Tucker Medical Consulting, LLC
Most of our providers are contracted with Medicare, Medicare replacement plans, and AHCCCS/Medicaid plans.
Commercial insurance plans, such as United Healthcare, Blue Cross Blue Shield, Cigna, Aetna and many others do not contract with surgical assistants.
Your primary surgeon's office should indicate to you that an assistant surgeon will be used. They may or may not know if we are contracted or not with your insurance. Please call us!
Our office does not find out about your surgery until after it has already taken place, anywhere from one week to 4 weeks after the date of service. We will always bill your health plan first in an attempt to get the insurance to pay.
Appeal Rights: in the state of Arizona you have mandatory appeal rights. Most Level One Appeals are done over the phone with member services, and they will give you a reference number and a time frame for decision. The reason for the appeal is that you as a patient did not have a choice in the surgical assistant used, and there are no contracted surgical assistants in network.
IMPORTANT!!!!!! You must call us back with the reference number given to you by your plan - we will document this information in your chart and allow 30 days for the appeal process to work.
If they tell you that they will have it "processed in network" , do not agree to that. Since we have no contract with them, it will not affect the amount due. Insist on the Level One appeal.
Level Two Appeals can also be done, however those are in writing. Please contact your plan for more specific information related to your policy. The reasons are exactly the same as the Level One - it is just a third person looking at your claim and health policy
If you receive a check from your health plan - this is not your money to keep. It belongs to the surgical assistant and must be turned over immediately. You do not need to cash the check, just send it in to our office with the statement that you received. If you would like to pay by credit card, we can arrange that as well.
Our providers understand that insurance doesn't always pay and that the bill may fall to you, the patient. We have generous discounts in place for those scenarios.
We can offer payment plans if needed. We also accept checks, Visa, Mastercard, Discover and American Express cards. Most HSA and FSA accounts work for our fees as well.