Dallas Orthopedic and Shoulder Institute is dedicated to making every effort to get payment from your insurance company. Please understand, it is the patients’ responsibility to keep the doctor’s office up to date with current insurance information and make them aware of any insurance changes. If proper notification is not made, the patient may be responsible for charges not covered at the time of service by the insurance company. If an insurance company requires a referral from the primary care physician, it is the patient’s responsibility to have this in place before the visit. The patient may receive a bill for the full charges of any items and services, or have to pay out-of-network cost-sharing under their health plan if the above requirements are not met. If you are paying as a “self-pay” patient, please understand that amounts paid will not count toward your health plan’s deductible or out-of-pocket limit.