North Jersey Orthopaedic Clinic :: Patient Information

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of the latest proceedures
and advancements
through the words
of Dr. Frank Alberta

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Patient Forms:

HIPPA Form (PDF 78k)

Patient Registration Form (DOC 1168k)

Medical Information Sheet (DOC 230k)

Patient Shoulder Questionnaire (PDF 118k)

MRI Arthrogram and Diagnostic Hip Injection (PDF 324k)

Insurance Information

North Jersey Orthopaedic Clinic and Dr. Alberta are credentialed with most major insurance carriers. We are participating providers with the following insurers:

Aetna-HMO/PPO
Amerihealth
B/C B/S-Blue Card/Traditional Plan
Cigna
Healthnet
IDA
Medicare
Qualcare

If your insurance is not listed above, our staff will be more than happy to assist you in determining your eligibility. In most cases, we can still accommodate you. Please call the office and speak with our Eligibility specialist, Lynda, to determine your benefits.

If you were injured in a work related or motor vehicle accident, we participate with most Workers’ Compensation & No-Fault insurance carriers. These insurers require preauthorization from your adjustor before you can be seen in our office. You must provide your claim number, adjustor’s name and contact information, and employer’s information at the time of your visit.

If you have been referred to us from your primary care physician or belong to a managed care or HMO program, you are responsible for making sure you have proper authorization and Referral forms for all your visits.

WITHOUT AUTHORIZATION, WE WILL BE UNABLE TO SEE YOU.

Co-Payments are expected to be paid at the time of service. We accept the following methods of payment: Cash, Check, MasterCard & Visa

What To Bring To Your Visit

ALL Insurance I.D.Cards
Referral Forms (if applicable)
Previous Health Records
List of Current Medications
ANY x-rays, MRI’S, medical notes and test results that pertain to your current problem

What To Wear To Your Visit

If you are seeing the doctor for a knee, hip, ankle or back problem - wear or bring a pair of shorts.

Women who are being seen for a shoulder, elbow or neck problem – wear or bring a sleeveless blouse or tank top/sports bra.

Cancellations

If you are unable to keep an appointment, we ask that you kindly provide us with at least 48 hours notice. This courtesy, on your part, will make it possible to give your appointment to another patient.

Prescriptions & Refills

All prescription renewal requests must be received during normal business hours or they cannot be filled. This policy is for your safety, since your full medical records are only available during these hours.

Hospital Affiliations

Hackensack University Medical Center
30 Prospect Ave.
Hackensack, NJ 07601
www.humc.com

The Valley Hospital
223 North Van Dien Ave.
Ridgewood, NJ 07450
www.valleyhealth.com

Metropolitan Surgical Center
433 Hackensack Ave
Suite LL01
Hackensack, NJ 07601
ph: 201-527-6800
fax: 201-342-9383
www.metrosurgerycenter.com