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PAYMENT POLICY

Please note that Dr. Lerner will be out of network with all insurance plans as of January 2024.

In the meantime, medical services will continue to be billed to insurance plans through our office, utilizing the billing services of Kareo.  

I will be charging the same fees in 2024 that I have been charging for my out-of-network appointments for the last three years.

New patient appointments will be billed $350.

Follow-up appointment will be billed $250.

Interim care decision making will be prorated at $250/hour. This includes reviews of results, explanations and/or recommendations for prescriptions with you, as well as communicating with pediatricians and insurance companies.

 

A "Superbill" will be provided to you following every visit and interaction, which you can submit to your insurance plan for out-of-network reimbursement of your payment.

 

Dr. Lerner's out-of-network status does not impact patients' costs for prescription medication or blood tests, as long as families continue to utilize in-network formularies and facilities, pharmacies, and laboratories.  

 

Copayments and coinsurance may be paid using cash, a check made out to "Shulamit Lerner MD", debit/HSA cards, Visa and Mastercard and AMEX.  

Copayments, coinsurance, and out-of-network office fees are due at the time of your child's appointment.

INSURANCE PARTICIPATION

   Please note that Dr. Lerner will be out of network with all insurance plans as of January 2024.

   Until then,  Dr. Lerner will be in-network with the following commercial plans.

   (Dr. Lerner is out of network even now for all Medicaid and Child Health Plus plans, as well as most Exchange   

   plans - since childrens' costs are funded via Medicaid. Please check with your plan to see if Dr. Lerner is listed

   under her 3220 Fairfield Ave. Bronx, NY address as an in-network provider in 2023.)  

   - Aetna plans

   - Blue Cross/Blue Shield Plans

   - CIGNA

   - The Empire Plan of United Healthcare

   - Montefiore HMO, LLC

   Oxford Plans

   United Healthcare Commercial Plans  

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