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Office Information: Insurance

Insurance

As a courtesy, we file most insurance's. It is your responsibility to make sure we are providers for your insurance company's network and that you have the proper authorizations or referrals needed to meet your insurance carrier requirements. You will be responsible at the time of service for any monies your insurance company determines as your responsibility.

We DO NOT get involved with Third Party Liability. Payment would be required at time of service. Upon payment for office visits you will be given a receipt. If requested, we can mail you an itemized bill, which can be submitted along with your claim form for reimbursement from the Insurance company.

Except in certain circumstances, your health insurance is a contract between the insured and the insurance company. We ask that you not lose sight of this fact. It is therefore necessary that you take the responsibility to follow-up a claim to your company if you feel it is not being paid promptly or properly. We will be happy to provide you with what information we can to help you substantiate your claim.

Please be aware that not all insurance coverage is the same. We cannot be responsible for the amount paid by your insurance company. Some have rate schedules that do not necessarily agree with the charges in our particular area.

HMO or PPO Plans

If you are a member of an HMO or PPO plan, please let our receptionist know, so that the proper forms and authorizations can be obtained to assure payment of your treatment. We share the concern of our patients about the cost of medical care, and participate with many of our local programs. Co-payments and completed insurance forms will be collected upon registering with the receptionist. You are responsible for obtaining your authorization.

Medicare Patients

Our Office has made an agreement with the Medicare Program to accept assignment on all Medicare claims. This means we will submit all Medicare claims and accept (as payment in full) THEIR APPROVED CHARGES. Medicare patients will be billed for non-covered services, their deductible and 20% co-insurance.

If your problem stems from an auto or other liability type claim, Medicare will NOT pay your charges, but becomes a secondary payer. We must have all other insurance information in order to file properly under the Medicare law.

Participating Plans

Please view our Insurance Contracts sheet and be sure to check your insurance company's website to see if we are a participating provider in your insurance plan.

Click here to download Insurance Contracts sheet »

This is a general list and is not a guarantee. It is the responsibility of the patient to confirm if our doctor is on their insurances' "In-Network" list of providers. There are insurance plans that have a different "In-Network" list of providers for each product they sell. For example, West Orange Orthopaedics is a Cigna provider, but not a Cigna Select provider. Please check with your insurance company before making an appointment.