Insurance Information

What does being contracted mean? It means that BNA patients covered by these contracts in the indicated categories (e.g., commercial, senior, etc.) will be seen and payment accepted at contracted "in-network" rates. All other coverages require special consideration as outlined following the list of contracted payers.

Aetna
Arizona Foundation
BCBS Arizona
Cigna
Coventry First Health
AMN/Multiplans/PHCS
Medicare Primary
MercyCare AHCCCS
United HealthCare

What if you don't recognize your insurance plan in the above list?

Take another look at your insurance card. Look for a logo. If your logo matches one of the contracts listed above, then you are also considered "in-network," and BNA has negotiated a contract to pay for your services.

If you still haven't identified your coverage, the following categories generally describe your options:

1. Commercial insurance, generally through an employer or self-employment: Check to see if your benefit plan includes out-of-network benefits. If it does, learn about those benefits and make a decision about whether you wish to incur the additional out-of-pocket costs. Remember that paying for an office visit utilizing out-of-network benefits is usually much, much different from paying for neurosurgery with out-of-network benefits.
   
   Some commercial policies do not provide out-of-network benefits. If you are willing to pay the neurosurgeon's full billed charges, then you are still entitled to request an appointment even though your policy will not be paying.
2. Medicare through a third party: This type of product has become very popular over the past 3 or 4 years. BNA is not contractually required to see you if your Medicare coverage is through a non-contracted company.
   
   If you wish to check the official government list for the senior plans marketed anywhere, but of which there are 59 in Maricopa County alone, please visit the website www.medicare.gov.
   
   If you find that your plan is out-of-network, you have the options of changing your plan during open enrollment, or personally paying for services.
3. AHCCCS or Medicaid: BNA is contracted with Arizona state AHCCCS and with MercyCare at BNA's Phoenix office. BNA is not contracted with any other AHCCCS or Medicaid plans. If you are not sure to which AHCCCS subcontractor you have been assigned, please go online at www.myahcccs.com or call AHCCCS Administration at 602-417-4000 or 1-800-654-8713. You have the option of changing your AHCCCS-subcontracted plan during open enrollment.
   
   BNA is precluded by law from collecting payments over and above co-pays, when they exist. You will need to contact your PCP for referral to another, contracted provider.
4. Worker's Comp: A few of BNA's neurosurgeons specializing in spine procedures are contracted through the State Comp Fund Provider Care Network (SCF/PCN). BNA also has a contract with Coventry/ First Health for its worker's comp product. Beyond these, BNA does not generally participate in worker's comp networks. BNA does NOT allow its staff to accept medical insurance in lieu of worker's comp when there is an open worker's comp case involving the medical condition being treated.
5. Military-related: BNA is not contracted to see the patients of military-related payers with the exception of those covered through the national credentialing center. BNA is NOT contracted through the regional TriCare agency, BCBSAZ.
6. Legal: As a rule, BNA does not accept patients with pending lawsuits such as from auto accidents.
7. Self-Pay: Self-pay patients are required to discuss their situations with BNA's Patient Financial Counselors. Prepayment for services is generally required.
8. International patients tend to also be self-pay patients. Prepayment for clinic, surgical and hospital services is generally required, and is generally arranged through the physician's office with the support of the billing staff.