In order to make sure your visit to the practice goes smoothly, we've put together all the important information about how things work at the practice.
Don't forget to bring your insurance information with you
In order to register and treat you promptly, we request that our patients bring their current insurance information with them for each visit.

For first time patients YOu can have the intake forms emailed to you at the you call for your appointment to speed up you initial visit

 

In General;

We will bill your visit directly to your insurance provider if you supply an updated proof of insurance at each visit. Please note that the insurance policy is between you and your insurance provider; we are happy to file the claim for you, but the balance is your responsibility if your plan does not pay after 30 days. Any amount not covered by your insurance policy is due immediately after you receive your first invoice from us.

***(Credit card info is taken at sign in pending verification of your policy/case)

 

At present we participate in:

Most United/Oxford Plans:    Make sure to bring your Insurance card with you.  He does NOT participate with Empire Plan/UHC, Community Plan, Compass and the Exchange Plans (Obamacare) 

Medicare: 
We accept patients on most Medicare plans. As a courtesy, we will also bill your secondary insurance provider directly. You will be asked to sign an Advanced Beneficiary Notice for services not covered under Medicare. You shall be accountable for covering these services.

Workman’s Compensation: Bring your case number

No Fault: You must have applied and received case number

AS of 1/1/21 insurance coverage expanded to:

Aetna (pending)

Affinity                                 

Cigna                               

Fidelis

Healthplus (Amerigroup)

HealthSmart (WTC)

Magnacare

Oxford

UHC

UHC-Community Plan

UHC-TOP TIER

Wellcare

GHI: Most GHI plans have an  automatic out-of-network provisions requiring a one time $200 deductable

Policy: We are in a new era where insurance companies and employers are changing their policies and coverages daily. Physicians themselves see increasing administrative costs as policy limitations and verification processes become increasing cumbersome and reimbursements less. My office has been opting out of many insurance programs because of this.Fortunately, many policies have out of network provisions that allow one to seek the medical care they deserve at minimal out of pocket cost. My office will explore your out of pocket costs with you if I am a non-participant in your program. We will gladly provide you with the necessary documentation to aid in your reimbursement. Please do not hesitate to call and see if I am still a participant in your insurance program since things can change on a weekly basis.

GOOD NEWS: For patient's with no "out-of-network" coverage,but coverage with AETNA you may be seen by one of my orthopedic partners, Dr. Sal Gupta on Fridays and I can see as a courtesy.  This is a trying time for us all, but help is available.

Sincerely, 

Steven C. Sheskier, M.D.

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