The physicians and staff of NY Health Nephrologists are committed to provide you with the best possible care. We feel that it is important to our professional relationship that you understand our financial policies. Please read this policy carefully.
Managed Care Plans
If you are covered by a managed care plan commonly referred to as an HMO, EPO or POS, our contract requires us to collect a co-payment at each visit. It is our policy to collect co-payments at the front desk before you see the doctor. We appreciate your cooperation in this matter.
Your insurance company may require a referral before you can be seen in our office. Our contract with the managed care companies prohibits us from seeing a patient without a referral. Therefore, if you do not have a referral when you arrive, you will be asked to contact your PCP to obtain the referral. This may delay and/or cause your appointment to be rescheduled for lack of required documentation. Should you decide not to follow the referral guidelines, a waiver must be signed and payment in full will be requested at the time of service. It is the responsibility of the patient to become familiar with his/her insurance plan, the referral pre-certification process and medical facilities approved by the plan
Because our physicians participate with Medicare, we are required to accept Medicare’s allowable fee as our total charge. However, Medicare pays only 80% of the allowable fee. If you have a secondary insurance carrier, we will send office charges to your secondary insurance for the remaining 20% fee. If you do not have a secondary insurance, we will collect 20% of the allowable amount at the time of visit.
It is our policy to file office charges to secondary insurances for those patients with Medicare as primary insurance.
Payment is expected at the time of service. If you are unable to pay the full amount, please ask to speak to our billing office to arrange a payment plan. Whenever possible, payment arrangements should be discussed prior to the initial appointment.
There will be a $20.00 returned check charge added to your account balance if a check is denied or returned for insufficient funds. Our charges are submitted to insurance companies on a daily basis. If your primary or secondary insurance company has not paid your charges within 90 days of filing, you will be expected to pay the balance in full. Should this occur, our billing office, upon your request, will furnish the necessary paperwork to assist you in obtaining direct reimbursement from your insurance company.