A list of a few commonly asked insurance questions we hear everyday.
Will my insurance pay for this?
Most likely your insurance will cover your visits, but this can vary based on your insurance plan. During your first call to our office, we will ask you for your insurance information and one of our patient insurance advocates will call your provider to check your plan’s specific benefits. We will call you before your appointment to review your specific coverage with you.
What insurance do you accept?
We accept payment from all major insurance companies. As there are many variations of polices, however, it is best to call us, provide us with your insurance information and have us contact your insurance provider to get details about the specific coverage your policy offers. We will then contact you to review your policy coverage with you.
What does “out-of-network” mean?
We are not in-network with every insurance provider and plan. However, being out-of-network does not mean that your insurance won’t cover your visits. Most likely, your insurance will still pay for your visits. Since every insurance plan is different, we will call your insurance provider to find out about your plan’s specific benefits and will call you the day before your appointment to discuss those benefits with you. We can answer any questions you may have during your initial call to us and will provide you with additional information during our follow-up call.
What is an “authorization”?
Some insurance companies require that they authorize your visits before you come in for your appointment (meaning that if you don’t wait for authorization, they won’t pay). We understand that this process can be tedious and typically takes about 2 – 3 business days. We will take care of making sure that your visits are authorized before you have an appointment* and will inform you before your visit about any specific details related to your insurance that you need to know regarding authorization.
*To protect our patients, it is our policy to not schedule visits that are not authorized, since there is no guarantee that your insurance will pay for the visits. However, many patients grow frustrated by this process and want to continue their treatment regardless of what their insurance company will do. If that’s you, we will do our best to let you know if we expect your visits to be authorized (but can’t guarantee that they will), but ask that you hold your appointments with a credit card in case they are not authorized and you still want to receive treatment.
What is a “referral”?
Some insurance policies require that your primary care doctor refer you to see a specialist before they will provide insurance coverage for your specialist visit. If your insurance requires a referral, you must see your primary care doctor first before you schedule an appointment with one of our physicians or physical therapists. Without a referral in these circumstances, your insurance won’t pay for the visits. During your initial call to us, we will ask you for your insurance information and will contact your provider to find out if a referral is necessary and will let you know if it is before your scheduled appointment. We understand that this is a cumbersome process, but it is a requirement of some insurance plans and we will do our best to help this process go as smoothly as possible for you.
Who do I talk to if I have a question or concern?
If you have any questions about treatment, scheduling, insurance or billing, you can email us at firstname.lastname@example.org. We check this email account all day long and will get back to you quickly with answers to your questions.
For answers to more specific questions about insurance and billing, you can also contact:
What if I want to talk to a manager?
Our managers would be happy to talk with you about any issues, concerns, compliments, recommendations or questions you may have. You can ask at the front desk to speak to a manager, email email@example.com and ask a manager to call or email you back, or call us at 212-620-0159 and we’ll put you in touch with a manager.