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Understanding Out-of-network Benefits

Most patients have a clear understanding of how their in-network benefits work; when you see a doctor who is contracted with your insurance provider, your out-of-pocket cost is minimized. Out-of-network benefits can be a little harder to understand. When you go to an out-of-network doctor, you will be responsible for a larger percentage, if not all of the cost. Many specialists are out-of network providers because their services are not required with the same frequency as more general practitioners, and therefore the insurance companies do not have prearranged contracted rates. If you have been referred to a specialist for a surgical procedure, it becomes very important to understand your insurance provider's out-of-network benefits. 

Many insurance providers will cover part of the cost of procedures performed by out-of-network doctors. Our friendly staff will be happy to work with you to help you understand what benefits are available to you through your insurance provider, and how to minimize your out-of-pocket costs. We will ensure that you fully understand all costs associated with your surgical procedure - both your costs and those paid by your insurance company - so that there are no surprise expenses while you are recovering. We have extensive experience working with major insurance providers, and can provide treatment that fits into your budget.

We Work with Several Major Insurance Companies

At New York Spine and Sports Surgery, we are pleased to work with most major insurance companies that offer a wide range of out-of-network benefits for our patients, including: 

  • Horizon Blue Cross Blue Shield
  • Cigna
  • United Healthcare
  • Oxford
  • Anthem

We also participate within Medicare and QualCare benefits coverage plans.

Contact Our New Jersey Office

We can help to guide you through the confusing and often difficult process of dealing with insurance companies and maximizing the benefits available to you. We have been very successful in providing our patients with the care that they need while working within their healthcare budgets. If you have questions about what your insurance can cover, please contact our office to schedule a consultation with one of our caring team members. We look forward to helping you receive the specialized care you need.

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