How it works Getting Started with Accarent

The Accarent Health web platform provides access to transparent pricing options and high-quality care providers, when considering a surgical procedure or medical treatment.


Our Program

How does Accarent Health work?

Search
and Compare

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Register to
Become A User

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Create
Patient Packet

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Register
A Patient

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Manage
Patients

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Register and log-in to gain access and browse the hospitals, procedures, prices and plan designs that are offered. Case managers will also be available to coordinate referral, consult and procedure scheduling with the hospital chosen.

Process Snapshot.

  1. Search procedures and compare pricing
  2. Register to become a user
  3. Contact the Accarent Care Team at casemanagement@accarenthealth.com to register a patient, inquire about a service, or register a patient through our web portal.
  4. Upload medical records
  5. The hospital reviews the patient's medical records
  6. A Case Manager contacts the patient to schedule either a consult or a procedure based on the medical record review
  7. Manage registered patients through dashboard.
How do I get started?

There are three ways to begin the procedure search:

  1. To search by procedure: begin with "Search Services".
  2. To search by categories of offered procedures: begin by "Search Our Medical Care Specialties".
  3. To search by hospital: begin with "Search Our Network of Providers".



Search Procedures and Compare Pricing:



Search Offered Procedures:



Search By Hospital:



If you want to search by Procedure...

First select the Patient Type, either Adult or Child. The age threshold for adult or child may differ for each hospital.



Next enter procedure type.



Next enter procedure code.



Next enter your location.



Next hit "Find Results".



After user registration and login prices can be viewed.

What procedures are available?

Accarent offers one of the most robust selections of medical procedures available. We currently have over 120 procedures offered by top-rated hospitals across the country, from common knee and hip replacement, to complex organ transplant.

Visit our homepage to view our growing list of available procedures.

Which hospitals are participating?

Here is a list of participating hospitals across the country. Do not see a provider of interest? New hospitals are continuously added to the Accarent network. Please use our ‘Subscribe to our Newsletter’ feature to receive the most current updates.

What are the credentialing criteria for the Accarent Network?

Network Credentialing is based on a combination of outside credentialing and rating agencies established in conjunction with Johns Hopkins Hospital. The quality standards are both a quantitative and qualitative analysis of those rating agencies combined with geographical criteria to develop a comprehensive national quality network.

I received a call from Tethys Health Ventures. Who are they?

Tethys Health Ventures is a network affiliate, in conjunction with Accarent Health, they will provide valuable case management, advocacy, and claim management services to you during your procedure.


Our Process

How will the hospital physician receive a patient's medical records?

Some complex surgical procedures require consultation or evaluation with the hospital where the procedure is to be completed. If previous medical records are available, they can be uploaded to a secure portal on the patient's profile or sent to a nurse case manager to assist with facilitation. Accarent will send the records to the hospital for physician review. Additionally, Accarent case managers can help schedule appointments for consultations, evaluations, and surgical procedures. They can also help the patient get in touch with the hospital directly to schedule care.

Where can I send medical records?

Medical records can be uploaded directly on the Accarent Health website, through a HIPAA compliant secure portal, within the patient profile. If you are unable to upload the medical records, you can fax to our secure fax number (410) 771-0696 or via secure email at medicalrecords@accarenthealth.com.

How does the patient get to the hospital?

Accarent’s Concierge team will connect patients with lodging options and transport services in the area of the hospital that is selected. The patient will be responsible for booking travel and lodging plans.

Contact Accarent’s Case Management Department directly via telephone at 1-866-771-0697 or via secure e-mail at casemanagement@accarenthealth.com with any questions on travel and lodging options.

Does the patient need someone to accompany them?

Yes! It is recommended a patient have a support person accompany them to their procedure.

Where does the patient stay during a medical consultation or evaluation?

Accarent's Care Team can connect patients with lodging options in the area selected. Please contact Accarent’s Case Management Department directly via telephone at 1-866-771-0697 or via secure e-mail at casemanagement@accarenthealth.com.

What will happen if the services a patient needs are different than the procedure or services the patient expected to have?

Sometimes when a procedure is being performed, the surgery may require a deviation from the initial clinical pathway discussed during the patient’s consult or surgical evaluation in order to achieve the best outcome. The procedure the patient needs for the best outcome will be performed and covered by the health plan.

The Letter of Agreement (LOA), includes pricing for related surgeries in the event that it is determined that a related procedure is in the best interest of the patient. Additionally, those services outside of the bundled rate will be repriced by Accarent at the agreed upon rate and paid by the health plan.


Coverage

Does Accarent provide concierge service?

Accarent's Care Team can assist you with lodging and transportation provider information in the area of the selected hospital.

Is there a travel benefit?

An optional travel benefit can be selected when the patient is registered for a procedure. The elective benefit, can be chosen for both the evaluation and procedure, and has a variety of options from $500-$10,000 to suit diverse needs.

The travel benefit is paid to the patient once the consultation, evaluation or procedure is completed. It is not necessary to send receipts to Accarent, to receive the travel stipend.

Does the patient need to save receipts to be reimbursed for the Travel Lodging benefit?

The Travel and Lodging benefit will be paid to the patient once the procedure has been completed. Accarent will send a check to the patient or guardian directly. Accarent does not require receipts to be sent for the payment to be released. A W-9 is emailed to the patient as part of a patient packet. This form will need to be completed and sent to Accarent to receive expense reimbursement. After the procedure is completed and claim paid, Accarent will send a check to the patient or guardian directly.

How will a patient know if they are scheduled for a consult?

The provider will contact the patient to schedule a time for consult. Please contact Accarent’s Case Management Department directly via telephone at 1-866-771-0697 or via secure e-mail at casemanagement@accarenthealth.com, if the provider has not made contact.

How will a patient know if they are scheduled for a procedure?

The provider will contact the patient to schedule a time for your procedure. Please contact Accarent’s Case Management Department directly via telephone at 1-866-771-0697 or via secure e-mail at casemanagement@accarenthealth.com, if the provider has not made contact.

What happens if a procedure has to be cancelled by the patient?

If a procedure has been scheduled and needs to be cancelled, an Accarent advocate will either be notified by the hospital or the patient. The Accarent advocate can assist in rescheduling the procedure at another time. Depending on when the procedure is rescheduled, the Letters of Agreement, eligibility check, and other patient documents may require re-verification. The hospital may request an updated consultation or evaluation.

Who will be the TPA/ Health plan contact and the patient contact during the procedure event?

The assigned Accarent Care Team advocate will assist the patient through the entire procedure, and coordinate any follow up services and billing.

Will anything be different for the patient at the hospital check in?

The patient and companion will need to bring the signed Letter of Agreement or their Accarent Identification Letter along with their insurance card with them when checking into the hospital for the evaluation/consultation and surgical procedure.

Does the patient or employer receive a card from Accarent Health?

The patient will receive an Accarent Identification Letter. This letter will be presented at admission to help ensure proper billing. Patient name, procedure, hospital and Accarent Health information will be provided in this letter. The patient will also need to bring their insurance card.


Transition Home

If a patient has problems should they contact their doctor or Accarent?

If there are any emergent medical issues once the patient has returned home, they should call their local physician or 911. If they have administrative questions or general medical questions, they can contact their Accarent advocate. They can also contact the hospital directly regarding medical issues.

What happens if a patient has to stay in the hospital longer than expected?

Each Accarent procedure includes a per diem amount in the event that the patient’s hospital stay exceeds the length of stay offered in the procedure bundle. Accarent case managers will continue to be the patient’s advocate until the patient returns home and is transitioned back to their referring provider.

Can you help with post procedure care?

The Accarent Care Team will assist as the liaison between the center and your insurance company for post procedure needs.

Will the patient’s local doctors be notified of the procedure and outcomes?

Yes, the patient will receive a Patient Packet which will include HIPAA Forms and Medical Release Forms. Once this is completed, signed and returned to Accarent, your patient advocate will have the information needed to share patient information.


Payment Information

Will a patient ever be balanced billed?

Accarent has negotiated rates and plan designs with the network hospitals for the procedures shown on the website. The patient should not be billed for any of the negotiated procedures beyond normal out of pocket payments.

Who pays the hospital and the physicians?

Accarent Health is billed directly for the procedure from the hospital and will receive all claims. Accarent will then collect payment from the patient’s insurance carrier or plan administrator once the procedure has been completed. Accarent then pays the hospital and physicians directly for the bundled rate.

Does Accarent accept care credit or credit cards?

An ACH transfer or check are the currently accepted forms of payment for the procedure.

How does Accarent Health coordinate with insurance carriers?

Accarent Health provides patients and payers access to the Accarent Health Network website which publishes our negotiated prices with the participating hospitals upon registration. Once a patient has registered, and a procedure and hospital have been chosen, insurance eligibility will be verified by an Accarent advocate and the patient will be approved to begin the process.

Will the patient have any out of pocket costs associated with the procedure?

Everyone’s insurance is different. A patient will need to check with their insurance benefits or plan administrator to determine if they have any out of pocket payments, deductibles or copays.

How does the Accarent payment work with a patient’s deductible?

Accarent is no different than any other network or insurance carrier negotiated rate as far as deductibles and copayments are concerned. The insurance carrier or hospital may ask for those payments. A patient should contact their employer or insurance carrier for any additional questions regarding specific out of pocket limitations.

How can I provide my employees access to this network?

There are two options, an employer can send the Accarent Health link to their employees and allow them to manage their own procedures, or designate a plan administrator to manage employee accounts as needed.

Can a patient pay for the procedure themselves?

Yes! A patient can register for a procedure. The bundled payment will be requested and must be paid prior to the scheduled procedure date. If the procedure is cancelled the payment will be returned.