The Pain Institute

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If you are seen at The Pain Institute's outpatient facility, we will file claims with your insurance company as a courtesy to you. However, if the insurance company does not pay the account within three months, you will be responsible for payment, or for assisting us in resolving your account with the insurance company. We provide services to you, our patient; and you are ultimately responsible for payment to us. An insurance policy is a contract between you and your insurance company.We are not a party to the contract; and we cannot control coverage decisions.

A. If your insurance company fails to pay your bill for more than 60 days, you first receive a bill showing that you are responsible for payment. If the bill remains unpaid, you will receive a delinquency notice. If you receive such a notice, please contact our office immediately to make payment arrangements. If you have been working with us to resolve an insurance problem, we will enter a note in the computer and suspend action on the delinquency until a decision is reached. Remember, although we bill your insurance company promptly, there are limits on what we can do to expedite payment.

Remember to bring your insurance identification card on your first visit. If the policy is in the name of your spouse or another family member, please tell us that. The physicians of The Pain Institute are specialists, providing specialized services. We accept Medicare and most private insurance plans, and we participate in many plans' provider networks. Other plans sometimes grant us in-network benefits because of our specialized services. However, each insurance plan has its own restrictions and requirements.

If you are a member of an HMO (health maintenance organization) or PPO (preferred provider organization), your plan probably requires you to receive care from physicians in the plan network. If you visit a non-network physician, you may be responsible for a higher copayment or larger portion of the cost. Ask your plan, or call our office to find out if The Pain Institute participates in your plan's network or qualifies for in-network benefits due to our specialty situation. As an HMO or PPO member, you may also be required to obtain an authorization or a referral from your primary care doctor.

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