Patient Forms

Please click on the documents below to prepare for your upcoming appointment or surgery.

Insurances Accepted

Please contact your insurance company to verify that Fox Valley Orthopedics is in network.

PPOs

Aetna
Blue Cross Blue Shield (BCBS)
Cigna/Great West
Humana
Unicare
United Healthcare
Coventry

Networks

Beach Street Network
First Health
Galaxy
Healthcare’s Finest Network (HFN)
HealthSmart
Multi-Plan / PHCS
PPO Next

HMOs

Blue Cross Blue Shield (BCBS)
Referral required from Fox Valley Medicine, Advocate Health Partners, or Northwestern / Cadence Physician Group

Need help?

If you have questions regarding your bill or insurance coverage, please call our Patient Accounts Department. Accounts are handled by different representatives according to the first letter of your last name.

A-F: 630-524-0147
G-L: 630-524-0153
M-R: 630-524-0151
S-Z: 630-524-0148

  • Attention: Worker's Compensation Patients

    Prior to your appointment, you must provide the name and telephone number of the appropriate contact at your employer and a record of your health insurance coverage. We require this information in order to confirm proper billing arrangements.

  • Financial Arrangements

    All co-pays, deductibles and co-insurance are due at the time of your visit or procedure. We accept cash, checks, MasterCard, Visa, Discover and American Express. We also accept Care Credit.

  • Self-Pay Patients

    If you are paying for services yourself (self-pay), we require a base payment of $150.00 for an evaluation. If you require treatment that exceeds your base payment, a representative from our Patient Accounts Department will call you to discuss additional payment arrangements.

Pay Your Bill Online

Pay your bill online safely and securely through Secure Bill Pay.