Pricing
Midlands Orthopaedics & Neurosurgery Pricing Plans
At Midlands Orthopaedics & Neurosurgery, we believe in price transparency.
Purchasing healthcare should not result in surprise bills. We offer bundled payment options for those seeking to pay directly for care apart from an in-network insurance plan. Bundles benefit self-pay patients, self-insured employers, patients with out-of-network insurance coverage, health sharing ministries and anyone who bears the out-of-pocket expense for our services.
In-Network Insurance Plans
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Which plans are considered In-Network?
Midlands Orthopaedics & Neurosurgery is generally considered an in-network provider for the following insurance plans:
- Absolute Total Care HMO* plans to include Dual ATC* and Medicare Advantage
- Absolute Total Care SC Ambetter plans
- Aetna
- BlueCross BlueShield of SC: all plans to include BlueChoice and BlueChoice Medicaid* (Plans with CNS prefix are out of Network for our office)
- BCBS plans of other states if participant has out-of-area benefits
- BCBS Federal
- Cigna
- Humana Medicare Advantage
- SC Medicaid*
- Traditional Medicare Part B
- Prisma Health Midlands Network
- Select Health: First Choice product (not Medicare or Dual plans)*
- United Healthcare: all plans
* Plans with asterisk are closed to new patients.
This list is intended to offer general guidance about our network participation. Our network participation is subject to change at any time without timely update to this page.
Which plans are considered In-Network for Dr. Gross?
(Updated 3/2017) I have contracted with the following carriers for reduced fee schedules as of 1/1/2011; therefore, I am considered an “in-network” provider with these plans:
- Blue Choice
- Blue Cross Blue Shield Federal Employee Plan
- Blue Cross Blue Shield SC *
- Blue Cross Blue Shield State Health Plan (SC)
*Most standard Blue Cross/ Blue Shield plans from other states have a reciprocal agreement with Blue Cross of SC, and are therefore also “in network”. We can tell you if this applies to your Blues plan.
I am NOT contracted with BCBS Medicare Advantage Plans.
When should I confirm plan coverage?
Always confirm our practice’s network status with your specific plan prior to your appointment. All providers in our practice may not be contracted with all plans. We welcome patients with out-of-network insurance or no insurance as well.
Out-of-Network Insurance Plans
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Why isn’t Midlands participating with my insurance plan? or Why did you leave the network?
What if my insurance plan tells me Midlands will be paid an in-network rate?
Will you file my insurance even though you are out-of-network?
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Can I get an itemized billing statement?
Do I have to purchase the package from the webpage?
Why do I have to pay ahead of time?
We require payment in advance because the care we offer is expensive to provide. Our physicians use expensive equipment and supplies to diagnose and treat patients. Our surgery center must purchase expensive implants for most surgeries before the surgery is performed. We incur those expenses before you receive the care, so it’s important for us to recover that cost.
We offer Care Credit to patients who need assistance with the pre-payment requirement. We can offer a pre-payment plan allowing you to pre-pay installments toward a surgery date in the future.
Why do I have to pre-pay when I have insurance?
We require payment in advance because the care we offer is expensive to provide. Our physicians use expensive equipment and supplies to diagnose and treat patients. Our surgery center must purchase expensive implants for most surgeries before the surgery is performed. We incur those expenses before you receive the care, so it’s important for us to recover that cost by collecting the total amount due, not only the portion insurance pays.
Can I set up a payment plan for the pre-pay amount?
Factors that may influence this decision on a case-by-case basis include whether the surgery is elective; the patient’s payment history with the practice; our up-front cost to render the service; and the portion of the total payment due to the practice or ASC that is the patient’s responsibility versus the insurance plan’s responsibility.
I shouldn’t have to pre-pay because I have claims from other doctors that will meet my deductible before this surgery.
Do you have any assistance programs to cover medical cost?
We accept CareCredit. Click here for more information.