Using Health Insurance?
We will bill your insurance provider(s) for each visit, unless you’re within the 90 day post-op period. You are responsible for paying any co-payments and outstanding balances due at the time of your visit. We accept cash, check, and credit card. We highly recommend that you familiarize yourself with your insurance plan so there are no surprises when it comes to your bill.
Non-Participating Insurance Accounts
A patient who is insured by an insurance carrier with which the practice does not participate, is considered a self-pay patient. It is the patient’s responsibility to inform the practice of any insurance coverage changes, to confirm the practice’s participation and to verify their eligibility before each visit. If you are covered by an insurance payor or plan for which Pacific Neurosurgery is not contracted with, you are obligated to pay the full charge(s) of all services rendered by Pacific Neurosurgery.
Self-pay patients are those who are covered by an insurance carrier with which the practice does not participate or patients without insurance at the time of service. As a self pay patient you are individual responsible to pay the full charges at the time of service.
HMO Referrals and Authorizations
If your insurance is an HMO (has a designated primary care physician), you are required to inform the office of this at the time of scheduling your appointment so an authorization may be obtained. If this information is not provided at the time of scheduling, you will be asked to reschedule your appointment.
It’s important to understand that some items and services are not considered “covered benefits” under your health insurance plan and as such, your insurance will not pay for these services. It is the patients responsibility to understand what your plan covers and does not cover. You will be responsible for all non-covered charges/services.
Failure to arrive for a scheduled appointment and/or failure to cancel an appointment within 24 hours will result in a missed appointment fee of $50 for each occurrence. The patient is fully responsible for this payment.
Billing–Dr. English and Dr. Kim ONLY
Because Dr. Joey English and Dr. Warren Kim are employees of CAIMA and affiliates of Pacific Neurosurgery, insurance participation and billing are kept separate for these doctors. Should you have any questions regarding Dr. English and Dr. Kim’s billing and insurance contracts, please send an email to: BillingQuestions@cairad.com