Book an Appointment

Billing & Insurance

Insurance


About insurance and billing for pilonidal cyst surgery.

Because our office is small, we are able to provide personalized attention when handling billing and insurance matters. Our clerical staff are experts at working with Pilonidal Clinic Billing Departmentinsurance companies, and in particular working with surgical claims. We encourage you to call, email, or write the office staff with any questions regarding billing and insurance. We are providers for a surprising number of national insurance plans so even if you live outside Wisconsin, if you have insurance there is a very good chance surgery by Dr Immerman will be covered. The cleft-lift procedure is not considered “cosmetic” and, in our experience, is always covered by insurance. In general, if you are covered by a Medicaid program in your home state, it will not cover care in Wisconsin. If you do not have insurance or the insurance you have does not cover care by Dr Immerman, we can have negotiated a discounted complete package price for surgery, hospitalization, anesthesia and lab with the hospitals and anesthesiologists. This is available for U.S. patients as well as international travelers.

Most of the pilonidal surgery we perform is covered by insurance.

We will fill out and submit the insurance forms related to the care provided by Dr. Immerman. If you would like us to check if our care is covered by your insurance, we need front and back images of your insurance card. If it is a plan we are not familiar with, our staff are experts in finding out if you have coverage, and sometimes facilitating an “out of network” referral. If we are not covered by your present plan, another option is to change insurance plans to one where we are considered “in-network”.

If you are outside Wisconsin and searching for an insurance product that includes our clinic, be aware that each insurance carrier and each plan can be slightly different.  Some out-of-state plans consider us in-network and others consider us out-of-network.  If acquiring new insurance, some nation-wide insurance carriers we recommend checking are:

  • Aetna
  • Anthem Blue Cross Blue Shield
  • Cigna
  • Dean Health Plan
  • HealthEOS/Multiplan
  • HealthPartners
  • Humana
  • Medica
  • Medical Mutual
  • Quartz
  • The Alliance
  • United Healthcare
  • WEA Trust
  • WPS

A few things to ask specifically is if Dr. Immerman is considered in-network or out-of-network and if the facility (either OakLeaf Surgical Hospital in Altoona, WI or HSHS Sacred Heart Hospital in Eau Claire, WI) would be covered as in-network.   If you cannot get firm answers on the insurance company or AHC website, our recommendation is to go to a private insurance agent. They are experts on what plans are available in your area  and helping you track down the details. Be aware, that there may be waits until the enrollment period or pre-existing condition issues to deal with.

If the insurance companies need more specifics regarding our clinic and the hospitals we use:

  • Surgeon’s Name: Steven C. Immerman, MD, FACS, Office Address:  719 W. Hamilton Avenue  Eau Claire, WI  54701
  • Hospital Location – at either:  OakLeaf Surgical Hospital in Altoona, WI  54720 or HSHS Sacred Heart Hospital in Eau Claire, WI  54701
As far as we are concerned, you do not need a referral from your local doctor to see us. It is an unusual situation where insurance requires that you have a referral in order to maintain your coverage. If your insurance plan does not cover the care we provide, we can help with discounted package pricing on hospital, anesthesia and surgeon costs. Many patients feel that the importance of having the right operation and getting on with their lives is worth going out-of-plan, and paying out-of-pocket. In all cases, we do everything we can to make your care as cost effective as possible. As one of our recent patients astutely pointed out:

“We did travel from TN to WI and it was worth every minute and dollar spent. We actually came out ahead over the last surgery, travel expenses included!”

07

Save