BACK COPY OF YOUR INSURANCE CARD/CARDS.Patient – Practice Agreement • April 16th, 2018
Insurance is a contract between you and your insurance company. Our group accepts most major insurance plans. Prior to your initial visit, please contact your insurance carrier to confirm that our physician participates in your plan. It is your responsibility to notify us when making your appointment if you need a referral or pre-authorization for the visit with Dr. Feigenbaum. Typically this is applicable for HMO policies. This referral is submitted to the insurance company from the Primary Care Physician’s (PCP) office. Please make sure you have obtained any required referrals in advance of your visit. If your insurance plan requires a referral and we do not have one, we will try to notify you prior to the visit. If we are unable to obtain a referral while you wait, you will be given the option to pay for the visit out of pocket or to reschedule for a later date. Please understand that if we have not been advised in advance of your program’s requirements and we provide a service that
Patient – Practice AgreementPatient Practice Agreement • April 16th, 2018
Insurance is a contract between you and your insurance company. Our group accepts most major insurance plans. Prior to your initial visit, please contact your insurance carrier to confirm that our physician participates in your plan. It is your responsibility to notify us when making your appointment if you need a referral or pre-authorization for the visit with Dr. Feigenbaum. Typically this is applicable for HMO policies. This referral is submitted to the insurance company from the Primary Care Physician’s (PCP) office. Please make sure you have obtained any required referrals in advance of your visit. If your insurance plan requires a referral and we do not have one, we will try to notify you prior to the visit. If we are unable to obtain a referral while you wait, you will be given the option to pay for the visit out of pocket or to reschedule for a later date. Please understand that if we have not been advised in advance of your program’s requirements and we provide a service that
PATIENT PRACTICE AGREEMENTPatient Practice Agreement • February 3rd, 2022
Insurance Billing: Insurance is a contract between you and your insurance company. It is your responsibility to know your plan coverage, benefits, eligibility, cost share amounts (deductible, co-payment, co-insurance, etc.) exclusions, limitations, referral, and pre-authorization requirements for specialty services. It is your responsibility to confirm that Feigenbaum Neurosurgery, PA (FN) participates in your plan. If FN participates with your insurance plan, we will file a claim on your behalf and bill you for your portion after insurance processing. FN requires a valid picture ID, all current insurance information, your referral, and an approved pre-authorization to bill your insurance for the visit. All copays are due at the time of service.
CONTRACT BETWEEN PATIENT and PRACTICEPatient Practice Agreement • May 19th, 2015
You have the right to be treated with courtesy and respect by the Practice staff and doctors. Please treat them in the same manner.
Patient – Practice AgreementPatient Practice Agreement • January 18th, 2022
Insurance Billing: Insurance is a contract between you and your insurance company. It is your responsibility to know your plan coverage, benefits, eligibility, cost share amounts (deductible, co-payment, co-insurance, etc.) exclusions, limitations, referral, and pre-authorization requirements for specialty services. It is your responsibility to confirm that Feigenbaum Neurosurgery, PA (FN) participates in your plan. If FN participates with your insurance plan, we will file a claim on your behalf and bill you for your portion after insurance processing. FN requires a valid picture ID, all current insurance information, your referral, and an approved pre-authorization to bill your insurance for the visit. All copays are due at the time of service.
