Even in the most experienced hands, surgery on or near the brain, spinal cord or nerves has the potential for adverse outcome. This risk increases with procedure complexity and/or patient-related factors. Consulting intraoperative neurophysiological monitoring (IONM) significantly reduces adverse outcomes and iatrogenic physical impairment. Without it, injury is noted only in the recovery room, rather than during the procedure itself; often, it is then too late to reverse.

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For more than 25 years, IONM has been available in specialized academic settings. Now, through significant IT developments, it is accessible to all hospitals using remote monitoring, thereby helping an increasing number of patients.

Malpractice premiums may be reduced with IONM and insurers have designated hospitals as specialist centers, increasing the reimbursement level based on IONM use.

Specialist professional expertise is mandatory since: a) monitoring methods are constantly changing due to IT and bandwidth improvements providing the capability to transmit very complex data and b) the increasingly sophisticated array of neurophysiological testing available allows more precise monitoring.

The information regarding the function of the patient’s nervous system will also be monitored remotely by one of Sentient’s neurologists. This is accomplished using sophisticated telemedicine technology that is detailed, highly reliable, and secure. Sentient’s surgical neurophysiologist and neurologist will confer with one another regarding any changes in the patient’s condition and will communicate that information to the surgeon.

Consulting Neurophysiological Surgical Monitoring is a remote Telemedicine specialty

The majority of intraoperative medical supervision is performed by remote linkage. The paradigm used by Sentient is for a surgical neurophysiologist to be present in the OR with the surgical team and patient, concentrating only on that procedure, in constant communication via a secure, stable, HIPAA compliant teleconferencing visual link with a supervising neurologist directing the monitoring team remotely in real time.

Continuous interaction occurs among the Neuromonitoring Team members (surgical neurophysiologist, supervising neurologist and SISS) and the Surgical Team. Neurophysiological signal acquisition lends itself most readily to this approach. This allows the leveraging of exceptional expertise so that patients will be assured of the most advanced and competent monitoring.

Expertise is hard to come by, especially in rural and remote communities so telemedicine affords the opportunity to provide exemplary coverage which otherwise would not be available.

Additional Information

Additional Information

Sentient – A Clinical Partner

From large, multi -thousand bed tertiary academic centers performing highly specialized, complex spine and brain surgical procedures, to smaller rural facilities, Sentient prides itself on the range of interventions on which we are consulted and the hospitals with which we partner. Learn More

Surgical Neurophysiologist Qualifications and Training

Several years ago the American Society of Electroneurodiagnostic Technologists (ASET) developed a board certification program for surgical neurophysiologists. This board certification is called the Neurophysiologic Intraoperative Monitoring (CNIM) and is the only board certification program available for surgical neurophysiologists. Sentient requires that all of its surgical neurophysiologists obtain and maintain their CNIM as a condition of continued employment. Learn More

Quality Assurance

The Sentient Quality Assurance Program was instituted in 2006. The Quality Assurance Committee meets regularly to review reports on clinician performance, alerts and adverse outcomes in addition to other matters that affect the delivery of care. Learn More

Operating Agreements

To better serve the unique needs of our healthcare facility partners, Sentient can deliver intraoperative neurodiagnostic monitoring services under a variety of operating agreements. Learn More

Network Coverage

Participation in Medicare, Medicaid, Blue Cross, and Insurers

Sentient provides Intraoperative Neurophysiological Monitoring during complex surgeries, such as surgery on the brain or spinal cord. Monitoring is provided by Sentient staff – surgical neurophysiologists in the operating room, supported by physicians who provide physician monitoring services in real time via online connection. Monitoring services are provided under a contractual arrangement between Sentient and the hospital. It is the surgeon’s responsibility to inform the patient if Intraoperative Neurophysiological Monitoring is requested for the surgery.

Network Participation

Sentient physicians have network participation for most major insurances such as Medicare, Medicaid, and Blue Cross & Blue Shield. Depending on the patient’s insurance plan, this means that the patient may be receiving IONM services from an out of network provider. It may be necessary for the surgeon to obtain a pre-authorization from your insurance company for the provision of monitoring services.

Insurer Medical Policies

Claims for monitoring services are submitted in accordance with AMA/CPT guidelines and practice billing policies – a copy of which is available on request. Medicare and other in network claims are reported subject to applicable payer policy and AMA/CPT guidelines, accompanied by additional disclosure if necessary.

Billing Process

Charges related to monitoring services are billed directly to the patient’s insurer. After the insurance company pays the claim, Sentient will provide the patient with information on behalf of the monitoring physician about any amount owed. Any balances after the insurance payment is received will be the responsibility of the patient based on plan coverage.

The amount charged to the patient will be limited to any applicable deductible, co-insurance, and co-pay.

Billing Policies

Patient Billing Policy

Sentient provides Intraoperative Neurophysiological Monitoring during complex surgeries, such as surgery on the brain or spinal cord. Monitoring is provided by Sentient staff – surgical neurophysiologists in the operating room, supported by physicians who provide physician monitoring services in real time via online connection. Monitoring services are provided under a contractual arrangement between Sentient and the hospital. It is the surgeon’s responsibility to inform the patient if the surgeon is requesting Intraoperative Neurophysiological Monitoring for the surgery.

Coverage

A claim for monitoring services will be submitted to the patient’s insurer. Most insurance providers will pay for Intraoperative Neurophysiological Monitoring. However, it is a good idea for patients to check, or ask the surgeon’s office to check, with the insurer prior to surgery.

Network Participation

Sentient physicians are in-network with Medicare, Medicaid, Blue Cross & Blue Shield, and with certain other insurers. Depending on the patient’s insurance plan, this means that the patient may be receiving IONM services from an out of network provider. It may be necessary for the surgeon to obtain a pre-authorization from your insurance company for the provision of monitoring services.

Billing Process

Charges related to monitoring services are billed directly to the patient’s insurer. After the insurance company pays the claim, Sentient will provide the patient with information on behalf of the monitoring physician about any amount owed.

To the extent the insurance plan provides coverage, the amount charged to the patient will be limited to any applicable deductible, co-insurance, and co-pay.

Payment arrangements for self-pay patients will be discussed with the patient on an individual basis. If you have any questions about the bill you receive, call the patient financial services department on weekdays between 8:30 am and 5:00 pm EST.

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