PATIENT INFORMATION
Pain Management Specialists of North Fl, PA participates with most major insurance carriers. Please consult your insurance company or contact one of our scheduling representatives prior to your appointment to verify our participation status with your insurance plan.
Prescription Request Policy
Prescription and refills for established patients of Pain Management Specialists of North Fl, PA are routinely issued during regular hours (Monday-Friday 8:00 a.m.-5:00 p.m.). You can call our office at 904 460 9555 to make your request.
Allow 72 hours for refills. No refills are issued during the evening, weekends, or holidays. To avoid an interruption of your medication, please anticipate your refill time.
Insurance and Billing Information
We verify your insurance coverage and eligibility before your appointment. Your benefit coverage is a contract between you and your insurance carrier. Please be aware that not all medical services are covered benefits under all insurance contracts. We advise you to become familiar with your insurance policy benefits and limitations. Contact your insurance carrier if you have any questions about your coverage and restrictions.
Pre-Authorizations
Prior authorization—sometimes called precertification or prior approval—is a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.
Prior authorizations for Visits
If you have an HMO plan, All your health care services go through a primary care doctor. That means that you need a referral before you can see any other health care professional, except in an emergency.
Prior authorization for Interventional Pain Procedures
Some PPO plans and most HMO plans require we obtain a pre- authorization for procedures. Our pre-authorization team will submit the necessary documentation to your insurance company and get approval in writing. The process can take 3-7 days.
Co-Payments, Co-Insurance, and Deductibles
All co-pays, co-insurance, and deductibles are due at the time of service. Co-payments are a flat fee paid each time a medical service is accessed and must be paid before any policy benefit is payable by an insurance company. Co-payments usually range from $20 to $50, depending on your coverage.
Co-insurance is a percentage of the allowed charge that the patient pays after the deductible has been satisfied.
Deductibles are amounts that must be paid out of pocket before an insurance carrier will pay any expenses. The patient must pay the deductible before the benefits of the insurance policy can apply.
Workers Compensation
Your adjuster or Nurse Case Manager can call us to coordinate the referral and review of the medical records.
Currently do not participate with Medicaid.
Auto Accidents Insurance:
We accept Auto accident insurance if you have Medical insurance coverage. We do not accept letters of protection (LOP).
