Billing & Insurance

We participate with most local insurance plans. Insurance plans vary in what they cover, based on the employers’ requests.

If you provide complete and accurate information about your insurance (including listing our physician as your child’s PCP), we will submit claims to your insurance carrier and receive payments for services. Depending on your insurance coverage, you may be responsible for co-payments, co-insurance, or other deductible amounts.

Pay Your Bill Online

It is your responsibility to know the coverage your plan offers, including which services require a co-pay or deductible (for example, physicals for children 18 and over sometimes trigger a co-pay because they are considered an adult under some plans). Please remember that co-pays are due at the time services are rendered.

Please contact your insurance carrier should you have questions regarding your specific coverage.

We accept the following Health Insurance plans:

Commercial plans:

  • Aetna
  • CIGNA
  • Excellus
  • MVP (not from the Marketplace)

 

  • Lifetime Benefits Solutions (Formerly RMSCO)
  • United Health Care
  • POMCO

 

Government plans:

  • Excellus Blue Choice Option
  • Excellus Child Health Plus
  • United Health Care Community Health Plan
  • Medicaid
  • MVP Option
  • MVP Child Health Plus

 

Marketplace Plans:

  • Excellus
  • United Health Care

 

Our Practice’s time of service expectations:

  • HMO and Hybrid plans require that the full co-pay is made at time of service.
  • High Deductible plans will now require a $35.00 minimum payment at time of service. (effective 1/1/14)
  • Government plans do not require a payment at time of service.

Please be prepared to make the appropriate payment on the day of the appointment or you may be charged a $20.00 lack of payment fee. We have a number of alternatives for you to make on-time payments so that you may avoid this additional charge

If you are considering getting insurance through the Health Insurance Marketplace (also known as the Exchange) for 2016, please go to the New York Exchange website https://info.nystateofhealth.ny.gov/ or to the Federal website www.healthcare.gov for information. Currently we do not accept any of MVP plans in the Health Insurance Marketplace. Since changes in health insurance are evolving, we will do our best to address situations as they arise.

Always feel free to call and ask if we accept a specific plan that you are considering.