Multiplan PHCS Plan – New York Urology Specialists
Our policy is to make available excellent urology care to all patients without regard to their insurance policy. For patients with health insurance policies that cover our fees, your costs will depend on your copay, deductible and co-insurance policy of your insurance plan. For patients with insurance policies that do not cover the fees for care provided by New York Urology Specialists, discounted self-pay rates are available for patient who prepay for their care in full at the time of visit.
New York Urology Specialists accepts patients with Multiplan PHCS commercial health insurance plans.
New York Urology Specialists is not an in-network provider; this means that we do not have a contractual agreement; as a result we submit all claims as an out-of-network provider. Typically, there may be higher deductible / copay / coinsurance when you see an out-of-network provider.
Laboratory tests (blood tests, urine tests) can be performed at one of the laboratories that are in-network with your insurance. We typically use Labcorp, Bioreference and Quest Labs.
Radiology studies (CT scans, X-rays, ultrasounds) can also be done at one of the in-network facilities with your insurance plan of your choice.
If you have any questions about your insurance benefits, to schedule a consultation or if you need a second opinion, please contact us.
We would be happy to check your health insurance benefits from Multiplan PHCS and to explain to you the costs (copays, coinsurance, deductible) that apply to you.
PPO Plans:
If your health insurance plan from Multiplan PHCS has out-of-network benefits, all or part of your costs of care at New York Urology Specialists for medically-necessary care will be covered subject to terms and conditions of your health insurance policy (including copays/deductibles/coinsurance).
Some tests and procedures done at New York Urology Specialists may be considered not medically necessary by Multiplan PHCS or non-covered by Multiplan PHCS . This determination is a business decision based on terms of your agreement with Multiplan PHCS . When you are offered or prescribed a course of treatment at New York Urology Specialists, our advice is based on best-available science and extensive experience treating patients with a given condition.
HMO Plans:
Most HMO plans do not have out-of-network benefits and your care at New York Urology Specialists will not be covered by your Multiplan PHCS HMO plan.
If you have an emergency and cannot find an in-network urologist who can see you in an urgent manner, you may be able to appeal to Multiplan PHCS to have your full or part of your bill covered.
At New York Urology Specialists, we require that you prepay your care. We can submit insurance forms (CMS 1500 form) with billing codes to your insurance plan on your behalf; if you prefer you can submit the forms on your own.
Why are you not in-network with Multiplan PHCS ?
We understand that many patients with Multiplan PHCS are looking for high quality urology care but have difficulty finding urologists who accept their plan in-network in New York City, Brooklyn, Queens, Long Island, Westchester and surrounding areas.
Multiplan is not a state insurer in NYS, rather it works as an intermediary.