Quality Health

If you have subscribed to an HMO plan, you must designate * a primary care provider to handle your care. Please telephone your insurance company (telephone number is on your insurance card) and give Customer/Member Service the name of your Quality Health provider. Alternatively, you may give the Quality Health office number for the physician you will see. The Quality Health office numbers are listed on the on the Our Practice website.
* There are exceptions in which a designation is not required.

Additionally, if you have any advanced directives (e.g. living will, durable power of attorney, do not resuscitate [DNR] orders) or paperwork regarding power of attorney or custody/ guardianship arrangements, please bring copies with you. (For more information on advanced directives please go to our Advanced Directives page.)

Bring the containers (bottles) of the medications, supplements, herbals, and vitamins you are currently taking, including over the counter medications. These will be reviewed with you. Please let your physician know that you need a refill, as necessary. If you are currently taking a controlled substance, please be advised that you will be required to sign and adhere to a Controlled Substances Management Agreement.

Billing Policy

• Billing: Insurance companies are billed directly. Any remaining balance (for example for benefits that are not covered or deductibles) must be paid by the patient within 30 days of receipt of the statement of fees. Note on non-contracted insurance: if a patient’s insurance company is not contracted with Quality Health, all charges will be considered the patient’s responsibility at the time of service. Quality Health will provide a claim form that the patient can submit to their insurance company in order to get reimbursed.
• Co-pays: all co-pays must be paid at the time of the appointment.
• Method of Payment: Patients can pay with cash, check, or credit card (we accept American Express, Discover, Visa and MasterCard)
• Special Payment Arrangements: If you are unable to pay for your care, and need to make payment arrangements, please contact the office before your scheduled appointment. Under certain circumstances, temporary payment arrangements can be made if approved in advance. Payments for a temporary payment plan must be made each month; failure to comply with this policy will result in the account being referred to an outside agency for collection. Please note that patients on a special payment plan must continue to pay at the time of the service.
• Returned Checks: all returned checks will incur a $25.00 charge
• Service Fee: interest fees will begin to accrue on any balance that is not paid within 60 days, regardless of special payment arrangements or secondary insurance status.

Accepted Insurances

Here is the list of insurance plans that we accept.
Aetna (PPO and HMO)	Oxford
Blue Cross / Blue Shield	MultiPlan
Cigna	Medicare
Island Group	Pomco
Healthcare Partners	HealthFirst
Fidelis	Health Plus (Amerigroup)
The Empire Plan (UHC)	GHI
United Healthcare	1199
UHC Community Plan	Affinity
Worker's Compensation	No Fault
If you do not see your plan on this list, please call us 516-599-5533.

Getting a Referral

A “referral” is a written authorization for a patient who is a member of a managed care plan to see a specialist physician or to have diagnostic tests performed outside of their primary care provider’s office. In some cases, a patient’s primary care provider or their staff can write a referral; in other cases, a patient must obtain authorization directly from the managed care plan. The rules governing referrals can usually be found in the "member handbook" provided by the health plan.

We will gladly provide our patients with a referral when a procedure or diagnostic test is needed which cannot be conducted in our office; however, we do have some rules regarding referral requests:

• Routine referrals are prepared by a dedicated member of our staff. We usually require two (2) business days to process a referral. We will make every effort to prepare emergency referrals quickly.
• We maintain a list of specialists whom we know and trust and are happy to recommend someone for you to see. However, if you require a referral to a specialist and have already selected the provider you wish to see, you will need to give us their contact information.
• Referrals are not provided without a visit to our office, NO EXCEPTIONS. We are happy to provide a referral when needed, but in many cases we can help you avoid a visit to a specialist (and a more expensive co-pay) by handling the problem in our own office.
• Referrals are NEVER “back-dated.” This is prohibited by all managed care plans. If you go to a specialist without a referral, we suggest you obtain a bill from that physician and submit it to your managed care plan along with an explanation as to why you were unable to obtain a referral prior to your visit.
• Please Note: most referrals to a specialist authorize only a single visit. The specialist will then report back to us so that we can collaborate on a follow-up plan, if necessary.