Insurance & Financial

NOTICE: New York Urological Associates P.C. and/or our doctors can not participate in any of the Affordable Health Care Act insurance plans offered through the Healthcare Exchange Marketplace for individuals as they do not fall within our existing contracts.  So far we have confirmation that our doctors participate in the “Small Shop” Oxford Liberty plan. We’ll continue updating as more information becomes available. Thanks for your patience in this time of change.

 A copy of our Financial Policy can be found here (PDF)

Participating Insurance List

Our patients’ care is our main concern.  For that reason, our doctors accept many insurance plan networks, to accommodate the needs of our community.  To make sure you can take the best advantage of your insurance benefits, we commit a lot of effort in verifying that your policy is up to date, what authorizations it may need and what limitations it may have in advance of your appointment.  This is done on a daily basis by our billing office team.  Once we understand how your policy works, we will advise you to the best of our knowledge, what you may need to do before you come to the office.  Health care is not just face-to-face time with the doctors, but it also involves many moving parts which, if left unchecked, could create delays and inconveniences at the office, during treatment and after services have been provided.  Also keep in mind that insurance verification does not guarantee monetary reimbursement.  Some policies have DEDUCTIBLES, COINSURANCE and COPAYS which are not disclosed until the claim is processed.  These are all responsibility of the patient.   Your insurance may also have clauses that may limit benefits for certain conditions or particular services.

Note that we try to obtain as much information in advance but are limited by what your insurance provides us when we call or check on their website.   Sometimes, diagnostic and treatment for conditions like ERECTILE DYSFUNCTION and INFERTILITY are not covered.  If you are visiting us to address these issues, you should verify your insurance benefits in advance in order to manage any related financial responsibilities.

Besides that, there are other matters for which we may ask our patient’s cooperation, such as obtaining referrals from their primary care doctors, contacting the insurance to update their coordination of benefits information or filling out a pre-existing condition questionnaires.  The insurance system is not perfect and requires constant attention as insurance rules change frequently.

To keep up with those changes, we must ask that you bring your insurance card at the time of service, every time. If you do not have your insurance card with you, we may ask that you provide a credit card until your insurance can be verified.   Referrals must always be available before your visit, to prevent delays on your appointment if we need to wait for it to be generated or sent to our office.

For those plans in which we do not participate (OUT OF NETWORK), such as MEDICAID, EMPIRE PLAN, GHI, EMBLEM, etc, the patient or their guardian is deemed responsible for all fees incurred at our practice.  Payment will be collected after services are rendered on your way out.  This is also applied for all UN-INSURED patients.  For patients with OUT OF NETWORK INSURANCE, we may be able to submit your claims so your insurance can reimburse you based on the OUT OF NETWORK benefits provided by your plan.