Q: What should I do when I receive an Explanation of Benefits (EOB) from my insurance company? No immediate action is needed. Please note that an explanation of benefits from the insurance company is not a bill from NuVasive Clinical Services (NCS). You will receive a separate bill from NCS for the amount of a co-pay, co-insurance or deductible that is identified by your insurance payer as your responsibility.
Q: What should I do if I receive a check from the insurance company? Although we will follow up with your insurance provider about the status, claims information is often sent directly to the insurance plan member (note that this often happens with Blue Cross accounts). Please forward any payment or correspondence you receive to our office as soon as possible. This will help us to update your account and apply payments properly. If the check is sent directly to you, please forward the check (or write a new check after depositing the insurance payment) and a copy of the EOB to the NCS office at 10275 Little Patuxent Parkway, #300, Columbia MD 21044. To endorse the check, sign on the back and write the name of the physician group that shows on the EOB below your signature. Please call 800-955-0079 with any questions.
Q: I received a bill from NuVasive Clinical Services (NCS) – can NCS appeal on my behalf? If the EOB and the bill you receive from NCS show that your claim was processed on an out-of-network basis, and you want to ask your insurance company to re-process the claim, NCS can assist. Please call 800-955-0079 and request that NCS send an out-of-network appeal to the insurance carrier. NCS will send you another bill when the outcome of the appeal is known.
Q: What do I do if I have concerns about my ability to pay the bill? Please call 800-955-0079 and request information about our financial hardship policy and monthly payment plans. NCS does make reasonable efforts to collect all amounts owed but does not refer overdue patient accounts to a collection agency.
Q: Why is the physician likely to be out-of-network? Our IOM monitoring physicians provide a specialty service to more than 900 healthcare facilities in 45 states nationwide. It is not possible or practical for network contracts to be negotiated with all the payers that may be accepted by the different facilities.
Q: How can you help? We ask that you verify the insurance information we have on file for you and sign the Assignment of Benefits and Authorization form prior to surgery. Your signature tells your insurance carrier to pay the physician directly for the monitoring services and allows us to engage with the insurance provider on your behalf as necessary to get the claim paid correctly. This may reduce or eliminate any out of pocket responsibility for you.
Q: What steps should the surgeon’s office take? Notify your patients that they will be receiving IOM during their surgery and that the monitoring physician may be out-of-network. NCS provides surgeons with information for them to give to their patients about IONM. This can be found here. Check with your patient’s insurance provider to find out if pre-authorization is required for a referral to an out-of-network provider.