Financial Policy and basic Insurance Information
PRIVATE INSURANCE - MEDICARE - PARTICIPATING PROVIDER
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Thank you for choosing New York Urological Associates, PC as your urological health care provider. We are committed to providing you with treatment of the highest quality and success in resolving your ailment. The following is a statement of our Financial Policy that we ask you to read and sign at the office prior to any treatment .

All patients must complete our information and insurance form before seeing the doctor.

FULL PAYMENT OR A VERIFIABLE PAYMENT METHOD IS REQUIRED AT THE TIME OF SERVICE. OUR DOCTORS ARE PARTICIPATING PROVIDERS OF SEVERAL INSURANCE COMPANIES AND NETWORKS. WE ACCEPT CASH, CHECKS, VISA, MASTERCARD, AND AMERICAN EXPRESS.

If payments are delinquent a service charge may be added to your outstanding bill.

PRIVATE INSURANCE:

Your insurance policy is a contract between you and your insurance company.

We are not a party to that contract. Patients therefore are responsible for full payment at the time of service. Surgical fees are to be paid partially prior to surgical procedure or according to prior agreement, otherwise payment is due upon receipt of statement.

If your insurance denies reimbursement our billing department and/or doctors will provide with the appropriate documents for proper appeal.

 
MEDICARE:

Our doctors are Participants of the Medicare Program. We accept assignment and abide by Medicare regulations. We will electronically submit your claims to Medicare for payment of the service provided. They will mail an explanation of medical benefits to you which you can then submit this to your co-insurance in case that out office has no contract with such co-insurance.

In the event that Medicare does not pay for a specific service we will appeal directly for the correct reimbursement You will not be deemed responsible for payment unless it is clearly stated by Medicare in their statement, by prior agreement at the time of service or if the insurance or demographic information received from you is incorrect. In this instance payment is expected upon receipt of our bill. If Medicare in turn pays the claim you will be reimbursed promptly thereafter.

 
 
PARTICIPATING PROVIDER:

To benefit from our participation in your insurance network or insurance company a valid insurance identification card must be presented at every appointment. Failure to do so will automatically make you liable for payment at that time.

If we are a participating provider in your insurance plan co-payments are payable at the time of service as estipulated by your policy. To minimize your out of pocket expenses you must provideour office with any referrals or authorization forms or numbers as required by your Managed Care contract. If you do not, you will be required to pay at the time of service as a "Private Insurance" patient.

If your insurance does not cover a service in our office and you want that service anyway you will be required to pay at the time of service. Your will sign an Insurance Waiver to this end and this waives your right to submit it to your insurance carrier for this service.

 
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