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Checking Your Insurance Coverage

How to Check your Insurance Coverage

Prior to your New Patient Evaluation, the administrative staff will prepare a financial overview of your coverage and benefits for treatments offered by Reflex providers. This financial estimate will be reviewed with you at the end of your Evaluation. However, should you want to check on your benefits beforehand, we have prepared a guide to calling your insurance company. The following steps will help you verify your insurance coverage.

  1. Call the member service information phone number on the back of your insurance card; or visit their website.
  2. Inform your insurance company that you’re planning to visit Integrated Joint Specialists (this is Reflex’s official legal name). If the representative requests the name of a specific provider, we have a list available on this page accompanied by their national provider identification numbers (NPI).
  3. Confirm your benefits and osteoarthritis coverage for the specific service you are seeking. You can ask your customer service representative for your deductible and out of pocket maximum, along with what has been accumulated towards them so far. Then you may ask for benefits on the services we offer, which can include specialist office visit, injections, and durable medical equipment for knee braces. A list of codes utilized during the evaluation can be found below.
  4. Verify if pre-authorization is necessary before receiving Hyaluronic Acid injections (see injection billing codes below).

When contacting an insurance company, they may ask for the following details:

Facility Legal Name: Integrated Joint Specialists

Address: Four Lincoln Center 10250 SW Greenburg Rd. Ste. 115 Tigard, OR 97223

Tax ID (TIN): 273312107

Initial Evaluation CPT Billing Codes:

  • 99203 – Outpatient/Office Visit
  • 73560 – X-ray image
  • 76881 – Ultrasound, non vascular, real-time with imaging report
  • 76882 – Ultrasound, non vascular, real-time with limited image report

Injection CPT Billing Codes:

  • 20611- Inject/Drain Joint/Bursa (Ultrasound Guidance)
  • J7323- Euflexxa Injection per dose
  • J7324- Orthovisc Injection per dose
  • J3490 – Durolane Injection per dose
  • J7326 – Gel One Injection per dose
  • 77002- Needle localization by X-ray

Diagnosis Code:

  • M17.0- Osteoarthritis, localized, primary involving lower leg

Providers:

  • Dr. Samuel Kim (NPI: 1881795078)
  • Dr. Frances Lawson (NPI: 1851334387)
  • Dr. Robert Craig Raymond (NPI: 1972544435)
  • Dr. Russell Riggs (NPI: 1356384838)
  • Dr. Jamie Schlueter (NPI: 1952353393)
  • Dr. Gregory Tanksley (NPI: 1871621607)
  • Natacha Yonezuka-Gullo, PA-C (NPI: 1689655938)
  • Ariana Bissinger, NP (NPI: 1740694660)

 

Give us a call at (503) 719-6783 to schedule your consultation today!