TO ALL PATIENTS OF THE COMPREHENSIVE PAIN MANAGEMENT GRP LLC
We are sorry, but we DO NOT Participate in all Insurance Programs.
IMPORTANT
**This is to notify you that we can no longer guarantee that your Insurance Plan
will cover all our services.
Because our Medical Group does not have signed contracts with most Insurance Companies our services may Not
be covered 100%. However, your policy may have Out-Of-Network Benefits. Please call your insurance company,
give them our tax Identification Number Tax ID #36-4367464, and they will inform you of your Out-Of-Network
Benefits. We welcome all patients to our practice, but must inform you up front that some out-of-pocket costs may
be experienced.
Who will NOT be affected? We will remain participating providers in the Medicare Program. Therefore, Medicare
will pay for eligible Medicare patients. However, if your secondary insurance is not a true Medicare Supplement
and attached to a managed care plan, it may not cover your 20% Co-Amount due.
In this case, the co-amount due will be your responsibility.
Blue Cross/Blue Shield patients: We will remain participating providers in all Blue Shield Plans. However,
patients
with HMO of Illinois plans still must secure their own referrals/approvals from their Primary Care Physicians
in order
for them to be seen at CPMG-MA LLC. This is the patient’s responsibility.
Please note* This is the ONLY HMO taken.
Workman’s Compensation patients: If you have a verified Worker’s Comp Claim on file and your Case
Manager approves your visits and procedures, your coverage should not be affected. If your Worker’s Comp
Case is in Dispute,payment is expected at time of service.
*Please Note: Workman’s Comp patients are responsible for informing
our office of their Date of Injury, Case
Number, Case Manager, and a Billing Address for their services.
Co-Payments: All patients who have Co-Payments are expected to pay them at the time of their office visits.
Public Aid: We Do Not Accept Public Aid Patients.
We hope this keeps you informed of our Insurance affiliations and policies. Thank you for your kind cooperation
and prompt attention to all insurance and payment matters.
Billing Service:
Medi-Services
All Billing Inquiries: 1-847-945-4550
Revised 04/09
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