Health Insurance Information for Patients
Just like each patient is different, insurance plans can be varied and offer differing benefits. At New Jersey Spine Specialists, our goal is to work with every patient and insurance plan to provide individualized medical care that improves your quality of life and function. Our goal is to get you back to doing things that you want to do as fast as possible.
Please call us at (908) 608-9619 to speak with one of our experienced spine patient advocates with any questions you may have regarding your insurance benefits.
Regardless of the doctor you see, a financial hardship program is available to those patients that meet our program’s qualifications.
Some of our providers are out-of-network with insurance carriers. What does that mean?
- Out-of-network means the physician has chosen not to enter into a contract with the insurance carrier.
- Typically, physicians that are in-network are willing to accept a lower fee from the insurance carrier in exchange for access to a larger volume of patients.
- By reducing the number of patients that they see, out-of-network physicians and their staff can dedicate more time and attention to every patient
- Patients seeing an out-of-network provider typically have insurance with out-of-network benefits.
- Similar to in-network benefits, out-of-network benefits may have deductibles, co-insurance, and annual maximum out-of-pocket amounts.
- At New Jersey Spine Specialists, we understand your concerns and do our best to maximize payment from your insurance carrier. Our patient advocates will explain and walk you through the process so that there are no financial surprises.
These are some key points why going out-of-network can be a better option for surgery:
- Given the complexity of spinal surgery, many of our NJSS physicians have chosen to be out-of-network, so that they can spend more time with you.
- New Jersey Spine Specialists is an independent practice that is not owned by a large entity. In many cases, large corporations put time and productivity pressures on their doctors.
- Our NJSS physicians are highly conservative by nature and being independent and out-of-network allows us to be extremely selective about when we tell our patients that surgery is necessary. Our physicians frequently steer patients away from surgery that was recommended by other surgeons if our physicians believe the surgery is not in your best interest.
- Out-of-network practices such as NJSS are considered “concierge practices” that cater to the patients’ specific needs since in-network physicians cannot afford to spend as much time with each patient due to higher patient volume.
- As a result of lower patient volume, NJSS office appointments and surgeries can frequently be scheduled sooner and more conveniently.
- Going out of network also allows patients to have easier access to our NJSS staff and physicians. While we have a dedicated team of physician assistants, nurse practitioners, and nurses, you will always see a physician when you come to the NJSS office.
Medicare – Drs. Hullinger and Kupershtein participate with Medicare. Drs. Drzala and Reiter have opted out of Medicare.
Medicaid – None of our physicians participate with Medicaid
Telehealth – NJSS also offers virtual telehealth services, using high-definition video and audio technology. Our telemedicine service provides patients real‐time, two‐way communication via secure online virtual sessions. Telehealth is now covered by most insurances.
Workers Compensation – Our physicians also work with many workers’ compensation carriers. Please reach out to one of our patient advocates at (908) 608-9619 to see if our physicians participate in your policy. Our patient advocate will then contact your adjuster to determine if an appointment can be made.
Auto insurance (PIP) – Our physicians participate with PIP. Please reach out to one of our NJS patient advocates at (908) 608-9619 who will then contact your adjuster to determine if an appointment can be made.
Dr. Hullinger is in-network with most insurance carriers. She accepts most Blue Cross Blue Shield and commercial insurance plans with the following exceptions: Advance EPO, Anthem BCBS, Aetna plans, AmeriHealth (no EPO), Great West, Health Republic NJ, QualCare, and Tricare. Some of these may have tiers or limitations, so please contact the office first to confirm coverage eligibility at (908) 376-1530. Of note, Dr. Hullinger does NOT participate with MagnaCare, United Healthcare Medicare Complete HMO, BCBS Advance EPO, or Humana.
To schedule an appointment, call:
Mitchell Reiter, M.D.
Mark R. Drzala, M.D.
Heidi Hullinger, M.D.
Ilya Kupershtein, M.D.
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