Insurance Information

Spine West accepts most insurance plans.

If you are covered by health insurance, consult with your health insurer to determine your financial responsibility for health care services provided by Spine West.

All patients should:

  • Talk to insurers PRIOR to coming in for their appointment.

  • Verify if a referral is required by your insurance carrier.

If you are not covered by health insurance, contact our billing office at 303-494-7773 x111 to discuss payment options prior to scheduling treatment.

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Insurance Tips

Patients interested in self-paying for services should call for pricing.

Please Note:

  • If choosing to self-pay, payment in full is due at the time of service.

  • Self-pay costs will not go toward deductible.

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Using motor vehicle accident insurance?

  • Spine West does not take liens.

  • The motor vehicle insurance used to pay for your medical claims at Spine West must be your own.

  • If your motor vehicle insurance declines to pay for your medical bills, treatment costs become patient responsibility.

How Does Medical Billing Work?

At Spine West, we want our patients to understand how medical billing works. These are terms you will often see when your insurance company sends you an explanation of benefits (EOB).

For more information on these terms visit HealthCare.gov.

  • The charged amount is the standard amount we charge your insurance for a particular service. Depending on what was done or performed, this can vary. Keep in mind the amount we charge an insurance company for a particular service is the same for all insurance companies. (example: We charge Aetna, United Healthcare, Blue Cross Blue Shield the same amount for an MRI which is $1,000)

  • The allowed amount is the contracted rate your insurance company allows for that particular service or procedure. The allowed amount is really what is important. (example: Although we charged United Healthcare and Blue Cross Blue Shield $1,000 for an MRI, United Healthcare will allow typically $610 and Blue Cross Blue Shield allows $575)

  • This is the amount by which a medical claim was “adjusted” or “discounted” by your insurance company. This is charged amount – allowed amount. (example: If you have Blue Cross Blue Shield, for an MRI, charged amount $1,000 – allowed amount $575 = adjustment of $425). In essence, the adjustment or discount is by how much the charged amount was reduced by for having that particular insurance.

  • This is the amount you agreed to pay for your health care services every year before your insurance starts to pay. (example: If you have a $3,000 deductible every year with your insurance company, then you pay the first $3,000 of covered services)

  • This is a fixed amount you pay as dictated by your insurance plan. Copays are usually required after you’ve met your deductible and are always due at the time of service.

  • The percentage of costs you share with your insurance company after the deductible is met. (example: If you have a plan that stipulates you will have a 20% coinsurance after your deductible is met then you are responsible for paying 20% of the allowed amount for any claim)