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Building B, Suite 424
Dallas, TX 75230

Practice Billing Philosophy: What are my insurance options?

Neurosurgical Consultants, P.A. does not participate in any insurance plans. EVEN THOUGH WE ARE NOT PARTICIPANTS IN YOUR PARTICULAR INSURANCE PLAN, we are pleased to see you in consultation, help you to fully understand your Neurosurgical condition and determine the most appropriate course of action for you. We are always willing to work with you regarding the financial aspects of your Neurosurgical care.

Out-of Network Benefits

Most plans allow patients Out-of Network Benefits. In most cases this will provide our patients adequate coverage. You may wish to verify the parameters of your out-of-network benefits with your particular plan before you come in for an appointment. However, we would not permit this to stand in the way of your consultation should you desire one. Our professional assistants are experts in assisting patients with various health insurance issues. Please feel confident in discussing your concerns with them.

In many instances the ACTUAL OUT-of-POCKET EXPENSES may prove to be LESS than if a patient remains "In-Network". While this seems counter-intuitive, it is quite factual. Once our office staff helps you to determine the details of your insurance plan, they can then assist you in working through these financial details. PATIENTS ARE OFTEN VERY PLEASANTLY SURPRISED TO LEARN THAT THEIR PERSONAL FINANCIAL COST IS LESS SINCE WE MAY HAVE CONSIDERABLE MORE LEEWAY TO LOWER THE ACTUAL "OUT-OF-POCKET" COST THAN AN "IN-NETWORK" NEUROSURGEON DOES.

AS OUT-of-NETWORK NEUROSURGEONS, WE ARE NOT CONTRACTUALLY OBLIGATED TO ANY OF THE INSURANCE COMPANIES' RESTRICTIONS THAT AN ORDINARY NEUROSURGEON IS REQUIRED TO IMPOSE ON THE PATIENT. Having this latitude permits us to work with the patient to REMOVE BARRIERS that WOULD ORDINARILY stand in the way of your access to the level of Neurosurgical assistance offered by our Surgeons.

We do not believe that these matters should stand in the way of your access to the types of highly advanced techniques offered by our Surgeons.

Insurance Schemes that Do Not Provide Out-of-Network Benefits include HMO (Health Maintenance Organization), managed care, Medicaid, Medicare and Tricare. Some "private" health insurance plans do not provide out-of-network benefits as well. We urge all patients to verify their "out-of-network" eligibility as indicated in their health insurance policy.

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 even though we are not contracted with ANY INSURANCE SCHEMES and are "out-of-network" providers for any and all health insurance companies.

  1. ALL BCBS patients will qualify for an INITIAL NO OUT-OF-POCKET COST COMPLETE Neurosurgical Consultation with our Senior Neurosurgical Staff.

  2. There will be NO OUT-OF-POCKET COSTS for follow-up visits related to that initial Neurosurgical Consultation.

  3. In the event that Neurosurgical Treatment becomes appropriate in your care, we will provide you with an ITEMIZED WRITTEN ESTIMATE OF THE SURGEONS' FEES TOGETHER WITH AN EXPLANATION OF WHAT THOSE SERVICES ENTAIL.

  4. Neurosurgical Consultants, pa will offer to BCBS insured patients the same discounted service and guaranteed fixed professional fee for the specific Neurosurgical services as is offered to our Medicare patients.

  5. BCBS "Co-pay" and/or "deductibles" will NOT APPLY to any services provided by our Neurological Surgeons.

  6. Neurosurgical Consultants, pa will file BCBS insurance claims on behalf of the patient and REFUND to the patient those funds collected on their behalf provided that there is no outstanding balance on their account with our office.

  7. Neurosurgical Consultants, pa will assist all BCBS insured patients as they seek to recover additional payments from BCBS and will provide all the relevant medical information and documentation to support that claim.

  8. Services provided by the hospital and/or other healthcare professionals are billed to BCBS by those entities according to their specific and separate contracts.


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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.