Welcome to Pain Management Institute

To make an appointment for any of our locations, please call
  (815) 464-7212

Insurance Carriers

Coverage for pain treatment varies; contact your insurance provider before your first appointment to find out which services are covered.

Coverage can be categorized as self-pay, Medicaid Coverage, Medicare Coverage, managed care/commercial insurance coverage or Workers’ Compensation Coverage. Please refer to the following guidelines for each category.

SELF-PAY
Our financial counselor will collect a deposit for services at the time of your visit unless prior arrangements have been made.

MEDICAID COVERAGE
MEDICARE COVERAGE
MANAGED CARE/COMMERCIAL INSURANCE COVERAGE
WORKERS’ COMPENSATION COVERAGE
FINANCIAL COUNSELING
MEDICAID COVERAGE
Please bring your Medicaid card to your first appointment. You must show your Medicaid card to the financial counselor at your first visit and at the first appointment of each month thereafter.

MEDICARE COVERAGE
We accept Medicare assignment for physician fees and other services covered under Part B. Please be advised that some of the services we offer, such as acupuncture, may not be covered by Medicare.

If a service is not covered by Medicare, check with your secondary insurance (if applicable) for coverage. Services not covered by Medicare or by a secondary insurance provider are considered Self-Pay. Please refer to the Self Pay category.

MANAGED CARE/COMMERCIAL INSURANCE COVERAGE
If your insurance requires a referral from your primary care physician before you can be seen by one of our specialists, it is your responsibility to obtain it. We prefer to have this referral in writing.

If your referring doctor recommends a consultation with the Pain Management Institute as well as a certain procedure, please make sure it is stated on your referral form.

If you do not have a referral and your insurance requires one, you will either need to reschedule your appointment with the Pain Management Institute or sign a waiver form that holds you financially responsible for the charges of
that day’s appointment.

Keep in mind that referrals are usually for a specific number of visits over a specific amount of time. If you continue to be a patient with us after the time permitted by your insurance company, it may be necessary for you to get more than one referral.

Procedures performed by our specialists often have to be pre-certified by your insurance company. Please have the specialist check with our Pre-certification Specialist before any procedure is performed.

Future procedures performed at the Pain Management Institute may also require pre-certification.

Before your next appointment, please call the Pre-certification Specialist at (815) 464-7212 to confirm that your procedure has been pre-certified by your insurance company.

WORKERS’ COMPENSATION COVERAGE
Before you can be seen by one of our specialists, it is your responsibility to obtain authorization from your primary care physician (or physician of record) – unless the appointment is to obtain a “second opinion.”

If you are coming to the Pain Management Institute for a second opinion, only the evaluation is covered (not the diagnostic tests). No other services will be covered unless your referring physician of record has submitted the appropriate request to the Bureau of Workers’ Compensation. After submitting the request, your physician must receive written approval from the Bureau for coverage of services other than a “second opinion.”

If you are covered by a self-insured company or out-of-state Workers’ Compensation Bureau, please bring a written authorization for services to your appointment.

In all cases, it is your responsibility to know your claim number and all pertinent information regarding your claim.

If you do not have a “physician of record” or desire to change your “physician of record” to one of our specialists, you must ask the specialist if he or she would be willing to become your physician of record. If the specialist accepts this responsibility, a “Change of Physician” form must be completed and submitted to your compensation case manager.

Financial Counseling Is Available
If you have any questions about your insurance coverage or workers’ compensation, please contact your insurance company and/or case manager.

If you have any questions about the fees associated with your evaluation and treatment, please call our Financial Counselor at (815) 464-7212.

Since some services may not be covered by your insurance carriers provider, financial counseling is available to help you decide how to manage your treatment expenses.