Participation with Payers Policy
Impulse Monitoring, Inc. (Impulse) provides intra-operative neurophysiologic monitoring
(IONM) services. IONM technical services are provided by on-site technologists
employed by Impulse, supported by physicians who provide physician monitoring services
in real time via online connection. IONM services are provided under a contractual
arrangement between Impulse and the hospital. It is the responsibility of the surgeon
to let the patient know if the surgeon is requesting IONM for the surgery.
This policy is intended to be a source of information for hospitals, surgeons, practice
administrators and insurance providers and is publicly available on the Impulse
website at www.impulsemonitoring.com.
Our physicians have limited in network participation: they participate with Medicare
and with certain other payer networks. Several also participate with Blue Cross/Blue
Shield. Depending on the patient's insurance plan, this means that the patient may
be receiving IONM services from an out of network provider.
Why is the physician likely to be out of network?
Why is the physician likely to be out of network? IONM monitoring physicians provide
a specialty service to more than 150 healthcare facilities in 27 states nationwide.
It is not possible or practical for network contracts to be negotiated with all
the payers that may be accepted by the different facilities.
What steps should the surgeon's office take?
- Notify the patient: Impulse provides surgeons with information for them to give
to their patient's about IONM.
- Check with the insurance provider: Check with the carrier to find out if pre-authorization
is required for a referral to an out of network provider.
After surgery, the patient will receive a letter from Impulse explaining the billing
The charges for the monitoring services are billed directly to the insurance provider
(including Medicare). It takes approximately thirty days for the claim to be processed,
but may take longer. After the insurance company notifies us of the amount of the
patient's co-pay, co-insurance and deductible, the patient will receive a statement
for the amount owed. Note that physician bills may come from one of four practice
groups: American Neuromonitoring Associates, P.C., Midwest Neuromonitoring Associates,
P.C., Pacific Neuromonitoring Associates, Inc. and North Pacific Neuromonitoring
Payer Medical Policies
Claims for IONM services are reported in accordance with AMA/CPT guidelines and
practice billing policies – a copy of which is available on request. Medicare and
other in network claims are reported subject to applicable payer policy and AMA/CPT
guidelines, accompanied by additional disclosure if necessary.
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