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please call
(972) 566-6444

7777 Forest Lane (map)
Building B, Suite 424
Dallas, TX 75230

PRACTICE BILLING PHILOSOPHY

IT IS OUR INVIOLATE POLICY TO PLACE THE WELFARE OF OUR PATIENTS ABOVE OTHER CONCERNS.

We are SENSITIVE TO THE FINANCIAL CONCERNS OF OUR PATIENTS and will make every effort to accommodate their financial situation in order to lessen the burden that their Neurosurgical problem has placed upon them.

We understand that:

  1. The practice of Neurosurgery along with the associated technologies, medications and procedures have become considerably more sophisticated which can make it more difficult for patients to understand;

  2. The complexities of the entire health care system have evolved into one that many patients view as unfathomable;

  3. Our patients are feeling most vulnerable when a Neurological illness has beset them;

  4. Dealing with a major Neurological problem that warrants Neurosurgical intervention is stressful;

  5. Having to comprehend and manage an insurance company's rules and regulations can be daunting;

  6. Identifying financial responsibility for co-payments or out-of-pocket expenses as well as understanding a hospital's demands for financial disclosure and guarantees of responsibility can add to this stress;

  7. The need for our patients to comprehend these complexities is essential;

  8. At a time when one is concerned for one's life and Neurological integrity, these additional issues can become overwhelming;

  9. Getting the most competent Neurosurgeon to care for you may not be geographically or financially convenient for you or your family;

  10. For many Brain and Spine surgery patients, the first surgical treatment is the most important one. It may well determine the quality of your existence for the rest of your life;

  11. This may be one of the most important choices that you will ever make in your life.

How We Can Help

Even though we are not participants in any Government (Medicare/Medicaid) or commercial insurance plans, we will work diligently to determine the requirements of your particular insurance company recognizing that "plans" vary from one to the other. Our staff members are familiar with and manage these matters for you to the extent that this is possible. Our staff will automatically "pre-certify" your Neuroimaging investigations as well as your operation with your health insurance company. They are familiar with the terminology and unique "coding" requirements of insurance companies and hospitals.

It is imperative that we have the correct information from you regarding you insurance plan and the healthcare coverage that plan provides to you.

Our Business Office will provide you with an itemized written estimate (with explanation) of the costs of the Neurosurgical procedures. If, for any reason, this has not been provided please request one.

We employ standardized "Procedural Codes" which are in general use in this country for any of the operations that we conduct.

BLACK BOX WARNING

BLUE CROSS-BLUE SHIELD of TEXAS (BCBS)

BLUE CROSS-BLUE SHIELD of TEXAS (BCBS) has instituted a physician payment scheme that ranks among the most restrictive in the USA. BCBS has chosen to pay "participating" (contracting) physicians at rates comparable to or lower than the already bottom-basement Medicare price schedules. This has resulted in several hospitals and multiple physicians/physician practice groups taking the drastic step to disassociate from BCBS. Patients who have used those physicians and/or hospitals must now find other facilities.

NEUROSURGICAL CONSULTANTS, pa has made special arrangements to accommodate patients who are covered by BCBS of Texas. Please see INSURANCE & COST SAVINGS.

In addition your Neurosurgeon will, on occasion, be required to ACT AS YOUR Patient Advocate This may require us to write to the insurance company, government agency or your attorney on your behalf. While you are in the hospital, your Neurosurgeon may need to support your need for a higher level of nursing care, special treatments, access to specialized equipment and a longer stay than is ordinarily underwritten by the insurance company (or Medicare.) These are added duties which we accept as part of our responsibility to you.

For any portion of your care that is not covered by your insurance plan you may use your personal check, Visa, MasterCard, or American Express. As the patient, you are ultimately responsible for payment for the care rendered. We appreciate your consideration in making payment at time of service.

LIMITATIONS

Unfortunately (and very importantly) there are limitations that the Neurosurgeon and the office staff are working under when it comes to your insurance company. Since you, another family member or an employer made a choice regarding the actual insurance company contracted with, the extent of coverage purchased on your behalf may have significant monetary, as well as procedural limitations. This may mean that some Neuroimaging and/or Operations, even though they are clearly medically indicated, may not be covered. Our office may be able to assist you in identifying these parameters; however, we have no capability to change those limitations on your behalf. This contract is between you and that company.

WE ARE NOT ABLE TO PROSPECTIVELY IDENTIFY THE ACTUAL REIMBURSEMENT THAT MAY BE FORTHCOMING FROM YOUR INSURANCE COMPANY FOR ANY SURGICAL PROCEDURES SINCE YOUR INSURANCE WILL NOT DISCLOSE THOSE TO US. UNFORTUNATELY, IN OUR EXPERIENCE, THEY RARELY EVER DISCLOSE THIS TO THE PATIENT AS WELL.

OUR ADVICE

DO NOT LET THE INSURANCE COMPANY DETERMINE WHO YOUR NEUROSURGEON WILL BE. For many patients this is a matter of FIGHTING FOR YOUR LIFE. It is imperative to recognize that health insurance organizations are generally in the business of making a profit which frequently means limiting their financial exposure and limiting your access to higher levels of medical care.

COST SHOULD NOT STAND IN YOUR WAY. You need the best, not the least expensive Neurosurgeon available.

OUR TEAM IS WILLING TO WORK WITH YOU TO MAKE THE TREATMENT THAT YOU NEED AVAILABLE TO YOU. We do not believe that financial issues should be the primary limiting factor impeding your access to the level of Neurosurgical assistance offered by our Surgeons.

WE UNDERSTAND AND ARE SENSITIVE TO THE FINANCIAL ISSUES THAT FACE OUR PATIENTS. Under certain circumstances, we will discount our fees in order to assure that you have access to the care that you seek. Our staff will work with you to arrange a payment plan and terms that will suit your needs. We encourage you to speak to a representative from our Business Office.

AS A GENERAL RULE, WE DO NOT IMPOSE INTEREST CHARGES ON ANY OUTSTANDING ACCOUNTS provided that the patient is candid and transparent in their financial commitment regarding the contracted services that we have provided. In unusual circumstances where the patient has, without adequate notice, explanation or reasonable effort, failed to meet their commitment, we reserve the right to impose interest and carrying fees that are consistent with contemporary commercial practices. In the rare event that this becomes necessary, the patient will be informed in writing well in advance of the implementation of those charges.

WE ARE RELUCTANT TO EMPLOY A "COLLECTION AGENCY"; however, the unusual circumstances referred to in the preceding paragraph may also result in our initiating alternative "Collection" methods.

OUR COMMITMENT

WE ARE SENSITIVE TO THE FINANCIAL CONCERNS OF ALL OF OUR PATIENTS.

WE WILL MAKE EVERY EFFORT TO ACCOMMODATE YOUR FINANCIAL SITUATION IN ORDER TO LESSEN THE BURDEN THAT YOUR NEUROSURIGAL PROBLEM HAS PLACED UPON YOU.

WE ARE WILLING TO BE YOUR ADVOCATE BEFORE, DURING AND AFTER YOUR STAY IN THE HOSPITAL.


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This page last edited on 2/19

All content ©2016 by Neurosurgical Consultants, P.A.
Author, Martin L. Lazar, MD, FACS
All Rights Reserved. See Usage Notices.