These are the steps taken:
- Providers will submit the claim.
- Insurance carrier will request your medical records pertaining to your current plan and past history.
- Insurance sends documents to their medical review board.
- Documents will be assessed.
- Decision will be made based on records received if your treatment meets the criteria of Medical Necessity.
It’s important to remember that what you or your doctor defines as medically necessary may not be consistent with your health plan’s coverage rules. Before you have any procedure, especially one that is potentially expensive, review your benefits handbook to make sure it is covered.
To Avoid Unwanted Healthcare Billing
Surprises, be sure to ALWAYS:
• Ask your insurance company what costs you
must pay out of pocket for your doctor visit,
test, procedure, or surgery.
• Bring your most up-to-date insurance
card(s) to every doctor appointment
and health care visit.
Send us a Message!
Manhattan (HQ)
Tel: (212) 641-0906
Fax: (212) 641-0522
115 E 57th St, Floor 11
New York, NY 10022
Procedures & All Appts Types
Manhattan Hours
Mon-Fri: 7:00am – 5:00pm
Saturday: 8:30am – 3:00pm
Sundays & Holidays: By Appt Only
Monitoring Hours
Mon-Fri: 6:45am – 12:00pm
Saturday: 7:30am – 11:30am
Sundays & Holidays: By Appt Only
Westchester
Tel: (914) 278-8800
Fax: (212) 641-0522
280 N Central Ave, Suite 303
Hartsdale, NY 10530
Monitoring & Consultations
Westchester Hours
Consultations
By Appointment Only
.
Monitoring Hours
Tuesday: 7:00am – 9:00am
Thursday: 7:00am – 9:00am
.
Long Island
Tel: (516) 830-2000
Fax: (212) 641-0522
300 Garden City Plaza, Suite 220
Garden City, NY 11530
Monitoring & Consultations
Long Island Hours
Consultations
By Appointment Only
.
Monitoring Hours
Monday: 7:00am – 9:00am
Wednesday: 7:00am – 9:00am
Friday: 7:00am – 9:00am
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