have with an in-network physician for the same care.
Dr. Wichman built this practice to put patients first, with the time to listen, the freedom to recommend what's genuinely right for you, and a billing approach designed to remove financial fear from the equation. Being out-of-network lets us practice medicine on your terms, not a contract's.
In the vast majority of cases, no. Our policy is to collect only your in-network-equivalent share, typically your copay, up front, and to pursue the rest from your insurance company ourselves.
No. We do not send patients surprise bills for the balance between our charge and what insurance pays. That's our commitment.
Some plans work differently. Please call us before your visit and we'll review your specific coverage and explain your options clearly, always before anything is scheduled.
Yes. Dr. Wichman is a participating Medicare provider, so patients with traditional Medicare are welcome and we bill Medicare directly. Medicare Advantage (Part C) plans are run by private insurers with their own networks and rules, so some may work differently or may not cover care with us. Call us with your specific plan and we'll check before anything is scheduled.
We're sorry, but we are not able to see patients whose coverage is Medicaid at this time. If Medicaid is your insurance, please call us and we'll do our best to help point you in the right direction.
We perform surgery at facilities that are in-network for you, so hospital and anesthesia costs are billed at your in-network rate. For our surgical fee, we work directly with your insurer, that part doesn't fall to you.
We'll give you a straight answer, before you ever step in the door.
This page describes our general billing philosophy and is not a guarantee of coverage or payment. Benefits vary by plan and situation. Please contact our office to confirm the details for your specific insurance. Wichman Orthopedics and Wellness is the trade name of Wisconsin Center for Orthopedics and Wellness, S.C.