Patient Resources
Insurance & Billing
Understanding your insurance coverage before your visit helps avoid surprises and keeps your focus where it belongs — on your care.
Note: Insurance coverage and benefits vary significantly by plan. The information on this page is general guidance. For questions specific to your plan, contact your insurer directly or call our office at (775) 557-6820.
Before Your Appointment
Confirm your plan is accepted
Dr. Chavarria accepts most insurance plans. Because individual plans and networks differ, please call your insurer's member services number (on the back of your card) and confirm your coverage for Dr. Joseph Chavarria under your specific plan — or call our office at (775) 557-6820 and we'll help you check before your visit.
Check whether a referral is required
HMO plans often require a referral from your primary care physician before you can see a specialist. PPO plans typically do not. If a referral is required, obtain it before your appointment — visits without a required referral may not be covered.
Understand your benefits
Ask your insurer about your deductible (what you pay before insurance covers costs), your copay or coinsurance for specialist visits, and your out-of-pocket maximum for the year. Knowing these numbers before your visit avoids surprises.
Bring your insurance card and a photo ID
Bring your current insurance card to every appointment. If you have changed insurance plans recently, notify our office before your visit.
Prior Authorization — How It Works
Many insurance plans require prior authorization (pre-approval) before covering certain spine-related services, including MRI, epidural injections, and elective surgery. Here is the typical process:
- 1.Your surgeon orders the recommended service (e.g., MRI, injection, or surgery).
- 2.Our office submits a prior authorization request to your insurance with supporting clinical documentation.
- 3.Your insurer reviews the request and issues an approval or denial — this can take a few days to several weeks.
- 4.If approved, the service is scheduled. If denied, your care team may appeal or discuss alternative covered options with you.
- 5.Approval does not guarantee payment — final coverage depends on your specific plan benefits.
Important: Do not schedule procedures expecting prior authorization to be automatically granted. Our team will notify you of the outcome as soon as it is received.
Common Insurance Terms
Deductible
The amount you pay for covered health services before your insurance plan starts to pay. For example, if your deductible is $1,500, you pay the first $1,500 of covered costs each year.
Copay
A fixed dollar amount you pay for a covered health care service (e.g., $40 per specialist visit) after you have paid any applicable deductible.
Coinsurance
The percentage of costs you pay after your deductible is met. For example, if your coinsurance is 20%, your insurance pays 80% and you pay 20% of covered services.
Out-of-Pocket Maximum
The most you will pay for covered services in a plan year. After you reach this amount, your insurance pays 100% of covered services.
Prior Authorization (Pre-Authorization)
Approval from your insurance company that certain services — such as MRI scans, injections, or surgery — are medically necessary before they are performed. Our office handles prior authorization requests on your behalf, but approval is not guaranteed and timelines vary by insurer.
In-Network vs. Out-of-Network
Providers who have a contract with your insurance plan are 'in-network' and typically cost you less. Providers outside that contract are 'out-of-network' and may result in higher costs or no coverage. Always confirm in-network status before care.
Explanation of Benefits (EOB)
A statement from your insurer showing what was billed, what was covered, and what you owe. An EOB is not a bill — it is a summary sent after your insurance processes a claim.
Facility Fee
Some procedures are performed in a hospital or ambulatory surgery center, which may charge a separate facility fee in addition to the surgeon's professional fee. Both may be billed to your insurance, but your cost-sharing may differ.
Billing Questions
If you have questions about a bill, your account balance, or payment options, please contact our office:
Billing Department
Phone: (775) 557-6820 — ask for the billing department
Office hours: Monday – Friday, 8:00 AM – 5:00 PM Pacific
This page provides general educational information about insurance and billing processes. It is not legal or financial advice. Coverage, benefits, and billing obligations depend on your individual insurance contract. Contact your insurer or our billing department for guidance specific to your plan.