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Dallas, TX 75230

PRACTICE BILLING PHILOSOPHY: WHAT ABOUT MEDICARE?

Medicare Issues:

We are pleased to have the opportunity to provide Neurosurgical care to Medicare insured patients and have made special accommodations for them in this practice.

We are not "Medicare providers"; however, this DOES NOT MEAN THAT WE WILL NOT OR THAT WE CANNOT CONTINUE TO PROVIDE CARE TO MEDICARE PATIENTS. It does mean that some changes are required by the Federal Government in order for us to provide that care.

We will share written information with you that explains this new relationship. While this change (from your usual Medicare expectations) may appear to cause you some concern at the outset, please take a few minutes to learn more about this since it may permit you to enjoy a higher level of care than you otherwise might have access to.

In addition there are a couple of hidden, pleasant surprises that go along with this change. The first change that you will notice and benefit from is that your initial comprehensive Neurosurgical consultation is free of any charge. Secondly, you may be eligible for some Federal Income Tax benefits in the event that you come to require a Neurosurgical operation. (This is explained in a little more detail below and you will want to consult your tax advisor regarding this potentiality.)

Your Hospitalization Continues to be Covered by Medicare Part A:

In the event that a Neurosurgical operation becomes appropriate for your care, Medicare will continue to cover your costs for hospitalization (and for any other physicians who do participate) under Medicare Part A which is the same as for anyone else. There is NO CHANGE and NO REDUCTION OF BENEFITS.

What "Medicare" Requires:

Another area of "change" relates to a part of your relationship with the surgeon. In this case both you and the Neurosurgical Consultants' surgeons are required (by the Federal Government) to enter into a "Private Agreement" (a "contract") regarding that care. This means that you and Neurosurgical Consultants must sign a special form which we will provide to you free of any charge.

The Federal Government absolutely FORBIDS YOU from filing any additional forms/claims for reimbursement of the costs related to the "contract" between you and Neurosurgical Consultants.

You cannot file any Medicare or Medi-Gap claims for reimbursement of our services.

This DOES NOT, IN ANY WAY, AFFECT YOUR MEDICARE COVERAGE FOR ANY OTHER MEDICARE ELIGIBLE SERVICES or other doctors who continue to participate in the Medicare program.

The "contract", referred to in the above paragraph, will have the details of the financial arrangement that is entered into regarding your Neurosurgical operation. It is this aspect which may provide you with an additional Federal Income Tax benefit as mentioned earlier.

Our Commitment:

Please know that we are sensitive to the financial concerns of all of our patients and particularly many who are covered by Medicare.

We will make every effort to accommodate your financial situation in order to lessen the burden that your Neurosurgical problem has placed upon you.

Written Cost Estimates

Our Business Office will provide you with a written estimate of the costs of the Neurosurgical procedures. This "estimate" will also include our commitment to you regarding the ABSOLUTE MAXIMUM "out-of-pocket" expense that you would ever be responsible for. This "out-of-pocket" guaranteed price is always at a considerable discount compared to the customary fee. We employ standardized "Procedural Codes" which are in general use in this country for any of the operations that we conduct.


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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.