We know it’s confusing. We’re here to help.
Paying For Your Visit
While we support your decision to purchase health insurance and will do everything in our power to help you make sense of it, regretfully we – even as doctors and staff with years of experience — cannot know precisely what your plan will cover.
Health insurance is a financial product that people purchase which doesn’t provide any clear services.
Insurance companies often obfuscate coverage detail and, knowing most of their members don’t have the time to gain enough insurance expertise to know any better, sell plans that are not quite as good as they seem. Click here for more detail on how know insurance really works… or rather, seems to work against you.
Frequently, we and our patients endure back-and- forth on paperwork and process in securing payment for services we have provided, and they may pay only a fraction of the actual charges. Our patients and we are told, “the patient is responsible for understanding their insurance”. Sometimes the amount of responsibility for payment is not determined until months after the service, and is an unpleasant surprise to our patients. The complexity and confusion created puts a huge burden on you and on us. It’s a big problem in medicine today and it can create friction between doctors offices and their patients. It’s bad vibes all around.
Still want to use insurance?
We just want to make sure you understand that health insurance isn’t a golden ticket to affordable care. You will be responsible for any co-pays and deductibles at the time of service. We have made an immense effort to minimize cost on your behalf.
In-Network or Preferred Provider
SPARCC is “in-network” (a preferred provider) for all payers listed below; each includes all subsidiary and third-party payers contracted with these payers. Call your third-party plan if you are unsure of its affiliation with payers below.
- Blue Cross Blue Shield
- CMDP – requires care document along with referral
- United Healthcare
NOT in network: SPARCC is not contracted with any Medicare or Medicaid/AHCCCS plans at this time.
Medicare: We cannot accept any Medicare or Medicare supplement plans. You can pay our self pay rates.
Medicaid/AHCCCS: Concussion patients may receive an authorization from their insurance company and a referral from their PCP to be seen out of network. We are no longer treating AHCCCS patients for musculoskeletal injuries.
Transparent, Discounted Rates
With the landscape of insurance in flux, uncertainties of coverage and high-deductible plans nearly ubiquitous, the idea of paying out of pocket at a discounted rate has become attractive to many. We are currently offering deep time of service discounts for all types of appointments to avoid any insurance hassle.
SPARCC’s self-pay patients receive a discount.
Frequently Asked Questions
When are payments due?
Payment is due in full at the time of your appointment. This includes any copay, coinsurance, or deductible for those using insurance and the full self-pay rate for self-pay patients.
What services do you provide at the initial visit?
The first visit can vary depending on the severity of the symptoms. Our model allows our providers to spend a lot of time face-to-face with the patient to observe and consult, and additional time after the visit analyzing the problem and determining the best path forward. Other tests are performed at the discretion of the provider.
Does SPARCC offer payment plans?
We do not offer payment plans at this time. Payment is due in full at the time of the appointment.
Why can’t there be one price like every other sane industry?
We do achieve this with a carefully calculated self-pay rate that, behind the scenes, is actually a group of discounted service codes. When billing insurance, medical providers have to adhere to medical coding standards. It’s unfortunate, because it looks like you are getting nickel-and-dimed, but that’s just how the medical industry works, and no medical provider can stay in business without it. It’s really kind of backwards for everyone. Providers would like nothing more than to be able to have a single, fair price for each type of visit even if submitting to insurance, but they cannot get paid unless they find an applicable code that represents a component of the service.