Employers with Managed Care Health
Plans such as Mountain State BC/BS, CIGNA and numerous others have the
option of customizing benefit plans for their employees. Therefore,
all benefits are not alike and you can no longer assume that all
medical services will have a covered benefit.
We are considered
"specialists" so your plan may require that you first seek
treatment from or be referred to us by your Primary Care Physician
(PCP) or family doctor. Recommended treatment plans and surgical
procedures may require prior authorization. It is your responsibility
to obtain prior authorization or precertification prior to your visit.
We are aware that insurance is very
confusing so we would like to offer as much assistance as possible. WE
REQUIRE ALL NEW PATIENTS TO CALL OUR OFFICE TO SPEAK WITH SOMEONE IN
OUR BILLING DEPARTMENT AT LEAST 3 DAYS PRIOR TO THE SCHEDULED
APPOINTMENT. You may reach our billing department by dialing
304-346-4400 extension 115.
We have decided not to participate
with a few managed care plans including Carelink and Aetna.
Each person covered under a group
health plan should receive a member ID card. However, possession of an
ID card does not guarantee coverage or payment of services rendered.
Patients will be required to present this card at each visit to assure
that coverage and benefits have not changed since their past visit.
This will aid our staff in verifying eligibility and benefits and
filing claims on your behalf.
It is to your benefit to know and
understand your insurance coverage. Failure to do so could result in
your financial loss through reduced benefits or denied payments of
your claims. You can obtain coverage and benefit information, prior to
your visit, by calling the toll-free number on your ID card or by
contacting the benefits department of the employer providing the
coverage. We can help you receive maximum reimbursement from your
insurance company if you can provide us with current and accurate
Thanks in advance for your cooperation