INSURANCES FOR WHICH DR. MULLER IS A PARTICIPATING PROVIDER:
- Blue Cross Blue Shield
- Medicare (Nonpar)*
- Oxford (ONLY as an Out-of-Network Provider)
Health Insurance Explained
Patients’ Personal Responsibilities:
Our practice provides the following overview in an effort to be transparent and to help you understand the out-of-pocket expenses that may be your personal responsibility.
Co-pays - the payment set by your insurance company to be paid by you each time you see a physician. The amount usually appears on your insurance card.
Co-insurance – the percentage of the payment set by your insurance company in which you share the cost of covered health care services. It is generally a percentage of the allowed amount as determined by your health plan.
Deductibles – the amount of money that you must pay (set yearly by your insurance company) prior to your insurance company paying your claims on your behalf. It is each individual’s personal responsibility to know what his/her own deductible is, how much has already been met and how much remains.
Please note, if Dr. Muller is a participating provider for your insurance company her contract expressly prohibits her from forgoing any portion of your personal responsibility as specified by your insurance company.
Non-covered services – medical services not covered under your individual plan as defined by your insurance policy. The fact that some services may not be covered by your insurance policy does not mean that you would not benefit from them, or that they are not medically necessary and appropriate, it simply means that they are not covered under your particular insurance plan. It is not possible for our office/Dr. Muller to know the specifics regarding coverage of each individual patient’s insurance plan. This is the responsibility of each individual (i.e. your responsibility).
Dr. Muller is a Participating Provider…
If Dr. Muller is a participating provider for your insurance company (“takes your insurance”) she has agreed to allow your insurance company to set her fees (i.e. your insurance company dictates her “contracted”, or “reasonable and customary” rates). Dr. Muller, as a participating provider, DOES NOT set her own fees/prices. In addition, your insurance company determines/dictates your personal financial responsibility in the form of co-pays, coinsurance and your deductible.
Payment Through An Employer Flexible Spending Account (FSA)
An Employer Flexible Spending Account is a benefit which allows employees to receive tax free reimbursements for eligible healthcare expenses. If your employer offers such a plan, you can pay for your healthcare using pre-tax dollars.
Payment Through a Health Savings Account (HSA)
A Health Savings Account is a flexible way to pay for your medical expenses using pre-tax dollars. You set it up with your own bank, the funds contributed to this account are not subject to federal income tax, it’s not “use it or lose it”, and you can put more money into it than you can a traditional FSA. For more information, simply type your bank's name with the words "health savings account" into the Google search bar and you should be taken to the appropriate page. http:/
Understanding your own healthcare policy/coverage:
We strongly recommend that you verify your own coverage, including confirming that Dr. Muller is a participating provider for your particular plan, and obtaining information regarding your co-insurance, copay, and deductible (including how much has been met and how much remains) so that you completely understand your financial responsibility before seeing any physician. By doing this, unwanted and unpleasant financial surprises can be avoided.
If you have any questions or concerns, our staff will happily assist you: (212) 585-3161, or [email protected].