About Your Visit

Triage Procedure

Because of the number of patients our surgeons see, your appointment may have to be scheduled far in advance. This is normal for specialists- especially surgeons; however, we make every effort to prioritize patients with urgent health matters. If you feel that the appointment time you are given is not soon enough, we encourage you to send your surgeon’s assistant the report of your imaging studies. The physician will review all the reports, and your appointment will be rescheduled to a sooner date if necessary.

Bringing Your Original Films and Reports to Your Appointment

If your CT/MRI was done at either of the Southfield or Novi campuses of Ascension Providence Hospital, we can retrieve your imaging through the St. John Picture Archiving and Communication System (PACS). In this case, there is no need for you to bring your films and reports.

If you had your imaging taken at any other location, you must bring your original films and reports to your appointment, which usually come in the form of a CD. Without imaging, it is unlikely your doctor will be able to reach a definitive diagnosis, and you will need a repeat visit.

X-rays (XR) Performed at Our Clinic

One of the major diagnoses leading to neck and back problems is spinal instability. Since CT and MRI provide static images which are taken when you stay motionless, dynamic spinal instability can only be diagnosed on flexion and extension XR/dynamic MRI. If you have a 4-view XR (AP, lateral, flexion and extension) of the neck/back done within 6 months of your appointment and bring the imaging disc to your appointment, you will not have to undergo XR at our clinic. Otherwise, all new patients who suffer from neck and back problem will have their 4-view XR taken at the time of their appointment.

Please note that not all insurance carriers will cover XR taken in our clinic. This is currently true for HAP, Priority Health, and Health Plus, but this could change in the future.

Cancellation Fee

If for any reason you cannot make your appointment, please give us at least twenty-four hours notice. Failing that, you will be charged a $35 cancellation fee.

Insurance Participation

Our practice accepts assignment from Medicare. We also accept patients from workers’ compensation and auto injuries. While we accept most insurance carriers, it is very important you check with your insurance company to make sure your visit will be covered, as they often make changes to their coverage.

Insurance & Financial Policy

Please bring your driver license and insurance card to your appointment.

Patient Responsibility

It is the patient’s responsibility to be familiar with your insurance coverage. We are not able to provide you details about your specific plan, and it is important that you get these directly from your insurance company.

The doctor renders service to you, the patient, and not to the insurance company. The insurance policy is between you and the insurance company, not with the doctor.

Medicare Patients

If you have Medicare as your primary insurance and another insurance as your secondary insurance, you will be expected to pay your secondary insurances co-pay. We will bill Medicare and your secondary insurance for you. If you have Medicare only, you are expected to pay 20% of the Medicare fee schedule at the time of service.

HMO Policyholders

A referral form is required from your primary doctor for any visits, tests or procedures, including surgery. It is your responsibility to bring all insurance information for the visit. If you fail to produce the referral form, you will need to reschedule your appointment or pay the full fee at the time of service.

Workman’s Compensation or Auto-related Injuries Patients

We require your claim number, the adjuster’s name and address, the insurance carrier’s name and the date of injury. We also require an authorization letter/letter of intent to the physician from the insurance company. If you fail to produce the above information, you will need to reschedule your appointment or pay the full fee at the time of service. Any legal action must remain between you and your attorney. We do not wait for legal settlement.

Participating PPO Insurance Holders

You need to pay your copay and deductible at the time of service. We will bill the insurance for the remaining balance. However, if your policy does not cover particular services rendered, you will be responsible for the charges incurred.

Non-participating PPO Insurance Holders

Unfortunately, at this time it is against our policy to see patients whose insurances we do not participate with. This is true for office visits to our clinic, and we suggest you call your insurance company to find a doctor who does take your insurance; however, if you are seen by one of our surgeons in the emergency room and it is determined you need surgery, you will not be turned away.

Second Opinion Patients

Some insurance policies will not cover for second opinion visit. We will bill the insurance and you will be responsible for any amount not covered by the insurance. If you neglect to inform us that this is a second opinion, you will be responsible for the resulting billing error.

BCBS Master Medical Patients

You are required to pay the full fee at the time of service. We will bill the insurance on your behalf and the insurance payment will be directly sent to you.

If you do not have insurance coverage, you will be responsible for all charges incurred. Please talk to us about our payment plan arrangement. We will be happy to assist you.

All the above information relates to office visits. If it is determined that you need surgery, the surgical scheduler will assist you with getting authorizations, knowing what expenses to anticipate, and when payment will be expected.

We are sorry that this has become so complex and laborious; however, these are rules imposed on you and us by the insurance industry. We are here primarily to care for your need.

Prescription Policy

Prescriptions are given on the day of visit and will be continued only for patients scheduling for surgery or in the first three months following surgery. Prescription request for non-surgical patients will be directed to your own primary care physician and the pain management clinic.

Please understand that we are a surgical clinic. The primary mode of treatment offered by us is surgery. We do not prescribe or monitor the long-term use of pain medication. It is to your benefit that the pain management specialists and your primary care physician manage your long-term prescription use.

Medical Records Policy

No long-term disability form will be filled out if you never have surgery with us. In no circumstances will a long-term disability be filled out after one clinic visit. We will consider filling out your long-term disability form only if you have surgery performed by us.