Insurance Policy

Pediatrics East of New York accepts new patients and recommends that everyone confirm that we accept their insurance plan beforehand.

We accept the following insurance plans:

  • Aetna
  • Cigna
  • Empire Blue Cross Blue Shield (excluding HealthPlus Plan)
  • Oxford Freedom and Liberty (excluding Metro and Kaleidoscope Plans)
  • United Heathcare (excluding Compass Plan)
  • Multiplan/PHCS
  • 1199 NBF SEIU
  • New York State Empire Insurance
  • Humana Tricare Select plan

(NOTE: we do not accept community based or Medicaid affiliated plans).


Copays are collected at the time of the service (ie, sick visits). Outstanding copayments will be subject to a $50 service charge. If your account is past due we may use the credit card on file or be forced to send the account to a third party collections agency.  We will attempt to contact you first and make every effort to work with you so a payment schedule could be set up for the account. If you have switched insurance plans, it is your responsibility to provide the updated information at your earliest convenience to our billing staff to avoid potential billing and appointment scheduling conflicts.

Online Payments

For your convenience, our practice offers a secure way to pay your balance online through InstaMed.  Payment options include Mastercard, Visa, and Discover.

Primary and Secondary Insurance/Health plans

Children and adults can be covered under more than one heath plan. When you’re covered under multiple health insurance plans, the plans will have to coordinate you and your children’s benefits, this is one of the reasons a health plan wants to know if you or your spouse has any other coverage and will contact you on a yearly basis to establish co-ordination of benefits.

To prevent payment problems, when children are covered under each parent’s group health plan, one plan must be designated as “PRIMARY” and the other “SECONDARY.”  This must be verified with the insurance carriers to avoid problems. The plan that is primary pays the claims first. The secondary plan pays any remaining costs not covered by the primary plan dependent on the benefits of the specific policy-but only if the medical care is a “covered benefit.”  If both of your insurance consider themselves to be PRIMARY or consider themselves SECONDARY, then neither will cover your services. As always, insurances will not reimburse you for services they do not cover.

Failure to provide proper insurance information may result in your carrier refusing payments for the services provided by the practice on your behalf. If such the is the case, you, the member, will be held responsible for any unpaid balances. We urge you to call your insurance carriers for further details regarding their policies and to be sure which consider themselves PRIMARY and which is SECONDARY on your behalf.

Birthday Rule Determines Health Insurance Coverage

Under the birthday rule, the health plan of the parent whose birthday comes first in the calendar year (by month and day, not year) is the primary coverage for your children.  If you do not wish it to be the case, please contact your insurance carrier to switch the designation.

Referrals to Subspecialists

We ask you to contact our office staff if you need a referral for any specialist visits. We are NOT responsible for referrals called in after the specialist visits, as the insurance carriers have set time limits on the creation of the referrals. For example, Oxford insurance gives a 72hr window.

For further information, please contact our office ask for billing or email

Telephone visits

The COVID-19 pandemic has changed many things about how we, at Pediatrics East of New York, P. C., practice pediatric medicine.  Our utmost priority has always been to ensure the health and safety of our patients and families.  As your medical provider, keeping you home as much as possible to prevent our healthcare system from being overwhelmed has become part of our professional responsibility; this means we must provide a lot more medical care, virtually, than we have ever done before.  While we have never charged families in the past for telephone/electronic consultations (medical advice, diagnosis, treatment, etc.), we have seen a tremendous influx in these visits since the start of COVID-19.  Telephone care/email communication is an important tool to stay connected with our patients and families, especially in times where we are practicing social and physical distancing. Our doctors used to do 10-20 phone calls per week, but now are each doing over 50 calls per week.  We are happy to meet the patient demand and provide essential service, but we must begin charging for this essential service to make it fiscally sustainable going forward.   

As a result, we will be charging your insurance for telephone visits (including videos and pictures sent via electronic communication) with our doctors as it is part of telemedicine. Whether you have a cost share or not is determined by your insurance plan and policy.  Please verify with your own insurance carrier for details.  If you have questions about our policy, please contact our billing office at We appreciate your understanding and cooperation. 

In response to the COVID-19 outbreak, we are now offering Telemedicine/Video Visits and Rapid COVID PCR Testing in office. Meet with your doctor to get a prescribed treatment plan, refill or get a new prescription and much more all from the safety and comfort of your home.