INSURANCE

These days, more of the financial responsibility for your medical care is put on you, the patient, parent or guardian: Higher deductibles and twenty to fifty percent coinsurance shift more cost to the consumer than to the insurance company. At Long Island Spine Specialists, P.C., we treat every patient on an individual basis. Please call our dedicated Patient Account Liaison (PAL) at 631-462-2225 ext. 246 with all your insurance questions and to understand how we can best help you or your loved one navigate the ever-changing insurance landscape. You can also contact us here.

Whether you have suffered a traumatic injury or an ongoing chronic condition, have back/neck injuries resulting from a Motor Vehicle Accident or a work-related injury of the spine, our NYS Workers Compensation Board-certified physicians will provide you with the best care.

Our practice currently contracts with the Long Island insurance networks listed below. We now accept all Blue Cross Blue Shield insurance plans. For patients who have a PPO plan, our PAL is experienced in working with your plan’s out of network benefits. For more information, please contact our office to discuss coverage options.


Aetna
Blue Cross Shield
Cigna
Oxford Freedom Insurance Agency
United Health Care

Long Island Spine Specialists, P.C., accepts:

 

  • Workers’ Compensation
  • No-Fault
  • BlueCross & BlueShield – All Insurance Plans

 

 

Long Island Spine Specialists, P.C., participates in:

 

  • Agewell
  • Medicare & Medicare Railroad
  • Magnacare
  • NYSHIP
  • NSLIJ United Healthcare
  • Medicare Advantage Plans via your Commercial “Part C” Carrier

 

 

Long Island Spine Specialists, P.C., works with the following plans that have out-of-network benefits:

 

  • Aetna PPO
  • Cigna – PPO
  • Commercial PPO Carriers
  • United Health Care PPO
  • Oxford Freedom POS & PPO

REFERRALS

Should your health plan require a referral to see one of our physicians, please provide us with the referral information as soon as possible before your office visit. Referrals must be obtained by the primary care physician doctor. Without a referral, you will be required to pay for the visit in advance.

WORKER’S COMPENSATION & NO-FAULT INSURANCES

If you are covered by Worker’s Compensation or No-Fault be sure to communicate insurance information to us before your scheduled visit so that your coverage can be verified.

AUTHORIZATIONS

Diagnostic Testing: Most insurance companies require authorization for certain diagnostic testing (MRI, CT, EMG/CV, etc.). If your insurance company does not require authorization, you should make an appointment for testing once you have received an order from your doctor. If an authorization is required, we will work to obtain the authorization and call you when we receive the approval from your insurance company. It could take up to 10 business days to obtain the authorization. Be sure to choose a participating facility to have your test done. Refer to your provider directory or ask your carrier for this information.

Physical Therapy: We will work to obtain approval for physical therapy from your insurance company. Worker’s Compensation carriers will permit the first six weeks of therapy without the need for an authorization on a new injury. Subsequent authorizations will require the submission of qualifying information to obtain your carrier’s approval.

Surgical Procedures: Specific requirements vary by carrier. We will work to obtain the authorization from your carrier. This process may take as many as 25 business days.

DEDUCTIBLE & COINSURANCE

It is our policy to bill patients for out of pocket expenses.

FILING A CLAIM ON YOUR BEHALF (ASSIGNMENT OF BENEFITS)

As a courtesy to you, we will file a claim with your insurance company on your behalf when we have your assignment of benefits signature on file. This assignment does not remove you from having the responsibility to work with us to ensure your insurance company pays us on the amount which is covered or allowed under NYS law. Under an assignment of benefits, you remain financially responsible for the account balance.

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