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CONTACT INFORMATION |
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J. Francois Eid, M.D.
50 East 69th Street
New York, NY 10021 |
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Ph: 212-535-6690 |
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Fax: 212-535-7025 |
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Insurance, Cost and Scheduling |
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Procedure Costs
If you are a suitable candidate for the procedure, the cost factor will depend on the Insurance that you carry.
Medicare:
Advanced Urological Care participates with Medicare. The procedure will take place either at New York Hospital or Lenox Hill, which both participates with Medicare.
Our contract with Medicare stipulates that the Physicians fee is $1325.00. If you do not have secondary Insurance, Medicare will pay us 80% of that amount and you will be responsible for 20% ($265.00). The secondary insurance will pick up the 20% balance.
Medicare also covers the Hospital costs, related to the procedure. Medicare will pay the hospital 80% of the Medicare allowable amount. The patient or the secondary insurance, if available is responsible for the remaining 20%.
Disclaimer: All costs are subject to change according to Medicare Fee Schedule, which varies from state to state.
GHI, HIP & Blue Cross/Blue Shield:
A pre-certification is required which our staff prior to scheduling performs. You will want to contact your carrier directly to determine the out of pocket expense you might incur regarding your deductible and co-payment. Every plan varies according to the contract. In order to assist you with the cost determination, and upon your request we can provide you with a letter of Medical Necessity, which includes the procedure codes so that you are able to contact the carrier to determine the exact cost expense.
Whether the procedure takes place at the Center or at the New York or Lenox Hill Hospital, the patient is treated as an outpatient unless your primary insurance is Medicare in which case you will be required to spend one nigh in the hospital.
Out of Network Insurance Policy:
The cost factor fluctuates with different variables. For plans, which are out of network, at the time of the first consultation, the office requires an upfront payment of $375.00. The Insurance Company will normally reimburse the participant by 80% of your company’s maximum allowable fee and according to your contract.
Fee for service at the outpatient facility is as follows (updated 9/2008)
The cost of the procedure will be an accumulated amount representing several independent different groups: Dr. Eid, the Center for Specialty Care operating room, the prosthesis company and the anesthesiologist.
For example:
a) 2 1/2 Hour OR and RR Fee is $2280.00*
b) The Penile Prosthesis device is $7990.00
c) Admin Fee is $500.00
d) Anesthesia Fee is $1,200.00*
e) Dr. Eid’s Surgical Fee
*Fees apply to a maximum 2 1/2 hours procedure time. All fees are subject to change. Please contact the office directly for more information.
The Surgery Center (Center for Specialty Care) accepts most Insurance plans (e.g., Humana, BC/BS, GHI, 1199). As previously mentioned, and in order to assist you with the cost determination, we will provide you with a letter of Medical Necessity, which includes the procedure codes so that you are able to contact the carrier to determine the exact cost and expense. This letter will also enable you to find out what percent of the Urologists fee is covered by your Insurance. The Surgery Center has a specialist to further assist you with the determination of your expenses. Should you need the assistance, the staff at AUC will make that referral as needed.
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