Appointments

• Patients are seen by appointment only and only by referral from physicians.
• Please arrive fifteen minutes early for your appointment.
• We make every effort not to keep patients waiting, so your prompt arrival is respectfully requested.
• Hospital emergencies may require changes in office schedules; we ask for your understanding and cooperation at such times.
• If you will not be able to keep your scheduled appointment, please notify us at least 24 hours in advance so we can offer it to other patients.

Information We Need to Know

• Your full name, as it appears on your insurance card, and your date of birth.
• Name of referring physician.
• Complete information concerning your health care coverage: identification numbers (individual and group), employer's name, insurance name and address.
• If you are being seen for an injury resulting from an accident at work, we need to know the date of the accident/injury, insurance company name and address, file/case numbers.

Patient Forms

Before your first appointment, you will need to fill out patient information forms. You can download and print out our forms using the links below, or you can arrive early for your appointment. [PDF/printable page help]

• Patient Registration form
• Medical History Questionnaire
• Responsibility for Payment of Services
• No Fault Authorization form (accidents)
• HIPAA Form (Page 1)
• HIPAA Form (Page 2 - Signature Req'd)
• Patient Confidentiality Form

What to Bring to Your Appointment:

• If you downloaded forms (above), please bring completed forms with you.
• All identification cards
• A written referral, if required by insurance; If you don't have this referral with you, your appointment may need to be rescheduled.
• All x-ray reports, test results, and a list of medications being taken at the time of the visit.

Hospital Affiliations:

• Nyack Hospital, Nyack, NY
• Good Samaritan Hospital, Suffern, NY

Insurance and Fees:

Currently our office is participating with the following insurance plans:

• AETNA
• Affinity
• Alicare (Blue Cross)
• Anthem BC/BS
• Beech Street/Medichoice
• Benesight / TPA
• Blue Cross
• Cigna
• Community Choice Health Plan
• Connecticare
• Empire Healthchoice (BC)
• Empire Metropolitan
• Fidelis
• GHI HMO Select ** only certain plans
• Great West
• HealthNet
• Highmark Blue Cross
• HIP
• Horizon Health
• Hudson Health Care (Health Source)
• Medicare
• Multiplan
• MVP
• No Fault
• One Health
• Oxford
• Oxford Medicare
• Prudential
• The Perfect Health
• TPA/Benesight
• United Health Care
• USHC
• Vytra
• Wellcare

When scheduling an appointment, please verify that the individual doctor you are seeing is a participating physician in your plan.

Anything not covered by insurance will be your responsibility.

• We request payment at the time of your appointment for services that are not covered by insurance.
• Payment may be made by check, cash or credit card.

Your insurance company may also require you to pay a co-payment at the time of your appointment.

If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at (845) 353-4344 and press 6 for The Billing Office. Questions regarding your coverage and benefits should be directed to your employer or insurance company.