We ask our patients to please arrive 15-30 minutes earlier when scheduled for surgical procedures. This will allow extra time to prepare before starting any procedures and to review consent forms. If you are more than 15 minutes late for your scheduled surgery/procedure, it is up to the discretion of the practice to decide whether or not you will be seen. Please keep in mind that patients will be seen in a timely manner and you might have to wait or re-schedule.

If you have an outstanding balance that requires special arrangements, please call our Practice Manager at (646) 844-0424 for assistance. It is our sincere desire to help you meet your financial obligations without being sent to collections. Outstanding balances that are not paid within 90 days will be sent to a collection’s agency. Once a patient’s account is sent to collections he/she is responsible for the outstanding balance on the account in addition to a Collections Fee of 35% of the outstanding balance plus any interest, service fees and/or legal fees that accrue while the account is in collections.

The practice accepts all major credit cards. Payments may be made in person, by email, or by phone. We DO NOT accept checks.

When a patient is less than 18 years of age, the parent or guardian who signs the patient registration form is responsible for all fees incurred by the minor. When a patient turns 18 or older, he/she becomes responsible for his/her account and financial obligations. If a parent prefers to assume complete financial responsibility for an adult offspring, we must receive notification in writing.

We understand that plans change and emergencies arise. Please notify us as soon as possible if you need to cancel or reschedule your appointment. We have a strict 24-hour cancellation policy. If you fail to notify us of a cancellation or rescheduled appointment within 1 business day prior to your scheduled appointment or you miss an appointment, we charge a penalty fee of $75 for office visits, $150 for medical procedures, and one in a series of 50% of the cost of the procedure (minimum $200) for cosmetic procedures. If you are more than 15 minutes late for your scheduled appointment, it is up the discretion of the practice to decide whether or not you will be seen. Please keep in mind that patients will be seen in a timely manner and you might have to wait. The penalties apply regardless of whether or not you receive a courtesy reminder from our office. They also apply to appointments made just one day in advance.

If your appointment is cosmetic we require payment in full at the time of service for cosmetic/non-medically necessary procedures and services provided by staff. There is a cosmetic consultation fee of $375. As explained above, in order to schedule cosmetic procedures, we must have a valid credit card and authorization on file as we require a deposit to hold any aesthetic appointments. There are no refunds for cosmetic procedures or any products bought in the office.

Athena Health mails billing statements to patients. Payment for any outstanding balance is due upon receipt. Outstanding balances may result from remaining patient balances after we have billed your insurance company. For example, we will bill insured patients for unmet deductibles, additional, co-payments, non-covered services or any other charge that the insurance carrier assigns to the patient. We will also bill patient’s penalty fees associated with our policy for cancellations, rescheduling, and no-shows. In those instances when a patient has a follow-up visit before receiving a statement for prior amounts owed, we will inform the patient of the outstanding balance and request payment at the time of that follow-up visit.

We will return any refunds owed to your insurance plan. If there are credits or refunds owed to a patient, we will first apply them to any outstanding balance. Remaining patient credits and refunds can be left on the account to be used towards future charges or can be returned to the patient (or to the responsible party who made payment). Please allow 30-45 days for processing.

Payment is due in full at the time of service for self-pay patients. Self-pay appointments start at $400. We offer discounts for many of our medically necessary services for people who pay out-of-pocket. We will discuss the cost of any recommended procedures or services in excess of the basic office visit fee prior to the provision of service. We do not and WILL NOT bill insurance after a patient has paid a medical visit out of pocket. If your insurance is not active at the time of visit, we advise you to reschedule your appointment to a more convenient time (when insurance is active).

Insurance, Co-Payments, and Co-Insurance: (a fixed dollar amount that is assigned to the patient) and co-insurance (a percentage of total charges that is the patient’s responsibility) are due at the time of visit. Our contracts with insurance companies obligate us to collect these fees; we cannot waive them or bill them. It is the patient’s responsibility to know their insurance plan.

Some insurance plans require a referral from the patient’s primary care physician in order to be seen by a specialist. It is the patient’s responsibility to: (1) know if his/her plan requires a referral; and (2) to obtain a referral, if needed, prior to the visit to our office. If you are uncertain about your plan’s requirements, please contact your insurance plan prior to your visit. Patients without a valid referral that meets insurance plan requirements will have to to pay out-of-pocket for the visit on the day of service or reschedule the appointment until the office receives the referral (see late cancellation policy below). Please note that any claims that are denied because of a missing referral, will be the patient’s responsibility.

Our bills for service may not include pathology studies or laboratory tests. If you receive any of these services, you may receive a separate bill from the facility where the services were performed.

If we cannot verify your insurance or you are not eligible for insurance, we will consider you to be self-pay and financially responsible for the cost of your care at the time of the visit. By signing our Insurance Coverage Waiver Form, you will agree to accept full financial responsibility for the care that we provide.

Each time you come to our office, please bring with you a current insurance ID card and a valid government issued photo identification card (e.g. driver’s license, passport). We will seek to verify eligibility and, if valid, we will file a claim on your behalf. Even when your insurance plan verifies your eligibility and benefits, it does not guarantee the accuracy of the confirmation of coverage of benefits. In some cases, your insurance plan may not cover the services we provide or may determine that some of the services are not medically necessary. Your insurance company’s rejection of all or part of your medical insurance claim does not relieve you of your financial obligation.

We participate with most major insurance plans. If we are a participating network provider for your plan, we will be happy to file a claim on your behalf. Please remember that your health benefit plan is an arrangement between you and your insurance company. Your individual plan determines what benefits it covers, coverage limits, and the need for prior authorizations and referrals. We will be happy to help, but we strongly encourage you to contact a representative of your insurance company for answers to questions regarding your insurance benefits.

We require that you provide our office with a valid credit card number and authorization so that we can keep the information on file. We may charge this card for one of three reasons: (1) if there is an unpaid balance remaining on your account 61 days after service that neither you nor your insurance company has paid; (2) to schedule all cosmetic procedures; and (3) if you fail to comply with our cancellation policy as explained below.

We require payment at the time of service. If you have health insurance and we are a participating network provider, we will ask for your co-insurance, co-payment and any unmet deductible, if applicable. If we are not a participating network provider for your insurance plan or if you do not have insurance, we require full payment at the time of service. We accept VISA, MasterCard, Discover, and American Express. We do not accept personal checks or cash.

1. Health Insurance Card if you have health insurance, we can’t see you without making a copy of your insurance card.

2. Written Referral from your Primary Care Physician only if required by your insurance plan (or you can call us before your appointment to verify that it has been faxed to us by your primary care physician). Please be aware that we are not obligated to inform you if you need a referral or not; it is the responsibility of the patient to know.

3. Co-pay or Deductible to be paid before your appointment.

4. Cosmetic procedure fees are due at time of visit.

5. Completed Patient Registration Form

6. Parent or Legal Guardian must accompany patients who are minors.