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.
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
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
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.
- ALL BCBS patients will qualify for an INITIAL NO OUT-OF-POCKET COST
COMPLETE Neurosurgical Consultation with our Senior Neurosurgical Staff.
- There will be NO OUT-OF-POCKET COSTS for follow-up visits related to
that initial Neurosurgical Consultation.
- 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.
- 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.
- BCBS "Co-pay" and/or "deductibles" will NOT APPLY to any services
provided by our Neurological Surgeons.
- 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
- 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.
- Services provided by the hospital and/or other healthcare professionals
are billed to BCBS by those entities according to their specific and separate
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This page last edited on 2/19