Insurance & cost
What this will cost you, before you book.
Most of what we do is covered by insurance. A few things generally are not. Here is the honest version of both, and how to get a specific number for your plan.
The short version
Diagnostic visits and the majority of interventional procedures — epidural steroid injections, facet and medial branch blocks, joint injections, radiofrequency ablation, nerve stimulation — are billed to insurance as medical procedures. What you pay depends on your plan: your deductible, your co-insurance, and whether the plan requires prior authorisation for that specific procedure.
Regenerative treatments are the exception. Platelet-rich plasma and bone marrow concentrate procedures are generally not covered by insurance in the United States, and are quoted directly. SoftWave therapy is likewise usually self-pay. We will tell you which category your treatment falls into before it is scheduled, not after.
We do not publish a fee list, because the honest answer for any individual is a function of their plan rather than of our chargemaster. What we will do is verify your benefits and give you a specific estimate before you commit to anything.
What drives what you pay
Your deductible
If you have not met it for the year, procedures apply against it. Early in the calendar year this is usually the biggest single factor.
Prior authorisation
Many plans require approval before an injection or ablation. We handle the submission; it typically adds days, not weeks.
Facility vs. office
Procedures done in our office avoid a separate hospital facility fee. That is often a meaningful difference in what you are billed.
Diagnostic vs. therapeutic
A diagnostic block and the treatment it points to are billed separately. We will say up front when a plan involves two steps.
Regenerative procedures
PRP and bone marrow concentrate are quoted as self-pay. You get the number before scheduling.
Referral requirements
Some plans need a referral on file before a specialist visit will be covered. We check this when we verify benefits.
Insurance questions
Do you take my insurance?
Can you tell me what I will owe before the procedure?
Is PRP or stem cell therapy covered?
Do you offer payment plans for self-pay treatments?
What about Medicare?
Eliminate pain and reclaim your life.
Request an appointment with Dr. Loch, or call the office at (904) 750-3787. Most patients are seen within a week.