Forms
New Patient Packet
Participating Insurance Plans:
| AARP |
Emblem Health |
NYSHIP |
| AETNA Medicare |
Empire BC/BS |
Orange/Ulster |
| American Progressive Today's Options |
GHI |
Palmetto Railroad Medicare |
| Blue Card Out-of-Area |
Humana Medicare |
Tricare |
| Blue Cross Blue Shield/NE NY |
Medicare |
Unicare |
| CASEBP |
MVP/Cigna MVP* |
United Health Care |
| CDPHP |
National Health Administrators |
|
| *No MVP Essential and HQNET plans |
Referrals
It is your responsibility to be aware if your insurance requires a referral and, if so, to have your primary care physician complete the referral and send it to our office as well as the insurance company 48 hours prior to your visit. Should you arrive for your appointment without your referral you will be asked to reschedule your appointment.
Payment Information
All co-payments and deductibles are due at the time of the visit. For non-participating and secondary insurances we will provide the necessary receipt of your payment if needed. Payment for services is required the day services are provided.
Please bring your insurance card and a photo ID on the day of your appointment.
The patient (or legal guardian) is responsible for any deductible, co-payment, or portion of
a bill that is not otherwise covered by insurance.
We accept: Cash, Check, and all major credit card. |
