Knowing Your Benefits: Outpatient Injections

Understanding your health insurance benefits can feel like navigating your way through stormy seas without a compass.  It is important to find out your benefits ahead of time so there are no surprises when you receive an Explanation Of Benefits (or EOB) from your insurance or a billing statement from your health provider.  Here are some tips below to help the process go more smoothly!

To determine your insurance benefits prior to coming in for a procedure at the surgery center, you may contact your insurance provider directly and follow the steps below:

·         Call the Member Services number located on your insurance card; if needed our Tax ID is 45-4054764.

·       Ask the representative what the benefits are for the CPT Codes associated with your procedure (please see list below):

99144- Conscious Sedation

64483- Transforaminal Epidural/Nerve Block (Lumbar/Sacral) (1^st level)

64484- Transforaminal Epidural/Nerve Block (Lumbar/Sacral) (2^nd level)

64490- Paravertebral Facet (Cervical/Thoracic) (1^st level)

64491- Paravertebral Facet (Cervical/Thoracic) (2^nd level)

64492- Paravertebral Facet (Cervical/Thoracic) (3^rd level)

64493- Facet or Medial Branch Block (Lumbar/Sacral) (1st level)

64494- Facet or Medial Branch Block (Lumbar/Sacral) (2^nd level)

64495- Facet or Medial Branch Block (Lumbar/Sacral) (3^rd level)

62310- Interlaminar Epidural (Cervical/Thoracic)

62311- Interlaminar Epidural (Lumbar/Sacral/Caudal)

Remember, there are going to be 2 separate sets of charges associated with your procedure; one set for the physician (Dr. Hyman or Dr. Chimes) and one set for the Ambulatory Surgery Center (Overlake or Evergreen).  To determine what the charges are for the surgery center, please contact them directly at the phone number provided on your injection forms.  I hope this information can assist you in obtaining your insurance benefits and continuing on the path to staying active!