Melanie Herzfeld Au.D.
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Insurance

 

As a patient, it is in your best interest prior to any visit to know and understand your insurance plan benefits including your responsibility for any deductibles, co-insurance, or co-payment amounts. Not all services are covered in all insurance contracts. For example auditory processing disorder testing is covered by many insurance companies, but excluded by others. If your insurance plan does not cover a service or procedure, you are responsible for payment of these charges.

While you may have insurance coverage to pay your audiological bills, you are ultimately responsible for all charges. You are responsible to notify us of your insurance and to provide the necessary information about your insurance plan. Please have your current insurance card with you at at the time of your visit, as well as a photo ID such as a driver's license, military ID, or government issued ID.

It is your responsibility to know your insurance company's patient responsibilities and procedures. If proper procedures are not followed, you may be liable for full payment of the bill. If your insurance company requires a referral and/or prior authorization, contact your primary care physician prior to seeing our office. If your insurance company requires a referral and/or prior authorization and you do not have one, you may not be seen for your scheduled appointment, or you will be responsible for full payment of your bill at the time of service.

insurance policy

Benefit and coverage rules and policies differ among insurers and even between different plans of the same insurer. If you are an out of network patient, your insurance company may only pay a portion of the rates they determine are usual, customary, and reasonable (UCR). You will be responsible for the amount of charges over the insurer's UCR plus your usual deductible and co-payment as applicable.

Note for Medicare patients: Per Medicare regulations, to see an audiologist Medicare requires a referral from a physician and visit must be a medical necessity.

Listed below are the insurance providers each doctor currently accepts. Please note insurance providers are continuously adding, deleting and revising plans and plan names. The list below is not comprehensive. Please confirm coverage when scheduling your appointment.

Our office accepts the following insurance:

  • Beech Street PPO
  • CareConnect
  • Cigna
    • Cigna HMO
    • Cigna PPO
  • CIIPA (Clinical Integration Network)
  • EmblemHealth
  • Empire Blue Cross
    • Empire HealthChoice Deluxe PPO/EPO
    • Empire HealthChoice HMO Select or Prestige HMO/POS
    • Empire HealthChoice Senior Plan Medicare
    • numerous other plans - call our office or check your policy
  • Empire Government Plan
  • GHI-Emblem
  • Great West
  • Healthnet
  • HIP
    • HIP Health Plan of NY Commercial
    • HIP Health Plan of NY Medicare
  • MagnaCare PPO
    • Oscar Insurance
  • Medicare
  • Oxford
    • Oxford Health Plan Freedom HMO/PPO
    • Oxford Health Plan Liberty HMO
    • Oxford Health Plan Medicare Advantage Medicare
  • United HealthCare non-Medicare
  • Vytra Healthcare VHLI HMO
  • 1199 Health and Hospital Workers local