Does Medicare cover surgery at Laser Spine Institute?
Determining what procedures and services your medical insurance will cover can be confusing. Coverage seems to be different depending on your policy and the health care provider. At Laser Spine Institute, we are devoted to ensuring our patients receive the best care possible. So when you asked about Medicare coverage, we listened.
We sat down with Clay Grossman, Laser Spine Institute’s Vice President of Patient Financial Services, to help answer your questions.
Q: Is Laser Spine Institute in contract with Medicare?
A: Laser Spine Institute is in contract with Medicare for the professional services provided by our physicians. However, we are not in contract with Medicare for the facility fee which includes services provided by the Laser Spine Surgical Center (LSSC).
Q: Why does Medicare not cover the Laser Spine Institute facility?
A: Simply put — Medicare does not cover surgery center fees because they’re not included in our contract with Medicare. That’s why patients with Medicare are responsible for fees incurred at our facility, which is supplied with the state-of-the-art equipment and amenities to keep us at the forefront of minimally invasive spine surgery.
Q: Will a secondary insurance cover the procedure?
A: Laser Spine Institute’s contract with Medicare includes the professional fees associated with surgery. Typically, a secondary insurance plan will help to cover these fees. Because our contract does not include the facility fee, a bill will not be submitted to or denied by Medicare — that’s why a secondary plan does not offer coverage for this portion.
Q: Will Medicare ever cover Laser Spine Institute’s Ambulatory Surgical Center (ASC) costs?
A: Our goal is to always help our patients find the most cost-efficient way to get the relief they deserve. Laser Spine Institute is continually educating all insurance providers about our minimally invasive spine surgeries. Proper reimbursement for our procedures enables Laser Spine Institute to deliver the best quality of care to our patients. Patient care and satisfaction will always be at the forefront of every decision we make, and our team has worked diligently to provide many financing options. Feel free to ask our team for more details.
Q: Why do some doctors not accept Medicare?
A: In certain cases, Medicare’s reimbursement rates do not cover the costs of some services or products at other medical facilities, which is why some providers do not choose to enroll with Medicare. Laser Spine Institute is pleased to work with Medicare, as well as many other insurance companies, as we continually work to make our procedures more accessible to patients.