No insurance covers every treatment that is recommended by your doctor, even when they are contracted and in network with your plan.
That is why we’ve devised this FAQ to help you navigate the ins and outs of insurance coverage when it comes to cutting edge procedures and state-of-the-art approaches to spine care. We have a team that is dedicated to answering your questions, and if you have any questions remaining you can reach one of our representatives by submitting a brief contact form below.
Whether you have a commercial insurance from providers like Aetna, Cigna, Blue Cross Blue Shield, or United Healthcare and any of their subsidiaries (Humana, Optum, Coventry, Meritain Health, etc.) or even a smaller local insurance provider like Oscar, Health First, or Advent Health, we will do our best to get you covered for any office visits, procedures, or surgeries done at our facility in Melbourne Florida.
How do you advocate for my treatment?
By accepting all patients regardless of their insurance, we are placing the patient care pathway easily within each person’s individual grasp. We believe that the best outcomes are a result of the patient’s involvement in the decision-making when it comes to their own care. This is why we offer a free initial consultation, and many other free resources to give you the greatest understanding of your condition, sources of your pain, and options for treatment. Once YOU decide how you’d like to proceed, we will fight for payment from your insurance provider to get you treated.
Why does my insurance company deny paying for affordable, effective treatment?
Insurance companies exist as private entities with shareholders and CEOs just like any other business, and so it stands to reason that their primary goal is to post quarterly and annual profits. The way insurance companies make profit is by denying to pay for medically necessary treatment whenever possible. Even when a provider is contracted and in network with an insurance company, recommended treatments may still be denied or postponed, not to the benefit of the doctor, and certainly not to the benefit of the patient, but to the benefit of the company’s shareholders. That is why, despite being contracted with many major insurance providers, the Deuk Spine Institute is fully prepared to defend you against denials made by your insurer.
That will depend on the kind of treatment you receive. If you are willing to follow the care pathway outlined and approved by your insurance, you will pay according to your benefits. We will still collect a certain percentage of any amount billed (typically not in excess of 15-20%) to cover immediate facility costs to be reimbursed after your insurance delivers payment. We do this as a precautionary measure to avoid non-payment by your insurer.
Even as an in-network or contracted doctor with a pre-authorization for treatment, that does not guarantee that we will be paid for any services rendered. The deposit allows us to move forward with your treatment, and in the event that your insurer declines to pay for your treatment, will allow us to cover our facility costs and avoid going bankrupt. It is an unfortunate reality, but we must operate this way to protect our doctors from the predatory practices of insurance companies that have shut down entire hospitals and left many people jobless.
Absolutely, getting injured workers back on the job, and motorists back on the road is our number one priority when it comes to treating cases like yours. We have a dedicated team of coordinators who specialize in workman’s compensation claims, personal injury/liability, and auto claims. We provide an initial consultation via videoconference or in-person, and can help you submit any needed documentation to your adjuster/provider to facilitate a transfer of care and payment for the most effective treatment for your injury.
Do you take Letters of Protection or LIENS?
Unfortunately, we do not accept letters of protection from personal injury attorneys or medical liens from lenders. All contracted rates must be negotiated beforehand, and payment will need to be received before any treatments are administered for your case. This is done in order to standardize the cost of treatment and to protect our practice and its employees against non-payment or underpayment of your claim. Exceptions may be made on a case-by-case basis.
How much will I have to pay with my particular insurance?
Costs can vary depending on a large number of factors. The following is an estimate of what you can expect to pay at Deuk Spine Institute.
Office visits: $25 patient responsibility.
Diagnostic Testing: Subject to yearly deductible./copays.
Treatments: Subject to yearly deductible/copays.
Office visits: $25 patient responsibility.
Diagnostic Testing: Subject to yearly deductible/copays.
Treatments: Subject to yearly deductible/copays.
Office visits: In network specialist office visit copay or coinsurance subject to deductible.
Diagnostic Testing: Subject to yearly deductible/copays.
Treatments: Subject to yearly deductible/copays.
Office visits: In network specialist office visit copay or coinsurance subject to deductible.
Diagnostic Testing: Subject to yearly deductible/copays.
Treatments: Subject to yearly deductible/copays.
