Spine West Insurance Information

Insurance Information

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

If you are not covered by health insurance, you are strongly encouraged to contact our billing office at 303-494-7773 x111 to discuss payment options prior to receiving treatment from Spine West.

Spine West accepts most insurance plans

  • We ask that you contact your insurance company to verify individual coverage.

  • For questions about billing, please call (303) 494-7773 x 111 or email: billing@spinewest.com

  • Current patients can check their latest statement via our patient portal. 

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

Using motor vehicle accident insurance? Here is what you need to know:

  • We do 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, it becomes patient responsibility.

How Does Medical Billing Work?

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

  • Charged Amount 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)

  • Allowed Amount 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)

  • Adjustment or discount 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.

  • Deductible 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)

  • Copay 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.

  • Co-insurance 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)

For more information on these terms visit HealthCare.gov.