Brain & Spine Network Center of Excellence
The Brain & Spine Network developed the Center of Excellence program not only to give you access to some of the area’s most respected providers, but also to have those providers in place where and when you need them for spine and neurological procedures.
This program allows us to be completely at your service. Quality care is not limited to procedures themselves. Care coordination is woven into the program's fabric, with concierge service that guides you and your caregivers at every step along the way. In addition, eligible services provided through Center of Excellence may be covered with little or no out-of-pocket costs for you. So, you can focus on getting better. It will be important that you work with the COE Navigator and your benefits representative to understand your financial responsibility.
The Center of Excellence is built on the strong foundation of the Brain & Spine Network. All our providers are committed to delivering excellent care, reducing your pain and improving your quality of life. We are also deeply invested in making sure you and your caregivers are active in your care and have a clear understanding of your treatment plan.
The following services or procedures may be eligible for this program. Eligibility is determined during your clinical evaluation:
- Conservative Care Management (non-surgical): This bundle of services focuses on the non-surgical management of spine and neck pain. Over 80% of Members in the COE program do not need a surgical procedure. These services are designed with that member in mind.
- This bundle will include up to five clinic visits with COE providers, as well as, specified diagnostics all occurring within a 120-day period. Prior to placement in the Conservative Management Bundle, the patient will be scheduled for a clinic visit to determine eligibility. This first clinic visit will be billed to the primary insurance, co-pays and deductibles will apply.
- Each employee/dependent who meets the requirements of the program is eligible for one Conservative Management Bundle for the same problem/injury within a 12-month period. (For example, a back injury and a neck injury presenting at two different times would be two different episodes and each is eligible for a bundle within the same 12 months. The same back injury would not be eligible for two bundles within the same 12 months.) The member is eligible for two bundles overall for the same problem/injury.
- The COE also now offers virtual conservative care management as a second pathway for receiving non-surgical care. Through a collaboration with Vori Health, eligible members may select this as their preferred care path and be seen by both physicians and physical therapists utilizing telemedicine. To understand if this is available to you, please visit your employer-specific page on this website.
- Surgical Evaluations (Cranial and Spine) – Members who are recommended for surgery must have the procedure within 180 days of the evaluation or be required to complete a second evaluation. Eligible procedures may include:
- Craniotomy and endovascular intracranial procedures
- Selective catheter placement
- Spinal fusion
- Back and neck spinal fusion
- Spinal procedures
- Low back disk surgery injection, single
- Interventional Pain Management (Nerve blocks): This service includes up to three blocks per injury/problem within a 120-day period. The timeline will start with the first block. Patients are eligible for one, 120-day period (up to three blocks) during each 12-month period. Any blocks for the same problem that are provided outside of these timelines will be billed to the primary insurance, co-pays and deductibles will apply.
- Physical Therapy: The Center of Excellence offers both a general physical therapy bundle used during the conservative management of the injury or problem, as well as, two post-operative therapy bundles for surgical patients. Therapy services are available across the region for care close to home.
- Advanced Imaging (CT, MRI)
- Concierge Service to guide your through your medical journey
PLEASE NOTE THAT NOT ALL NEUROLOGICAL AND NEUROSURGICAL PROCEDURES OR SERVICES ARE INCLUDED IN THIS PROGRAM.
Brain & Spine Network Center of Excellence Program Identification Card
The Center of Excellence comprises a dedicated provider network. All our providers are committed to delivering quality, value and connected care for you, your spouse/eligible dependents and your caregivers.
In addition to high-caliber clinical providers, this program’s specialized services and benefits include nurse navigators to guide you through procedures from start to finish, access to patient/caregiver education and no out-of-pocket expense for you. All these features contribute to reducing pain, improving quality of life and helping you return sooner to daily activities.
Your member ID card will provide you with the information you need to access services. Download and print the member ID card and keep it with your other insurance information.
When you call to schedule an appointment, the navigator will ask for some information to verify your eligibility for this program.
Concierge Service: The Nurse Navigator Team
Our nurse navigator team guides Center of Excellence patients and caregivers through appointments and procedures, creating a seamless experience.
The nurse navigator team starts by helping you find the most appropriate Center of Excellence provider for an evaluation or a procedure. When that vital step is completed, the team also helps with booking initial appointments, making travel arrangements, coordinating aftercare and follow-up appointments, and connecting patients and caregivers to educational and other resources along the way.
Throughout the process, the nurse navigator team also serves as a liaison between patients, caregivers and providers to help you understand each step, know what is next, keep you apprised of progress and ensure that your questions are answered.
Frequently Asked Questions
Here you'll find responses to the most commonly asked questions about the Brain & Spine Network Center of Excellence.
What is the Brain & Spine Network Center of Excellence program?
This medical program offers eligible participants access to Center of Excellence facilities and providers for neurologic and spine procedures. Patients benefit from a dedicated network of providers committed to preventive care, wellness, and ongoing care navigation and support.
Will I be charged for any services provided through the Center of Excellence?
If the patient meets the clinical requirements and is eligible for the program, there may be little or no out of pocket expenses. The COE physician will determine clinical eligibility. Any services that do not meet the clinical requirements will be billed to the member’s primary insurance, and the member will be responsible for co-pays and deductibles.
Please check your employer-specific page for details about your benefits or contact your benefits representative.
How do I enroll in the plan?
For more information and to enroll in the plan, please contact the Center of Excellence program by calling 901-227-8927, Monday through Friday, 8 a.m.-4 p.m.
How do I qualify for these services?
If your employer has enrolled with the Brain & Spine Network, you may be eligible for these services. Please check your employer-specific page for details about your benefits or contact your benefits representative.
Who confirms that I am eligible for the program?
Your clinical eligibility is determined by the Brain & Spine Network physician(s) after a complete review of your medical records and an initial evaluation. It is important to remember that not all neurosurgical procedures are included in this program. Your provider, along with the navigator, will be able to provide additional information about your specific diagnosis.
What do I need to give my provider to obtain services?
Contact the nurse navigator to begin your journey with the Brain & Spine Network. The nurse navigator team will schedule your appointments. In order to schedule your appointment, please have your primary insurance card available when you call. If you’re already enrolled, welcome!
Can I choose my own doctors or hospital for the services covered by the program?
No. The Center of Excellence comprises a select group of physicians and facilities. This dedicated Center of Excellence team provides you with high-quality care.
If I undergo a procedure at the hospital, how is the discharge process handled?
The hospital will develop your post-procedure care plan. This plan will include written instructions about self-care and contact information for your surgical team. The hospital and your Center of Excellence Nurse Navigator will work with you to schedule your first follow-up appointment and coordinate home care as necessary.
Do I need to submit claims to my current medical carrier?
No. You do not need to submit claims for services and procedures covered by the Center of Excellence. For any services or procedures not covered by this program, your provider will need to submit claims to your medical plan administrator.
I have a question about the Center of Excellence that is not answered here. How can I get more information?
We’re happy to answer your questions. Contact the Center of Excellence program, by calling 901-227-8927, Monday through Friday, 8 a.m.-4 p.m.