Patient Billing Practices

Billing for intraoperative neuromonitoring is very complex compared to other specialty billing and it is key to keep current with each individual payer’s clinical guidelines. Not knowing these payer specific guidelines could result in patients being unexpectedly billed. Guidelines issued by the payers not only define the policies of intraoperative neuromonitoring, but they also outline the documentation requirements for such procedures necessary for reimbursements.

We interviewed Lindsey, Manager of Billing & Collections, at NuVasive Clinical Services to hear about patient billing practices and how it affects NCS.

How does NCS approach patient billing?

NCS approaches patient billing the same way we approach all of our services—patient care always comes first! This is not always easy to do because of high deductible plans, but we are always mindful that patients may not know about our service pre-surgery. We have a dedicated patient care team who have extensive experience in IONM and are committed to working with insurance plans and patients to keep patient responsibility to a minimum.

How does NCS work with patients to minimize out-of-pocket charges?

NCS has a robust patient care process, offering many opportunities to patients to pay as little out of pocket as possible. As a company, NCS understands that surgery can be expensive! We offer payment plans as low as $25.00 per month, charity adjustments that will match the amount of charity assistance they are approved for at the facility, a very easy financial hardship application, and our staff is ready to appeal in an out of network situation. We are always looking for opportunities to help patients and alleviate financial stress.

What is NCS doing to improve our in-network portfolio for patients?

We are so excited to have added an Insurance Enrollment Specialist to the Billing and Collections team. This position is crucial to improve our collections and offer a more comprehensive in-network portfolio. Our Insurance Enrollment Specialist will help the NCS Billing and Collections team focus collection efforts and by going in-network, when possible, which can decrease patient responsibility.

What are the in-network vs. out-of-network rules of engagement? Why do we go out of network?

Traditionally, IONM providers have been out of network with the majority of insurance plans. NCS recognizes that healthcare benefits are changing and utilizing an out of network provider can add financial stress to the patient. Providing the best care possible is always our goal and may include in-network participation.

IONM never fits into any traditional billing and collections model because of the remote aspect of our service. We participate in surgeries all over the United States, and our physicians are never in the operating room or even in the same state as where surgery is being performed. Providing remote services can make it difficult to contract because some insurance plans will not allow an out of state physician to participate in their network.

We are learning a lot from our Safe Passage partnership on how to navigate in-network agreements and foster those relationships. Breaking out of the traditional out of network model is a big step forward towards innovating our billing and collections process and differentiating ourselves from other IONM providers.

To learn more about NCS, click here.

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