Billing & Insurance
Our Credit Card Requirement
Because of today’s managed care plans with their In-Network Deductibles and
Co-insurance Charges, we now require that we have a credit card on file for all patients.
Most visits are fully covered so this is only a precaution. Nothing will be charged to your
card unless services are not covered by your insurance company or if your plan includes
unforeseen charges. No charges will be made without your notification.
If you’d prefer to pay out-of-pocket, we accept cash as well as all major credit cards.
What is a Deductible?
The deductible is the amount of money that you may have to pay 100% out of pocket over the course of one year before covered healthcare is paid for by your insurance company. In most cases, copayments or coinsurance costs will not count toward your deductible, and preventive doctor visits such as regular PCP check-ups or vaccination appointments are usually covered whether the deductible has been reached or not.
What is an Out of Pocket Maximum?
This one may seem a little more self-explanatory. In addition to a deductible, some plans will have a separate, higher number which places a maximum amount that you can spend out of pocket during one year. After your out of pocket maximum is reached, one hundred percent of medical costs will be paid for by your insurance provider. Some packages are “no cost after deductible” plans, in which the deductible itself represents the out of pocket limit.
A copay is the set amount of money that you will be required to pay for various services which are covered under your health insurance. Copayments will vary from plan to plan and service to service – for instance, a normal visit to your primary care provider may have a different copay than an urgent care visit or mental healthcare appointment, etc.
What is Coinsurance?
Once your deductible has kicked in, your coinsurance determines the percentage of your healthcare costs that will be shared between you and your insurance provider. So, if your coinsurance is 20%, you’ll be required to cover 20% of costs while your insurance carrier takes care of the other 80%, from the point the deductible is reached up to your out of pocket maximum. A no cost after deductible plan will show 0% under coinsurance.
We accept the following health insurances:
- Alliance (PPO)
- Beech Street
- Empire Blue Cross Blue Shield
- Island Group Administrators
- Nippon Life Benefits
- NYS Empire Plan
- Oxford Freedom
- Oxford Liberty