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Internal Medicine/Pediatric Practice

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Insurance

Billing, Insurance and Payment for Services

East Aurora Family Practice (EAFP) patients are ultimately responsible for the payment of their medical bills. Our billing staff will be glad to work with you regarding your medical bill.  You are responsible for the deductible, payment of the bill, or the balance of the bill after the insurance company has made payment.

If your insurance requires a co-payment, the co-payment is due at the time of your visit. If your insurance requires pre-authorization for certain procedures or hospital admissions, you should inform your physician’s office. This will enable you to secure the necessary pre-authorization and avoid possible delays in receiving the care you require.

Health Maintenance Organizations (HMOs)

A health maintenance organization is a corporation that combines health care financing and health care delivery in a single organization for enrollees or subscribers within a geographical area, and uses a specific group of providers. In Western New York, the main HMOs are Independent Health, Community Blue, and Univera Healthcare. EAFP will submit claims to HMOs on your behalf.

Links:

Community Blue
Independent Health
Univera Healthcare 

Referrals

You can now request referrals through the patient portal. Please speak to an office staff to get registered. You need a working email to register. Some insurance companies require referrals when patients seek care from a doctor other than their primary care physician. All patients are responsible for obtaining referrals for any specialist. If a referral is not available at the time of service, the patient will be required to sign a waiver before services are rendered. We encourage you to contact our office before the specialist appointment to obtain a referral so that you will not be responsible for paying the entire bill.

It is important for you to know that it is the policy of East Aurora Family Practice not to back date referrals.

Co-Payments

East Aurora Family Practice requires payment at the time of service. If EAFP participates in your health plan, applicable co-payments will be collected at the time of registration.

Blue Cross Blue Shield

Our Billing Office will submit insurance claims to Blue Cross Blue Shield for you.  Payment will be made directly to your doctor if he/she is a participating provider.  You are responsible for paying for any services not covered under your contract.  In most cases if you have Blue Cross Blue Shield, EAFP Billing Office will submit the initial claim to your insurance company. Ultimately, the insurance company may send its payment directly to you. If this occurs, the payment should be forwarded to the East Aurora Family Practice.

Commercial Insurance (Aetna, Prudential, Travelers, etc.)

In most cases if you have commercial insurance, EAFP Billing Office will submit the initial claim to your insurance company. Ultimately, the insurance company may send its payment directly to you. If this occurs, the payment should be forwarded to the East Aurora Family Practice. The amount of the payment you receive is based on the terms of the contract you have with the insurance carrier.  East Aurora Family Practice cannot accept responsibility for negotiating a settlement with your insurance company for a disputed claim, or for collecting your payment from the insurance company. If you have any questions about such matters, a member of our Billing Office will be available to talk with you. Please call 716-650-5545.

East Aurora Family Practice Fees

The fees charged for tests and procedures performed by East Aurora Family Practice are considered to be fair and reasonable. Some insurance companies may have reimbursement rates (the payment rates received by East Aurora Family Practice for services) lower than our fees. However, you are still responsible for the payment of the entire bill after insurance adjustment has been applied.

Resolving Payment Problems

If you have a problem paying a bill, or fall behind with payments, please call our Credit Department immediately at 716-650-5545, so we may assist you in resolving the matter.

Site Information

112 Olean St #220, East Aurora, NY 14052 - Click Here for Directions | Ph: 716-805-1072

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