Insurance, Billing, Rockford Spine Center, Adult Spine Surgery, Pediatric Spine Surgery, Northern Illinois

Thank you for choosing our practice! We are committed to the success of your medical treatment and care. Please understand that payment of your bill is part of this treatment and care. For your convenience, we have answered some commonly asked financial policy questions below. If you need further information about any of these policies, please ask to speak with a Billing Specialist or the Practice Manager.

1. Do I Need A Referral?
If you have an HMO plan with which we are contracted, you need a referral authorization from your primary care physician. If we have not received an authorization prior to your arrival at the office you will need to sign a waiver in order to be seen that day or your appointment be rescheduled.

2. Which Plans Do You Contract With?

3. What Is My Financial Responsibility for Services?
Your financial responsibility depends on a variety of factors, explained below.

IF YOU HAVE	YOU ARE RESPONSIBLE	OUR STAFF WILL
Commercial Insurance Also known as indemnity, “regular” insurance, or "80%/20% coverage."	Payment of the patient responsibility for all office visits, x-ray, injection, and other charges at the time of office visit.	Call your insurance company ahead of time to determine deductibles and coinsurance. File an insurance claim as a courtesy to you.
HMO & PPO plans with which we have a contract	If the services you receive are covered by the plan: All applicable co-pays and deductibles are requested at the time of the office visit. If the services you receive are not covered by the plan: Payment in full is requested at the time of the visit.	Call your insurance company ahead of time to determine co-pays, deductibles, and non-covered services for you. File an insurance claim on your behalf.
Insurance with which we are not contracted (Out of Network).	No payment is necessary at the time of the visit	Call your insurance company ahead of time to determine out of network benefits, co-pays, deductibles, and non-covered services. File an insurance claim.
IF YOU HAVE	YOU ARE RESPONSIBLE	OUR STAFF WILL
Medicare	If you have Regular Medicare, and have not met your yearly deductible, we ask that it be paid at the time of service. Any services not covered by Medicare are requested at the time of the visit. If you have Regular Medicare as primary, and also have secondary insurance or Medigap: No payment is necessary at the time of the visit. If you have Regular Medicare as primary, but no secondary insurance: Payment of your 20% co-pay is requested at the time of the visit.	File the claim on your behalf, as well as any claims to your secondary insurance.
Worker’s Compensation	If we have verified the claim with your carrier No payment is necessary at the time of the visit. If we are not able to verify your claim Payment not to exceed $250 will be required	Call your carrier ahead of time to verify the accident date, claim number, primary care physician, employer information, and referral procedures.
IF YOU HAVE	YOU ARE RESPONSIBLE	OUR STAFF WILL
No Insurance	Payment not to exceed $250 will be required	Work with you to settle your account. Please ask to speak with our staff if you need assistance.

If your physician recommends surgery, our surgery scheduler will complete all pre-certification/authorization as your insurance company may require. She will contact you by phone to answer specific questions about the surgery scheduling process, discuss the paperwork and tests involved. The Surgery Billing Coordinator may request a pre-surgical deposit, the amount of which depends on your coverage and deductible amount. A cost estimate which shows your financial responsibility, based on the benefit levels and coverage of your insurance plan, will be explained by the Surgery Billing Coordinator.