Surgical Centers

Contracted rates with many surgical centers of excellence throughout the United States providing access to the best surgeons at a savings of 30-80%. Working with a professional Care Coordinator ensures understanding of reduced expenses and provides assistance with scheduling, travel and accommodations.

Considering Surgery?

The Surgery Centers of Excellence offer access to a wide range of surgical procedures including:

  • Joint replacement for knees and hips and other orthopedic procedures (e.g. ACL repair, shoulder reconstruction, carpal tunnel repair).
  • Heart surgery including bypass procedures and valve repair/replacement.
  • Heart procedures including catheter/stent procedures and placement of pacemakers or defibrillators).
  • Spine surgery for decompression (laminectomy or discectomy), spinal fusion and placement of artificial discs.
  • Vascular (vein) surgery including carotid artery repair.
  • Weight loss surgery including gastric banding, bypass procedures and gastric sleeve procedures.
  • Cancer therapy using the CyberKnife a non-surgical radiation therapy for tumors of the brain, lung, prostate, pancreas, and spine.
  • Conditions related to seizure disorders and epilepsy.
  • Repair of detached retinas, corneal transplants, cataract procedures and other eye procedures.
  • Transplants - heart, lung, kidney, liver or pancreas.

In addition, the doctors and hospitals will consider patients for a wide range of medical treatments related to the procedures listed above.

This not only gives you access to high quality care; it also includes a pre-negotiated fixed price that is lower than what is available to you locally.

Frequently Asked Questions

What is the Surgery Center of Excellence Network?

It is a high quality specialty medical network for orthopedics (joint replacements), cardiology (bypass surgery and heart valve replacements), spinal fusion, and other planned surgeries.

Where are these Centers of Excellence located?

Providers are located in 30 cities throughout the US, as well as in 11 countries around the world. All meet high quality standards, and offer pre-negotiated fixed case pricing for planned surgeries.

How does the process work?

Personal Care Coordinators manage every step in the process, from initially explaining options available to the plan member, to assisting in the transfer and review of medical records, to handling all travel arrangements to make sure the overall experience is hassle free.

What will it cost?

Providers in the Surgery Centers of Excellence Network offer very competitive "case pricing" that results in substantial savings that will average 20% - 40% below the local PPO network. Savings at international locations is even greater. Additionally, plan members will have fewer complications and lower costs over time.

What is included in the "case pricing"?

Case rates are built around an "episode of care." defined as a period of time beginning when the patient arrives for the pre-surgical consultation and ends when the surgeon discharges the patient to return home. Case rates include all medical costs incurred during this episode of care including: inpatient hospital days, laboratory tests, radiology, anesthesiology, surgeon services, facility costs, surgical team, pharmacy, physical therapy and durable medical equipment.

What about a patient who has a complication from the surgery requiring a longer hospital stay?

The case rates will cover most circumstances resulting from a complication. The provider agreements actually makes the provider "at risk" for costs greater than the global case rate. Any expenses not included in the case rate with receive a deep discount.

What criteria are used to identify "high quality" providers?

Only providers who are in the top quartile nationally for their surgical specialty are accepted.

Why are these providers offering such good rates?

This network offers providers access to patients outside of their local market areas. This enables them to build their patient base and gain name recognition around the country. Also, the providers are paid prior to the procedure being done to eliminate the high cost of collecting insurance payments.

What is the cost for accessing the Surgery Centers of Excellence Network?

Administrative fees are included in the medical case rate costs. The travel costs are itemized separately and pre-arranged with you and any travelling companion.