1.) The Neurologic Group participates with most insurance plans. If you have questions regarding participation or coverage, please contact the billing office in North Wales @ 215-699-3727, Mon. - Fri., 8AM - 3:30PM.
2.) All HMOs require appropriately coded referrals before the patient is seen. Please contact you primary physician to obtain such prior to your scheduled visit.
3.) If you are being seen because of Worker's Compensation injury (WC) or a motor vehicle accident (MVA), the following information must be provided at, or before, the time of the visit:
Insurance Co. name and address
Name and Telephone Number of Adjustor
Health Insurance Information
A Commonly Asked Question
Why is my health insurance information necessary if I'm covered by the MVA or WC insurance? Because of the law. The laws of the Commonwealth of Pennsylvania allow your insurance company to retrospectively review your care as provided in this office. If they decide that your care was not necessary or reasonable, you insurance company can deny payment for such services. How does this happen? Your insurance company sends your records to a physician who has never and never will see you. This physician, after reviewing only your records, can then recommend to your insurance company that the bills not be paid. It may not seem fair, but that is the law in our state (Act 6 - motor vehicle accident & Act 44 - workers compensation).
If this happens, the responsibility for payment falls back to you. In order to protect you in this situation, it is our office policy to request information regarding your medical insurance. This will serve as a back up insurance policy should YOUR motor vehicle or workers
Insurance Company Denies Payment
This problem is real. We don't like it any more than you do, but our hands are tied by the law. Again, our office policy as stated above is for your financial protection. Once care is provided, the bill for such care is YOUR responsibility, one way or another. If you have medical insurance that does not require referrals, we simply need your medical insurance information. If, however, you have medical insurance through managed care requiring referrals for specialist care, the situation is more complicated. For each visit in our office, it is YOUR responsibility to obtain a referral as back up insurance. The HMO's have stated that your family physician will provide such upon your request-you must contact your family doctor BEFORE your visit with us to obtain this referral. If you come to our office without such a referral, you will not be seen.