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      • Carol A. Jackson-Gibson, M.D.
      • Ashok Nigam, M.D.
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Billing Policy
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Participation means we accept what your insurance carrier determines as the reasonable fee for services rendered. Depending on the type of insurance you have you may be responsible for co-pays, co-insurance and/or deductible amounts. You will also be responsible for fees associated with SERVICES WHICH REQUIRE PRE-AUTHORIZATION, PRE-CERTIFICATION OR PRE-APPROVAL of any kind if one was not obtained in advance by you or your healthcare provider. You will also be responsible for services which are non-covered your insurance.
 
Non-participation means that you are responsible for the entire charge for our services.
If your insurance coverage is NOT listed below,  we may NOT be participating providers. This means that we will forward your claim to your insurance on your behalf. When your insurance processes your claim, they will generally forward their payment back to the provider of service. Once that occurs, you will be billed for any outstanding balance. Should your insurance send the payment to you, we ask that you kindly forward the total amount of our charge to us.
 
Co-payments are due at the time of service. If you fail to pay your co-payment at the time of service and we have to bill you for it, a $10.00 billing fee will be added to your account for each service date wherein the co-pay was not paid. It is your responsibility to know your co-pay amount for imaging services. Please contact your insurance company if you do not know it.
 
All payments are expected within a reasonable period of time but not more than 30 days from the billing date. Should your account be sent to our collection agency, you will be responsible for the original balance plus an additional forty three percent (43%) collection fee. All accounts placed for collection are reported to a credit reporting bureau. Please help use avoid this final action.
 
** WE CAN NOT ACCEPT FIDELIS CARE PATIENTS **
 
We currently participate with the following medical insurance companies:
 
AETNA Open Choice ® PPO
       Open Choice ® PPO (HealthFund)
       Open Access TM Managed Choice ® (HealthFund)
       Open Access TM Elect Choice ® EPO (HealthFund)
 

Managed Choice ® POS
Managed Choice ® POS (Open Access)
Elect Choice ® EPO
Elect Choice ® EPO (Open Access)

BLUE CROSS OF WNY  (All plans)
BEACH STREET 
CIGNA
COMMUNITY BLUE (All plans)
INDEPENDENT HEALTH (ALL PRODUCTS)
  PREFERRED CARE (ROCHESTER ONLY)
CARE TO CARE

EMPIRE STATE PLAN
NOVA

MAGNACARE
       ADMINISTRATIVE SERVICE CONSULTANTS
       AMERIHEALTH 
       BENEFIT COORDINATORS
       BRIDGESTONE CLAIM SERVICES

       CLAIMS MANAGEMENT SERVICES
       HEALTH PLAN SERVICES
       SUPERIEN HEALTH NETWORK

 

ALLIED BENEFIT SYSTEMS INC
ASSURECARE
BENESIGHT
CHICKERING CLAIMS - UB STUDENT
HTH WORLDWIDE  - UB STUDENT
CORESOURCE
PROFESSIONAL BENEFIT ADMINISTRATORS
US LIFE

MEDICARE
MEDICARE+CHOICE PPO
MVP HEALTH PLANS
NORTH AMERICAN PREFERRED
RMSCO
UNIVERA  (ALL PRODUCTS)
UPSTATE BENEFIT ADMINISTRATION
WORKERS COMPENSATION
  MEDICARE RAILROAD
MEDICAID NEW YORK
NO-FAULT
NORTH AMERICAN ADMINISTRATORS
PHCS
UNITED HEALTHCARE
US IMAGING
 

 

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