Insurance, Fees, Payment Options, Cancellation Policy
Dr. Asher is committed to making his services accessible to everyone who can benefit from them.
||This is the best experience I have had with and in a doctor's office. Excellent, truly excellent.
Desiree Pardi, MD
Patient and Internal Medicine Specialist
Weill-Cornell Medical College, New York
Quality-of-care issues impede our ability to sign-on as an in-network provider. Insurance companies have the right, with their network participants, to dictate treatments protocols for each specific diagnosis. Dr. Asher's success is based on his ability to develop highly individualized therapeutic plans that draw from a broad spectrum of integrative modalities.
If you have out-of-network coverage, and you have met your deductible, a significant portion or all of our fees should be reimbursed by your insurance carrier. Increasingly, more carriers are refusing to accept assignment from out-of-network practitioners and will only reimburse the subscriber directly. We are therefore unable to bill insurance companies directly, or accept insurance assignment of any kind, including Medicare.
As a courtesy, we offer to complete and mail claims on your behalf in order to assist you in obtaining timely reimbursement. While Dr. Asher is a licensed MD whose fees and services are considered "reasonable, usual, and customary" by most insurance companies, Benjamin Asher, MD, PC cannot guarantee or be responsible for any reimbursements. We always do our best to advise you in dealing with your insurance company, and provide them with whatever information they need to process your claim. However, because we do not contract directly with any carrier we cannot represent you in obtaining collections - nor is your plan provider likely to disclose the details of your coverage with our office.
We will contact insurance companies directly on the patient's behalf when ordering tests that require pre-certification and we are always available for troubleshooting.
It is your responsibility to understand your benefits and all the obligations set forth by your insurance company.
If coverage is a concern, please contact your carrier, prior to your first visit to ask them if your plan provides out-of-network coverage.
- If the answer is, "no" - and if you are part of an HMO, this likely is - then your visit will not be reimbursed. If finances are an issue, please call us to explore the possibility of other payment options and accommodations.
- If the answer is, "yes" you should find out: what your deductible is; how much of it you have met to date; what percentage they pay of "usual and customary" services once the deductible has been met (Dr. Asher attempts to set his fees at or near to what most carriers consider allowable); and if you need a referral from your primary care physician or other pre-approval prior to consulting a specialist such as Dr. Asher.
IMPORTANT NOTE: Whether you have in-network or out of network coverage - and HMO or a PPO - we STRONGLY recommend you clarify whether or not routine lab or imaging tests (i.e. blood work, CT scans) ordered by Dr. Asher - but carried out at an in-network facility - require a requisition from your primary care physician or other form of pre-approval. This is rarely the case, but not knowing could be a costly omission.
Medicare subscribers will receive Dr. Asher's "Opt-out" letter, which will allow you to collect from any secondary insurers. Dr. Asher is not a Medicare or Medicaid provider; Medicare and Medicaid will not cover any services provided by Benjamin F. Asher M.D, P.C.
||I often refer to my work as "Restorative ENT," because restorative means, "Healing, curative, uplifting, invigorating, soothing, recuperative; to return something back to an earlier and better condition; to reestablish strength and vigor."
It best describes my intention in approaching Ear, Nose, and Throat disorders: to facilitate the body's natural healing abilities as much as possible.
-- Dr. Asher
Benjamin F. Asher MD, PC cannot, at any time, be held responsible for the amount of reimbursement received.
We ask you to pay for our services in full at the time they are rendered, unless other arrangements have been made in advance.
Fees are assessed on time spent and procedures performed.
Initial consultation rate run 45 minutes to one hour.
Extended follow-up consultation run 20 to 30 minutes
Brief follow-up consultation run 10 to 15 minutes
Services included in the consultation fees (not all will apply to each patient):
- cranial osteopathy
- laryngial myorelease therapy
- myofacial release
- dietary counseling
- prescriptions for pharmaceuticals and nutritional supplements
- surgical second opinions and referrals
- instruction in stress reduction practices
- customized integrated treatment plan
Commonly performed procedures not included in the initial consultation (about half our new patients require one):
- Rigid nasal Endoscopy
- Flexible Laryngoscopy
- Laryngeal Stroboscopy
- Cerumen Removal
- Rapid Strep Tests
Additional costs may be incurred for externally provided services such as lab tests, prescriptions, supplements, or adjunctive therapies, if required.
Many of these additional costs may be covered by insurance - even if you have only in-network coverage.
We do our best to direct our patients with labs and radiology groups that directly bill and / or accept most insurance plans.
We do not sell supplements directly, or make a profit on their recommendation (or any other products, services, or lab tests we suggest).
We have arranged for wholesale direct prices, via mail order, for nutritional supplements whenever possible.
After your initial visit, you will have a better idea of the overall costs you are likely to incur. Some conditions require as few as one or two visits, others are more complex.
For a more detailed fee schedule, please call our office: 212-223-4225.
We accept cash, checks, American Express, Mastercard, and Visa.
A $25.00 fee will be assessed for all returned checks.
Again, Dr. Asher does not want finances to the barrier to you benefiting from his services. For patients who do not have out-of-network coverage (including those with extraordinarily high out-of-network deductibles) and cannot otherwise afford the visit, we offer a variety options and accommodations.
Please contact our office manager for more details.
As part of Dr. Asher's commitment to providing an extraordinary level of care, he allots a generous amount of time for each patient, does not "double-book" appointments, or run more than one exam room at a time.
In order to maintain our high-level of personalized service, each patient must adhere to our cancellation policy:
Established patients (after your initial visit with Dr. Asher):
- Cancellation OR RESCHEDULING of appointments must occur a minimum of 24 BUSINESS HOURS IN ADVANCE.
- We must charge in full for all appointments not cancelled or rescheduled with 24 hours notice.
Note: For Monday appointments, a cancellation on Friday (before the time of the appointment on Monday) is required to avoid fees.
This same is true for holidays: any changes in your appointment must be made on the prior business day, and before the time of your appointment (so please don't call us at 5:00 p.m. on a Friday before a three-day weekend if your appointment is for the following Tuesday at 9:00 a.m.)
- We must charge the FULL CONSULTATION FEE for same day cancellations, changes, and "no shows."
Please note: It does not matter how much we like you OR when you scheduled your appointment OR if we fill the slot - this policy holds for all appointments, even those made by our most loyal patients at the last minute (we get frequent emergency calls, so even if you made the appointment just a few hours prior, you may be holding a time someone else needs).
New Patients (prior to your first visit):
- You must confirm appointments 48 BUSINESS HOURS in advance to preserve your time slot.
We will give you a reminder call 72 hours in advance; we must either speak to you OR hear back from you in order to hold your appointment.
Note: this means Monday appointments must be confirmed or rescheduled by the previous Thursday; Tuesday appointments by Friday, etc.
This same is true for holidays: any changes in your appointment must be made two business days in advance, and before the time of your appointment (therefore, prior to a three-day weekend we will be confirming new patient appointments through the following Wednesday).
New patients who reschedule less than 48 hours in advance will be required to provide us with a deposit that covers the full new patient consultation fee in order to re-book an appointment.
- You maintain the right to cancel or reschedule your new patient appointment with no charge as long as you provide us with 48 hours notice.
- However, if you cancel or reschedule with less than 48 hours notice a second (or third) time, you will be responsible for the full new patient consultation fee.
We appreciate your understanding and cooperation in this matter.