We are a medical billing company that contracts with healthcare providers nationwide to submit claims to insurance companies on their behalf. We are not a collection agency, we only process and submit medical claims to insurance companies and send statements to patients for the portion that the insurance company stated that is their responsibility as requested by the provider.

A Surgical Assistant is someone specifically trained to assist a surgeon in surgical procedures to help ensure the safety and the best possible outcome for the patient.

We are contracted by the Provider (Assistant at Surgery) in your surgery to submit the medical claim, after processing the claim, your insurance company has determined that you are responsible for the amount in your statement, your payment should not be made to us, it should be made to the providers address listed on the statement.

After reviewing your medical history and the surgical procedure that was to be performed, your surgeon determined that an Assistant was medically necessary for your safety and well-being.

This is a decision that is made by the surgeon, who may or may not feel that such technical detail needs to be discussed with you. It is similar to many other technical issues which they may or may not have discussed with you prior to your surgery. For your safety and for a good outcome to the procedure, they may decide there is a need for certain a service or providers to get involved in your care.

Most assistants are not able to be participants in every PPO and HMO mainly because insurance companies do not cover this necessary service. If your insurance company does not contract with surgical assistants in your area, you can appeal their determination and most plans will cover these services because they do not have surgical assistants in their network. You need to make this appeal directly to the insurance company and request payment(s) be made.  You have significant influence over your policy and may be able to get the determination of benefits changed.

Insurance companies often make their determination of medical necessity based on the policy purchased by the member and not the true the standard market needs of the surgeons.  The use of an assistant is always at the discretion of the surgeon.  Your surgeon felt that an assistant was medically necessary and you should appeal any negative determination with your insurance company.

It is based on the policy purchased and benefit language.  Most insurance companies will cover the charges for a surgical assistant if you appeal directly to them for payment. You should review your individual insurance plan policy. You will have to discuss any exclusion of service with a representative of your insurance carrier or other appropriate individual. 

Yes. We regularly perform this service as a courtesy for our clients and their patients. We do not know that your insurance carrier will change their payment determination with an appeal but, if you personally call your insurance carrier and demand they allow payment, it can help.  If you already have received a statement, this means that all our appeal efforts have been exhausted with your insurance provider.

Yes, certainly. Please email us at info@mederiservices.com, live chat or call us at 877-563-3374 to make payment arrangements.  We will contact the provider / client and help work out payment arrangements.  Some provider's now accept credit cards and PayPal.  Please check your statement for details.

The hospital policy regarding this should be stated on the surgical consent form. This form explains that assistant at surgery or other healthcare providers may be called to help with your operation and care. The need for an assistant is not always pre-determined.  When you selected your surgeon, you relied upon his judgment and skill to make decisions that were in the best interests of your health and well-being. There are many decisions that your surgeon made on your behalf in the process leading up to your surgery, the actual performance of your surgery, and the immediate recovery period following your surgery. It may be that your surgeon was unable to discuss each of these decisions with you prior to the surgery but after reviewing your history and/or the complexity of the surgical procedure to be performed, the surgeon alone determined if it is necessary for an assistant at surgery to be utilized during your procedure. This would be similar to asking the surgeon to pay for any anesthesia or medications that were not authorized by you in advance.

Yes, when possible we bill your insurance company on behalf of the provider once all necessary information is received.