Frequently Asked Questions


Please bring your updated insurance card and any necessary health coverage information. Be aware that you may require a referral from your primary care physician for authorization before treatment can be provided by a specialist. Please contact your insurance carrier if you have any questions about your plan, coverage, and need for referrals.

List of ALL medications (both over the counter and prescription) including doses and how often you take them.

Preferred Pharmacy information including the address and telephone number.

Driver’s License and/or government issued identification (ID).

Any prior x-rays, CT scans or MRIs (not older than 6 months) for this condition only.

Clinic notes or operative reports from your referring physician or prior surgeons (that relate to the condition for which you are seeking medical consultation from our physician).

Should you have any questions before your visit, please contact us at (210) 259-8155.

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You should contact your insurance company representative who can help you determine if a referral is needed. Your primary care physician must generate the necessary paperwork to ensure your visit is authorized. All referral arrangements need to be completed before the time of your visit. Our specialist will be unable to evaluate you or provide treatment until authorization, if required, has been obtained.

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We accept MOST major insurance plans and worker’s compensation. Unfortunately, it is not feasible for us to participate in all plans. If we are out-of-network for your insurance plan, we are VERY WILLING to work with our patients. We will help you understand your insurance allowable fees and facilitate the out-of-network process regarding expected costs. Many times the cost directly to the patient can be made affordable or even similar to the expected in-network costs, particularly if surgery is necessary. It must be remembered that most patients today have high deductibles, which means greater patient responsibility for payments even for in-network procedures. For specific questions, please call our office at (210) 259-8155.

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Pain medication prescriptions for surgery will be either provided to you at the time of your evaluation in the office prior to surgery or provided to you on the day of surgery. Our policy is to accept requests or inquiries about new prescriptions and refills only during our regular office hours of 8 AM to 4:30 PM, Monday through Friday, at (210) 259-8155. Please have the telephone number of your pharmacy when you call our nurse. Understand that not all requests for pain medication will be provided or refilled until your case has been reviewed with our physician to determine medical necessity.

If you should need additional prescription pain medication, please plan accordingly by calling early in the day during the normal business week as we will not be able to accommodate your request after 4:30 PM on weekdays or on weekends. If you should feel that a prescription for pain medication or refill is needed outside of our normal hours of operation, then you will need to be seen in an emergency room and be evaluated by a physician.

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Emergencies may occasionally occur when our patients need to contact our physicians regarding pain or other symptoms. If you need to contact the physician when the clinic is closed (after-hours or on weekends), please call (210) 259-8155. Our answering service will receive the call, or an automated voice system will prompt you for leaving a voice mail. Our physicians will then contact you. If your condition is serious, you may need to be seen in an emergency room or an urgent care center.

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A “fracture charge” represents a one-time charge or bill for the management of your broken bone or fracture. Insurance carriers handle specific billing “codes” for fractures which correlate to different types of fractures involving specific body parts such as the finger, hand, wrist, elbow, or any extremity part. Each “fracture care” code has a value determined by the healthcare industry (including Medicare) which is used to determine charges.

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The fracture code is specific to the body area and type of fracture. Additional charges can apply if more than one bone is broken as each broken bone has its own fracture code. The fracture code also only pertains to care of the broken bone. If any other injuries such as wounds or tendon injury are present, these injuries are considered separate from the broken bone. If additional treatment for those injuries is necessary, additional charges will occur. Fracture care charges cover the specialist’s professional component which includes the decision-making, planning, instruction, possible casting or splinting, and need for possible “setting” of the broken bone. The charges for fracture care are higher as the charges include ongoing follow-up care for an additional 90 days (the global period). In other words, fracture charges provide you with follow-up treatment for a “global period” of 90 days during which you will NOT be charged again for the “professional component” of your ongoing care.

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The fracture charge is for the professional component only during the “global period.” Additional charges do apply to any x-rays, supplies, or subsequent casting (if needed) beyond the initial cast or splint application during the “global period” as these are not considered inclusive to the initial fracture care charge by the insurance carriers. Only the initial splinting or casting by the physician is considered part of the initial fracture care charges. X-rays and supply costs are never considered part of fracture care charges by the insurance carriers.

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It may appear as a “surgery” or procedure which is how the insurance carrier defines and recognizes these types of charges. There are some insurance carriers that actually use the term “surgery” on your insurance explanation of benefits (EOB) which can be confusing to you. During the 90 day “global period” for fracture care, the follow-up visit specific to the broken bone appears on the statement as a no charge or “post op” visit, the same language used during the “global period” for surgery.

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Injuries or disease such as arthritis, bursitis or tendonitis result in inflammation. In turn, this inflammation can cause swelling and pain. A local injection of a corticosteroid (commonly called a steroid or “cortisone”) is provided in order to diminish inflammation. The steroid medication acts to reduce the amount of inflammation by limiting the release of chemicals that produce inflammation. By doing so, it will also decrease pain and swelling which is making you uncomfortable.

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As with any injection, you may feel pain. After the injection, use of an ice pack on the area for 10 to 20 minutes at a time should help. Do not apply ice DIRECTLY on the skin for more than 10 minutes to avoid skin damage. Local swelling from the medication may cause slight discomfort and maybe an increase or flare in symptoms for a day or two. It is best to avoid activities that put stress on the area the first few days after the injection.

Usually, local anesthetics (such as Lidocaine) are used to be sure that the injected steroid medication is placed in the right location. If this is the case, then the area will be anesthetized, or at least numb, for 1-2 hours while the local anesthetic is working. Once the local anesthetic wears off, the intensity of pain can be the same as it was prior to the injection or even worse. This does not mean that the injection is not working. A corticosteroid injection will take 3-10 days to begin having a positive effect to reduce pain.

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This will vary according to the type and severity of the symptoms being treated and the severity of the condition. Symptom relief may last weeks to months. Steroid injections are not necessarily a cure for your problem.

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Corticosteroids, when utilized properly, are safe and effective drugs. When used in a low dose the potential adverse reactions are minimal. Some patients may experience a sensation of flushing for several days. Very infrequently, there is a local reaction, which may include increased discomfort for a period of time in the area that has been injected. A steroid injection should not be used over and over again. Multiple injections in the same area can produce adverse effects such as tissue atrophy and degeneration of tendon or cartilage. A very small percentage of patients (0.5%) may develop an infection in the joint after injection. This is a treatable problem, but may result in permanent disability.

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If you are diabetic, an injection of a corticosteroid can raise your blood sugar level for a brief period of time. This may necessitate careful blood sugar maintenance or a need to contact your diabetic doctor.

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Please refer to our Surgery Preparation web page for more information.

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