Because we believe in delivering the highest quality of care to our patients, Apex Center for Regenerative Medicine is “out-of-network” with most insurance carriers.  We assist patients with submitting claims to insurance companies to maximize the out-of-network benefits for which you are eligible.

Understanding your out-of-network benefits

Apex Center for Regenerative Medicine was founded to deliver the most advanced and technologically up-to-date sports medicine care.  Our commitment to quality of care and clinical excellence require that we remain free from the restraints that in-network insurance policies can place on deciding your treatment plan.

Insurance carriers refer to Apex as an “out-of-network” facility.  This does not mean that we do not accept your insurance, but rather, it means that we do not currently have a contract with your health insurance provider.  However, if you have an insurance policy with out-of-network benefits (i.e., a PPO policy), you have the additional benefit of visiting physicians and surgical facilities that are outside of your insurance carrier’s network.

Why go to an out-of-network provider?

We believe that your medical care is important.  We choose to stay out-of-network with insurance companies to maintain flexibility in optimizing your treatment.  By remaining out-of-network, we can tailor our care plan to your needs, and not the needs of your insurance carrier.

In contrast, in-network facilities and hospitals are contractually obligated to adhere to the HMOs’ stringent rules regarding where, when, and by whom a procedure is authorized to be performed – sometimes right down to the specifics of how a particular procedure can be performed.  Insurance carriers are also slow to embrace new treatments and diagnostic tools, and we believe strongly in offering the most state-of-the-art tools and treatments to our patients.

What kind of bills and statements can I expect to receive from Apex?

After your treatment you will receive a statement called an Explanation of Benefits (EOB) from your insurance company.  It itemizes the fees charged and indicates the allowable amount covered by your insurance company.  After receiving the EOB, you will receive a bill from Apex Center for Regenerative Medicine.

When you receive the bill from us, we strongly recommend that you call us with any questions.  Our billing staff will help you to understand your billing statement and will clearly explain how these costs are derived.  We realize medical billing and insurance statements can be difficult to understand and can be very intimidating.  Our billing department will review with you the charges and reimbursements.  Most importantly, we will assist in maximizing your insurance company payment to you for your healthcare costs.