Midwest Neurosurgery & Spine Specialists (MNSS) is a medical practice serving the western suburbs of Chicago. Dr. Matthew Ross is dedicated to providing adult and pediatric patients with access to the most advanced treatments for injuries to the spinal column, brain and peripheral nerves. At MNSS, we strive to provide a unique, positive and caring environment for our patients, employees and physician. We operate an independent medical practice. This means Dr. Matthew Ross is able to provide the best medical care that is tailored to each patient's needs rather than follow insurance company prescriptions for general care. While general care meets basic needs, we have determined that our patients recover quicker and more completely when they have a voice and can brainstorm with our physician about treatment options.
Our primary objectives are to:
* Identify root causes of patient injuries and illnesses using examination and non-invasive, conservative techniques whenever possible
* Communicate findings to our patients, and explain how each patient may participate in the healing process using exercise, therapy and alternative forms of medicine when appropriate
* Exhaust conservative treatment options whenever possible to resolve patient injury / illness. When pain is accompanied by weakness and/or loss of function, the patient's ability to regain strength and/or function depends upon the expediency of performing surgery and removing the cause of nerve impingement or damage.
* Reduce patient stress through communication, understanding and action. We are patient advocates who work on our patient's behalf to make sure insurance companies pay their fair share of a patient's medical bills. We request insurance information prior to medical treatment so we may verify insurance benefits. This process enables us to explain insurance benefits to our patients so they can make an informed decision about whether to continue treatment options with Dr. Matthew Ross or seek medical treatment within their insurance network.
The consolidation of the health care industry in the past 30 years caused many important changes in the way medicine is practiced in the United States. Decades of wasteful expenditure and the burden of providing treatment to uninsured patients brought the industry to the brink of collapse. This resulted in drastic management reforms across the field. Hospitals, clinics and medical practices were all restructured with an emphasis on the bottom line. Health Maintenance Organizations (HMO's) were formed with the intention of providing affordable health coverage to working families and positive returns to investors. These corporations employed teams of doctors who were willing to accept less compensation in exchange for a steady stream of referrals. While the intention of expanding coverage was noble, the overemphasis on the bottom line led to a serious decline in the overall quality of healthcare available in this country.
The volume driven model of managed care limits the amount of time doctors can spend with patients. But the doctor / patient dialogue is an essential part of the treatment process, and the importance of spending time with patients cannot be discounted. Only when a patient fully understands their body, condition and treatment can they take an active role in recovering their health. The role of the doctor as a teacher and healer has been lost in the drive to treat the maximum number of patients with the least amount of overhead costs.
Independent practices like Midwest Neurosurgery & Spine Specialists do not participate in the managed care, patient referral programs. Dr. Matthew Ross is free to choose how much time to spend in a consultation, and what course of treatment is optimal for the patient's recovery. He is not constrained by insurance companies that pressure physicians to contain costs by limiting treatment options and allowing only 10 minutes per patient visit. It is our philosophy that time spent with a patient outside of surgery, developing an understanding of their condition, and building a strategy for their recovery, is as important as time spent on the procedure in the operating room. Dr. Ross does not employ a physician's assistant or a registered nurse as he prefers to personally oversee the care of all his patients. We haven't lost site of the bottom line; we just believe the quality of care provided is more important than quantity.
What does it mean that Dr. Matthew Ross is not contracted with any insurance companies?
It means that he is not included in your insurance company's network of physicians. He is considered a non-network physician. It means that your insurance company will not pay the same rate for your medical services that they will pay for an in-network physician. In many cases, the price difference between seeing an in-network physician and and out-of-network physician is only 10% to 20%. However, the amount of time your in-network physician will be able to spend with you is significantly less than Dr. Ross's standard schedule time per patient. In addition, our patients are evaluated and medically treated by Dr. Matthew Ross. He does not delegate medical treatment to a nurse or physician's assistant.
Before your first office consultation with Dr. Matthew Ross, we will request your insurance information so we may call your insurance company to verify your eligibility to treat with Dr. Ross. We will inform you if there are any significant constraints.
If it is determined that surgery is necessary, we will call your insurance company again to discuss the procedure being performed and request an estimate of your payment benefits. At the same time, we will provide our patients with procedure codes and prices for our services so they may call their insurance companies to receive a confirmed payment amount as well. With this information, our patients can make an informed decision to have surgery with Dr. Matthew Ross or to stay in network.
What if I have an insurance policy that requires a referral?
Dr. Matthew Ross treats many patients who have point-of-service (POS) or HMO plans. This means that we will require a completed referral form from your primary care physician before your insurance company will allow Dr. Ross to evaluate your condition. Otherwise, they will not pay for the medical services provided. In most cases, we are able to obtain referrals from primary care physicians.
What if I am injured or have a medical condition that requires me to go to the emergency room, and Dr. Ross is the neurosurgeon on-call who provides medical or surgical treatment? Will my insurance company penalize me for seeing a non-network physician?
It is against the law for physicians to refuse to treat patients in the emergency room because they are not in their insurance company network. In the same regard, insurance companies should not penalize their patients when they are treated by on-call physicians who are not in their insurance network. In cases where insurance companies try to shift payment responsibility to their patients as a result of an on-call doctor not being in network, we contact the Illinois Department of Insurance on behalf of our patients to report these insurance companies. The result is extremely favorable for our patients. The only exception has been with employers that are self-funded, or with unions. They are not bound by the rules and ethics enforced by the Illinois Department of Insurance. In these cases, the Department of Labor is the governing body. Unfortunately, they do not allow appeals by medical providers. They require the patient to issue the appeal. We have had a couple patients with self-funded insurance plans that have been successful in receiving favorable outcomes by contacting the Department of Labor.
What if I have a Worker's Compensation claim? Does Dr. Ross treat Worker's Compensation cases?
A significant percentage of our patients are Worker's Compensation claim patients. We are committed to not only helping patients heal from their work injuries, but to help them return to work and continue being contributing employees as quickly and safely as possible. In addition, we work closely with insurance adjustors to make sure treatment plans are approved prior to being scheduled to ensure medical care is not interrupted.