Estimating out of pocket expenses
We do our best to help you estimate any out-of-pocket costs for services at Women’s Urology New York. If you have out of network benefits, we will also submit claims to your insurance company on your behalf, so that you can receive your benefits according to your plan.
For certain services, we request payment upfront and we will submit a claim for you to be reimbursed directly by your insurance company. In other instances, you will not be asked to pay the full amount upfront and we will submit the claim to your insurance company first. Once we have received payment from them, you will receive a balance bill for the portion that they have not covered.
The amount the insurance will cover typically depends on your insurance plan’s:
- Allowed Rate (how much the plan pays an out of network provider for a specific service)
- Deductible (how much you pay before your insurance plan starts to cover services)
- Co-Insurance (the percent you are responsible for once you have met your deductible)
- Out-of-Pocket Maximum
If you have met your out of network deductible, you would be responsible for your co-insurance on the allowed rate, and if you have met your out-of-pocket maximum, you should no longer be responsible for paying any co-insurance. If Dr. Kumar’s fee is more than the allowed rate, you would also be balance-billed for the difference between the her fee and the allowed rate. In order to help determine what you will owe, our office will always attempt to obtain this information on your behalf. However, the insurance companies will not always disclose this information to the doctor’s office. In certain instances, they will only provide this information to the policy-holder. In these instances, it is best to call your insurance company on your own, and we can provide you with the diagnosis and procedure codes.
If you are uninsured, or do not have out of network benefits, please contact our office to request fees for self-pay consultations and common procedures.