Patient Information
Completing the proper medical forms, understanding patient financing, and providing us with correct insurance information is necessary during your initial consultation. In order to expedite your check in process, we have conveniently posted these forms on Plastic Surgery & Dermatology of NYC online for your use. Below, you may find links to Patient Forms, Patient Financing, and Insurance Information. You may simply click on the desired form, print the form, complete each field, and bring these forms with you on the day of your scheduled appointment. We look forward to meeting you when you visit Plastic Surgery & Dermatology of NYC.
Contents
Patient Forms
Completing the proper medical forms, understanding patient financing, and providing us with correct insurance information is necessary during your initial consultation. In order to expedite your check in process, we have conveniently posted these forms on Plastic Surgery & Dermatology of NYC online for your use. Below, you may find links to Patient Forms, Patient Financing, and Insurance Information. You may simply click on the desired form, print the form, complete each field, and bring these forms with you on the day of your scheduled appointment. We look forward to meeting you when you visit Plastic Surgery & Dermatology of NYC.
Insurance Information
Select providers participate with many insurance plans, but not all treatments and procedures are covered by insurance. Please call our office for further details.
Aetna
- PPO
- EPO
- POS
- Managed Choice
- HMO
- Basic HMO (Requires Referral)
- Medicare HMO (Referral Required)
- Open Access HMO
- Medicare Advantage PPO
- Aetna Choice QPOS HMO (Requires Referral)
Blue Cross Blue Shield
- POS Referral Specialist
- HMO RS Schedule P
- HMO RS Schedule S
- EPO PPO Network
- Mediblue HMO
- IPN Provider
- Network One CHP
- EPO Paid At HMO Rate
- For CT Bluecare Member HMO
- Matrix Participation
- Mediblue PPO
- Web Registered Site
- Mount Sinai IPA
- Blue Priority HMO Network
- Empire Dual Advantage
- Blue Priority EPO PPO Network
- Beacon IPA
- Empire Dual Advantage
Cigna
- HMO
- PPO
- Open Access Plus
Oxford
- Oxford Freedom
- Options PPO
United Healthcare
- Navigate POS
- Navigate EPO
- Navigate HMO (With Referral)
- Choice PPO
- Choice POS
- Choice EPO
- Select POS
- Select EPO
- Select HMO( With Proper Referral)