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About
Conditions
Treatments
Patient Info
Locations
Blog
Contact

CANDIDACY VERIFICATION

Unsure if you qualify for one of our minimally invasive surgical procedures? Use our Candidacy Verification tool to check your eligibility online!

For immediate assistance, please call 855.586.2615

Step 1 Group

Step 1: Tell Us About Your Treatment Needs
Which procedure are you interested in?*
- Axial Fusion
- Cervical Disc Replacement
- Coccygectomy
- Endoscopic Discectomy
- Endoscopic Foraminotomy
- Facet Fusion
- Interlaminar Spacer
- Laminoforaminotomy
- Laser Spine Surgery
- Microdiscectomy
- Orthopedic Surgery
- Sacroiliac Joint Fusion
- TLIF
- Other
If other, please specify.
Have you been diagnosed by a physician?
- Yes
- No
How old are you?
- Younger than 25 years old
- 25 - 34 years old
- 35 - 44 years old
- 45-54 years old
- 55-64 years old
- 65 years old or older
Are you a smoker?
- Yes
- No

Step 2 Group

Step 2: MRI Specifications & Details
Have you had a MRI?*
- Yes
- No
How long ago did you receive your MRI?
- 0 to 6 months
- 6 months to 1 year
- 1 to 2 years
- 2 years or more

Step 3 Group

Step 3: Health Insurance Information
Select your primary state coverage.*
What type of insurance do you have?*
- Preferred Provider Organization (PPO)
- Exclusive Provider Organization (EPO)
- Health Maintenance Organization (HMO)
- Personal Injury Protection (PIP)
- Worker's Compensation
- Medicare
- Medicaid
- Self Pay
- Other or Unknown
Who is your primary insurance carrier?

Step 4 Group

Step 4: Verify Your Eligibility
First Name*
Last Name*
Email*
Phone Number*
Best Time to Contact You
- As soon as possible
- Morning
- Afternoon
- Evening
Additional Comments or Questions?

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Phone
This field is for validation purposes and should be left unchanged.

LETS GET IN CONTACT

For immediate assistance, please call 855.586.2615

CONTACT

855.586.2615

NJ Spine and Orthopedic is dedicated to delivering minimally invasive laser spine surgeries to eliminate the pain, discomfort, and dysfunction of numerous conditions of the neck and back.

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Testimonials
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Sitemap

LOCATIONS

NEW JERSEY

Bridgewater
West Orange
Edison
Manalapan
Paramus
Cherry Hill

PENNSYLVANIA

Philadelphia
Allentown

LOCATIONS

Florida

Fort Myers
Hollywood
Palm Beach Gardens
Orlando
Altamonte Springs
Davenport
Miami

SURGERY CENTERS

Advanced Ambulatory Surgery Center
West Orange Surgery Center