Please Attach Front And Sample Contracts

BACK COPY OF YOUR INSURANCE CARD/CARDS.
Please Attach Front And • 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

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