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Billing & Insurance Policies

Insurance Processing

We encourage our patients to check with their insurance carriers to make sure Monterey Spine & Joint is in their care network. As a courtesy, we are happy to file insurance claims for our patients.

Monterey Spine & Joint can also provide care for patients as an out-of-network provider. Please discuss details of your financial responsibility with your insurance company. As a courtesy, we will file a claim to our patient’s primary insurance carrier, as well as any secondary or supplemental insurance plans.

We file claims to commercial insurers, Medicare, Medi-Cal, Tri-Care, and Workers’ Comp insurance agencies. Patients can help us file these claims by providing a copy of their current insurance cards and all necessary billing information. We participate in the following major plans:

  • Aetna
  • Anthem Blue Cross PPO
  • Aspire Health Plan/MBIPA
  • Blue Shield PPO
  • Central California Alliance for Health
  • Cigna
  • Coastal
  • Community Health Plan
  • First Health
  • HealthNet PPO
  • Medicare
  • Medi-Cal – (Please ask our schedulers if their physician is participating.)
  • Tri-Care
  • State Fund
  • United Health Care
  • U.S. Dept. of Labor
  • Other Commercial Carriers – (Please ask our schedulers.)
  • Other Work Comp Carriers – (Please ask our schedulers.)
  • Valley Health Plan
  • Vocational Rehab
  • Railroad Medicare

Additional Assistance With Insurance

We offer billing representatives who, if necessary, can interact with most major insurance payors to assist patients with questions about insurance guidelines and payments. We encourage our patients to also consult their insurance representatives to clarify coverage issues. Please call our billing office at (831) 324-4565.

Credit Policy

We strive to keep our fees reasonable. If you have any questions about your bill, please ask. You are responsible for payment of your account even if you have insurance. Your insurance contract is an agreement between you and your insurance company.

Depending on your contract with your insurance company, you may be required to make a co-payment or pay a deductible amount. Co-payments are required on the date of service. Insurance payments paid directly to Monterey Spine & Joint will be applied to your account. If there is a remaining balance, you will receive a billing statement.

Billing

Our statements are sent out monthly through our business office. All charges are due and payable within 30 days of receipt. We accept cash, check, Visa, Master Card, and money orders.

Please contact us if payment in full would be a financial hardship. We will set up a payment arrangement with you. For further assistance, please contact our billing office at (831) 324-4565.

Our billing office hours are weekdays, 8:00 am to 5:00 pm.

Referrals

If your insurance plan requires a referral for you to see a physician at Monterey Spine & Joint, it must be obtained from your primary care physician. Our medical assistants are primarily responsible for securing referral authorizations. Patients should verify that authorization is obtained before services are received. Our business office has referral coordinators available if further assistance is needed. For assistance, call (831) 324-4565.

Prescriptions & Renewals

Please request all prescriptions and authorizations for renewals on weekdays from 8 a.m. – 5 p.m., when our full records are available. We do not refill prescriptions after hours or on the weekend. It is your responsibility to ensure that you have an adequate supply of medication.

Appointment Cancellation Policy

Our goal is to provide quality medical care in a timely manner. In order to do so, we have had to implement an appointment cancellation policy. This policy enables us to better utilize available appointments for our patients in need of medical care.

In order to be respectful of the medical needs of Monterey Spine & Joint, please be courteous and call promptly if you are unable to attend an appointment. This time will then be reallocated to someone who is in need of treatment. This is how we can best serve the needs of all our patients.

If it is necessary to cancel your scheduled appointment, we require that you notify us at least four hours in advance. Appointments are in high demand, and your early cancellation will give another person the possibility to have access to timely medical care.

For more information, please see our No Show Policy.