Insurance Cards
If you have insurance, your insurance membership card must be presented at every visit. Please make sure you bring it with you, as the receptionist will ask to see it.

 

Insurance companies with which we contract:

 

The insurance plans that we accept are:

Blue Cross/ Excellus

Blue Cross / Blue Shield

Aetna

GHI

New York State Empire

Medicare

Medicaid

United Health Care

Fidelis

AARP

Lifetime Benefit Solutions

Today's Option

MVP Health Plan

ChampVa

 

This is a list of the majority of insurance payers with which we contract and may change from time to time. Please check with your insurance carrier regarding your plan benefits before scheduling an appointment. Ultimately you are responsible for the services rendered.

 

Patient Information
Be prepared to give us the most current information regarding the patient and/or guarantor:

• Patient name or Guarantor

• Address

• Telephone number

• Insurance company

• Insurance address

• Insurance policy number

 

Patient Responsibility
Parents and/or their guardian are personally responsible for all charges and/or balances for services rendered. If we participate with your insurance plan, we will bill it. If we do not participate with your insurance, payment is expected at the time of service.

 

Co-pays and Deductibles
All co-pays and deductibles are expected at the time of your visit. The cashier in each department will be expecting to collect these amounts as you check out after your visit with the physician. Failure to pay your co-pay at the time of service will result in a $10 administrative service charge.

 

For non-HMO plans, the co-pay expected at the time of service is 20% of your charges for that visit. Over payments will be refunded.

 

Worker’s Compensation Claims
Please let us know at the time you check-in if you are here for a Worker’s Compensation claim, No Fault Insurance claim, or Disability claim. We will need all necessary billing information including your employer information.

 

Notice of Past Due Accounts
Payments on all outstanding balances are due in full within 30 days of receiving your monthly bill UNLESS a payment plan has been arranged with our billing staff.

 

If we have not heard from you after 60 days, we will automatically refer your unpaid account to collections for further action. Referrals to the collections agency could adversely affect your credit.

 

Returned Checks
All returned checks will be subject to a $30 fee, which will appear on your statement. We may also choose not to accept checks from you for future payments.

 

Credit Balances
Credit refunds are processed and mailed out on a monthly basis. If you have a credit balance with us, you will receive a check from us after all outstanding charges have been paid.

 

Charge slips/Receipts
After each office visit and/or payment, we will give you 1 copy of our charge slip for your visit or a receipt for payment. Please retain all copies of charge slips and/or receipts for your future reference. Yearend requests for additional copies will result in a $10 charge.

 

Disability Forms
Please complete the personal data section on all disability forms and signs the forms before submitting forms to the physician’s office staff for processing.

 

Request for Release of Medical Records
All requests for copies of medical records generated by Finger Lakes Medical Associates LLP during the course of your relationship must be in writing and signed by the patient or guardian. Please allow 2 weeks for the processing of records. There is a charge for copying medical records.

 

Missed or Late Appointments

We strive to provide each patient with an appropriate amount of time with his/her physician through scheduled appointments. We discourage short-term cancellations except under extreme circumstances and request the courtesy of a 24-hour notice to change or cancel an appointment. If you are more than 15 minutes late for an appointment we may have to reschedule your visit.

 

Office/Waiting Room

Please do not leave children unattended or allow them to wander around the office unaccompanied. The safety and well being of the child are our main concern.