As a commitment to our patients and to accommodate their healthcare needs, we participate with the majority of managed care plans and at least one of our offices is open 365 days a year.
As you may be aware, employers are selecting healthcare insurance policies that have increasingly transferred costs to the employee. In addition to rising copays, there are now deductibles, co-insurance charges, and also the loss of some in- network benefits. Some employers have selected policies that limit the number of well visits. Deductibles and co-insurance mean that the patient is now responsible for a portion or percentage of the covered charges. Please review Understanding Your Insurance (including information for newborn parents) for questions to ask your insurance carrier to better understand your child's coverage.
It is cost prohibitive for us to participate in managed care and have to bill both the insurance company and you, the patient, for each visit. In order to continue our participation in managed care and accept your insurance, we are phasing out patient billing. We are requiring patients to leave a valid, open credit card with a signature on file, authorizing PEDIATRIC ASSOCIATES OF NYC to bill that card for the “patient responsibility” amount. This is clearly listed on the Explanation of Benefits (EOB) form which is sent to you by the insurer after each office visit.
Be assured that our billing department will continue to be aggressive in their attempts to collect appropriate payments from your health plan, however, the ultimate financial responsibility for your child’s health care rest with you.
Payment, including that for insurance copays and for non-covered services, is expected at the time of the visit. For your convenience, we also accept Visa, MasterCard, American Express credit cards and checks ONLY. We do not accept cash. Your insurance plan may restrict you to specific diagnostic facilities and/or hospitals. Please become familiar with the provisions of your plan as we do not have access to that information.
We participate in many Managed Care Health Plans. These include:
- PREMIER CARE NETWORK
- NATIONAL ADVANTAGE PROGRAM
- EMPIRE BLUE CROSS BLUE SHIELD
- BLUE CARD
- SCREEN ACTORS GUILD
- FEDERAL EMPLOYEE PLAN
- DIRECTORS GUILD
- EMPIRE WELLCHOICE
- GREAT WEST
- OPEN ACCESS PLUS
- LOCAL 1199
- UNITED HEALTHCARE
- UNITED NYU
- HMO/HMP PLUS
- NYS EMPIRE PLAN
- UNITED HEALTHCARE SHARED SERVICES
- HIX-NY HEALTH EXCHANGE
- EBCBS HEALTHPLUS/GATEKEEPER
- HIP -no longer in network as of 10/13/21