Forms

 

 

 

New Patient Intake Form

 

Telemedicine Consent Form

 

Arbitration Agreement

 

HIPAA Notification

 

 

 

Insurance

 

 

We are in network with most commercial (from your employer) Blue Cross, Cigna and Aetna plans. 

It is the patient's responsibility to confirm that this specific office location is in network with their specific plan prior to the appointment.

 

We are not accepting new Medicare patients at the present time. 

 

We do not participate with:

•BCBS 32BJ or 1199

•Any marketplace plans

•Any United Healthcare or Oxford Plans

•Any Medicaid or managed Medicaid plans

 

If we are out of network with your insurance and your plan has out of network benefits you may utilize them and we will provide the necessary documentation for you to file for reimbursemet from your insurance company.