Dr. Fraser C. Henderson, Sr.
- Out of Network
Dr. Robert E. Rosenbaum
- Blue Cross Blue Shield
- Workers Compensation
- Personal Injury
- MVA Cases
Dr. Malini V. Narayanan
- MD Medicaid
- MD Physicians Care
- Adventist Network
- Priority Partners
- Blue Cross Blue Shield
- United Healthcare (Commercial Plans Only)
- Aetna PPO
Note: Patients are responsible for their In-Network Deductibles, Out of Networks Deductibles, Co-insurance and/or Co-pays at the time or service based on information obtained live by our practice. If you have any questions about your insurance, please call our office and request information about how we work with Out Of Network insurances.
While many insurances do not require patients to have a referral, our practice does. This is not only to help our doctors understand the reason for your visit but also will help your insurance understand why our services are necessary.
Insurance Approvals: Pre-Certification and Prior Authorizations
Your MNG provider will decide which procedures, tests and other consultations you may need. Many health plans require pre-certification and sometimes predetermination of medical necessity prior to care being rendered. In addition, some services may not be a covered benefit for some plans.
For example, services that may require pre-certification include outpatient and inpatient hospital services, observation services, invasive procedures, CT, MRI and PET scans, Physical Therapy, Specialists treatments such as Immunologist, Orthopedist, etc.
Investigating coverage requirements and limits can take up to six weeks and obtaining approval can take up to two weeks. Please be mindful of the time limitations. Additionally, in the state of Maryland, approvals need to be obtained by the facility rendering services, please remember this when booking your appointments in your own state. We do not have staff to obtain approvals other than surgical.
Patients are responsible for knowing the pre-certification requirements of their health plans. We highly recommend that you contact your insurance company to determine benefits and coverage for our practice. Managed care plans such as health maintenance organizations (HMOs) and preferred provider organizations (PPOs) may deny or reduce benefits if care is obtained outside of the established network, authorization of the plan or out of your state.
If our facility is approved to treat you, they could provide only a reduced payment, in such cases, the patient will be financially responsible for more — possibly all — of the provided services.
A pre-surgery deposit is required for all surgeries.
Can Your Insurance Cover Your Visits at 100%?
To avoid paying a pre-service deposit or experiencing either denial of payment or a reduction of benefits, we highly recommend you contact your insurance carrier and establish good communication with someone willing to help you. Most times this will be a case manager. “Case management is designed to provide for a patient’s needs while controlling costs, with a case manager maintaining information on a patient’s outcomes.”
To get a case manager you need to contact your insurance and give them enough or all information about your health condition. You will need to let them know why it is imperative that you come see our providers. You will find under Resources Articles that we provide to our patients, with enough literature about the extensive research done within our practice for some of the conditions we treat. Additionally, you can ask your referring physician to provide your insurance with letters of medical necessity to support your needs.
Most times, when this is established your insurance will cover your visits at 100% or at a higher level so that your payment is minimal.
For surgeries, we will work pre-rate negotiated agreements with every insurance, once your insurance is willing to work with our practice, they can contact us and we will take it from there.
Please always contact us to verify that we have received your authorization and other forms from your insurance
8am - 5pm Eastern Time
Monday - Friday