Insurance and Billing

Do you participate with my health plan?
To find out, check your health plan’s website or contact them directly. While we encourage you to verify our participation with your plan directly, you can also e-mail us to check for you.

My primary physician participates with more health plans. Why don’t you?
At Brain + Spine, we take seriously what we see ethically as our social obligations and participate in many Medicare and Medicaid programs. Providing top-notch care to older people and those in need is important to us, and we’re happy to do it.

We also participate in several commercial insurance plans, but not all of them. Most insurance plans offer terms more favorable to primary care physicians, and so your family physician, internist, or OB/GYN may participate in more plans than we do.

If I have surgery, what will I have to pay?
Payment will depend largely upon whether we participate with your health plan, and what your insurance plan sets as your deductible or co-pay. We can let you know whether we participate with your insurance plan, but you will have to contact your insurance provider directly to learn your deductible or co-pay amounts.

After knowing that, we can estimate for you what your charges from us may be, but we never know until after a surgery occurs because sometimes additional unexpected problems are seen at the time of surgery that need to be addressed.

If I have surgery, what bills will I have?
Your health plan will likely receive separate bills from the surgeon, the anesthesiologist, and the hospital, and possibly also from a radiologist if x-ray studies are needed during your stay. You would receive from us a bill with charges for the services of one of our surgeons – David W. Lowry.

Why am I billed for an assistant?
Neurosurgery is one of the most complex human endeavors, and as in any complex task, getting it right requires intense concentration and consistency in execution. Achieving the desired result for you is more likely to happen if two people are watching over every step, much as a commercial flight is directed by not only a pilot but also a co-pilot. Having an assistant work consistently with a surgeon makes things go smoothly, and that’s what you want in your surgery. When unusual pathology or technical challenges arise in a neurosurgery case – and they cannot always be predicted – an assistant provides a second well-trained mind and two additional experienced hands to work through the challenge toward the desired goal. Using the services of a physician assistant, Scott Tuinstra, PA-C is a cost-effective way to provide that extra protection and quality to every single patient Dr. Lowry operates upon because a physician assistant’s fees are typically a fraction of what a second surgeon would have charged.

Patient Privacy
Our privacy policy complies with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA requires us to protect your private health information and provide you with a notice of our legal duties and privacy policy with respect to your protected health information.

Questions about our Privacy Policy may be directed to:
Brain + Spine Center
3299 North Wellness Drive
Building C Suite 240