FINANCIAL ARRANGEMENTS-AN OVERVIEW

PRACTICE BILLING PHILOSOPHY

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

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

Written Cost Estimates

Out-of Network Benefits

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 level of Neurosurgical assistance offered by our Surgeons.

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

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

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.

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. ALL BCBS patients will qualify for an initial NO OUT-OF-POCKET COST and FULL Neurosurgical Consultation with our Senior Neurosurgical Staff. There will be NO OUT-OF-POCKET COSTS for follow-up visits related to that initial consultation. Neurosurgical Consultants will offer the same discount service and terms to BCBS insured patients as is offered to our Medicare patients. 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. 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.

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