Insurance

Does Ponte Vedra Spine & Pain Center accept UnitedHealthcare?

Yes — we are in network with UnitedHealthcare (HMO, PPO and Choice Plus). Plans differ within a carrier, so we verify your specific policy before your visit.

Check my coverage Call (904) 750-3787

How UnitedHealthcare works at this practice

We are in network with UnitedHealthcare across its HMO, PPO and Choice Plus products. Choice Plus is the one most often held through a large employer, and it is the one that most often confuses people at the desk: it pays at an in-network level here, but the deductible and co-insurance are set by the employer group rather than by UnitedHealthcare, so two Choice Plus cards can behave quite differently.

Prior authorisation is where UnitedHealthcare plans are strictest. Radiofrequency ablation and stimulator trials generally need approval before they are scheduled, and diagnostic blocks are often required first to justify them. We submit that paperwork; it typically adds days rather than weeks, and we will tell you where it stands.

What we bill to UnitedHealthcare

Under an in-network plan we bill your evaluation and the interventional work that follows it: epidural injections, medial branch and nerve blocks, sacroiliac and joint injections, radiofrequency ablation, and spinal cord and peripheral nerve stimulation. All of it is placed under live X-ray or ultrasound guidance rather than by landmark.

The conditions most often treated under this coverage: back pain, sciatica, neck pain, herniated disc, spinal stenosis, knee pain, shoulder pain, hip pain and peripheral neuropathy.

What is not billed to insurance

Two things are not billed to any plan, this one included. Regenerative treatments — platelet-rich plasma and bone marrow concentrate — are not covered by United States insurers and are quoted directly. SoftWave and MLS laser therapy are likewise usually self-pay. You are told which category your treatment falls into before it is scheduled, not after. The full picture is on insurance & cost.

Before you come in

What to bring

  • Your UnitedHealthcare card and a photo ID.
  • A referral, if your plan requires one. Call us if you are not sure.
  • Any imaging relating to the pain — MRI, CT or X-ray.
  • Notes from prior treatment: physical therapy, injections, surgery.
  • A list of your current medications, including doses.

Not sure what your plan requires? Call (904) 750-3787 and we will check it with you.

UnitedHealthcare questions

Is Ponte Vedra Spine & Pain Center in network with UnitedHealthcare?
Yes — including HMO, PPO and Choice Plus plans. Because benefit levels are set by your employer group, the office verifies your specific policy before your visit.
Does UnitedHealthcare require prior authorisation for injections?
Frequently, particularly for radiofrequency ablation and nerve stimulation. We handle the submission, and in most cases the plan requires a diagnostic block first to establish that the treatment is warranted.
Being in network — does that mean my treatment is covered?
Not by itself. In network means we have a contract with the carrier and you are seen at your in-network benefit level. Whether a specific procedure is covered, and what you would owe, depends on your plan and sometimes on prior authorisation. The office verifies your benefits and gives you an estimate before anything is scheduled.
What if my plan is not UnitedHealthcare?
See insurance & cost for the full list of plans we are and are not in network with. If yours is not on either list, call (904) 750-3787 — we will confirm it rather than guess.

Eliminate pain and reclaim your life.

Request an appointment with Dr. Loch, or call the office at (904) 750-3787. Most patients are seen within a week.

Request an appointment