Telehealth and Transitions of Care Program

Insurance & Financial Policy

Our Neuro Network will utilize a hybrid care model that includes both insurance-based and self-pay care options. This structure is designed to expand access, preserve time for complex neurological care, and reduce fragmentation across care settings.

This model will reflect the realities of modern neurological care, where patients with complex conditions often require extended time, coordination, and continuity that traditional reimbursement structures do not consistently support.

Insurance-Based Care

Our Neuro Network is credentialing with and/or contracting with the following insurers in:

Hawai‘i

• Medicare

• Hawai‘i Medicaid (Med-QUEST)

• AlohaCare

• MDX Hawai‘i

• University Health Alliance (UHA)

• HCHA / PSWA

• TRICARE / TriWest

• ‘Ohana Health Plan (WellCare)

• Medicare Advantage plans including Devoted Health, Senior Medical Group, and Pacific Administration Inc.

Arizona

• Medicare participation is planned.

• Medicaid (AHCCCS) services will be offered where credentialing and regulatory requirements are met.

• Commercial insurance plans will be considered out-of-network.

Patients using insurance will be subject to payer-specific coverage requirements, including copayments, coinsurance, deductibles, and prior authorization requirements. Coverage and reimbursement will be determined solely by the payer and the terms of the individual policy.

Self-Pay Care

Self-pay care services will be available for patients who prefer extended visit time, enhanced access, or do not have applicable insurance coverage. Self-pay care will reflect the same clinical standard provided to insured patients. The difference will lie only in the payment structure and flexibility of time, access, and care delivery.

A La Carte Clinical Visits and Services

• Initial Comprehensive Evaluation

  • 90 minutes.

• Extended Clinical Follow-Up

  • 60 minutes.

• Focused Clinical Follow-Up

  • 30 minutes.

Clinical Care Packages

• Foundational Care Package

  • 1 × 90-minute initial evaluation.

  • 1 × 60-minute follow-up.

• Continuity Care Package

  • 1 × 90-minute initial evaluation.

  • 2 × 60-minute follow-ups.

• Complex Case Management Package

  • 1 × 90-minute initial evaluation.

  • 2 × 60-minute follow-ups.

  • Comprehensive record and imaging review and written interpretation supported by Purview Image (up to 90 minutes).

  • Complex chronic care management coordination (up to 90 minutes).

  • Online Digital Evaluation and Management support through Athena One and Spruce Messaging Portals.

Equitable Access Policy

A limited number of Equitable Access appointments will be available to support individuals experiencing financial barriers. This approach is intended to preserve access, continuity, and clinical safety while maintaining the same standard of care provided to all patients.

Equitable Access rates may be available for individuals who are uninsured, underinsured, or experiencing financial strain related to medical or life circumstances. Requests will be approached in a respectful, confidential, and individualized manner.

In alignment with the values of this practice, requests will be handled with trust and discretion. No extensive documentation will be required.

Availability of Equitable Access options may vary based on service type and clinical context. Determinations will be made thoughtfully and, when applicable, documented in the medical record in accordance with practice policy.

The goal of this approach is to support meaningful access to care while sustaining a limited, high-quality, and patient-centered practice.

Hybrid Model Approach

Patients may choose to utilize insurance, cash pay services, or a combination of both depending on their clinical needs and coverage.

This model will allow:

• Use of insurance for medically necessary care.

• Extended or more frequent visits when clinically appropriate.

• Greater flexibility for complex diagnostic and treatment planning.

• Continuity across transitions and care environments.

Patient Financial Responsibility

Patients will be responsible for understanding their insurance benefits, including copayments, coinsurance, deductibles, and non-covered services. Patient-responsible amounts are due at the time services are rendered unless other arrangements have been made in advance.

For out-of-network or non-covered services, patients may be provided with a superbill for self-submission to their insurance company for possible reimbursement when permitted by their individual policy. Reimbursement will be determined solely by the patient’s insurance carrier and plan benefits. Our Neuro Network cannot guarantee reimbursement and does not have control over insurance coverage determinations or payment decisions made by your insurance company.

Prior Authorizations

When clinically appropriate, Our Neuro Network may support prior authorization requests or provide medical documentation required by insurers. Approval determinations and timelines are controlled entirely by the insurer and cannot be guaranteed.

Out-of-Network Services

For services not covered by insurance, patients may be responsible for full payment. When appropriate, documentation may be provided to support patient-submitted claims. Submission of documentation will not imply or guarantee reimbursement.

What Our Neuro Network Will Not Do

At Our Neuro Network, clinical and consulting services will be guided by patient-centered care, clinical judgment, and ethical practice. As such:

• We will not guarantee insurance coverage or reimbursement, as payer decisions are determined independently and vary by plan and circumstance.

• We will not alter clinical recommendations or care plans to meet payer-driven productivity metrics or administrative demands.

• We will not limit visit duration, complexity, or depth of evaluation to satisfy external administrative constraints, as each encounter is tailored to the individual’s clinical needs.

Cancellation & Rescheduling Policy

Appointments will be reserved intentionally due to the limited and specialized nature of services provided.

A minimum of 24 hours’ notice will be requested to cancel or reschedule an appointment. Changes may be made using the link provided at the time of scheduling.

We recognize that many individuals we serve are living with complex neurological conditions, including fluctuations in cognition, pain, fatigue, and autonomic function. If you are experience a change in your condition that affects your ability to attend or participate in your appointment, we request that you inform us as soon as you are able.

Late cancellations and missed appointments may result in forfeiture of the session fee or applicable charges, consistent with practice policy. Consideration may be given in the setting of medical or neurological exacerbation.

Payment will be required prior to the start of your session to confirm your appointment.

This policy is intended to support both access to care and responsible allocation of limited clinical resources.

Scheduling links will become available on this page when our services formally launch.

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