Dr. Boettner participates with the following insurance plans
- Oxford Freedom Network and Liberty Network
- Oxford Medicare Advantage
- United Healthcare
- HMO[Choice Select]
- POS (Choice Plus, Select Plus)
- please talk to us if you have the Empire Plan
- United Exchange: United Health Care – Compass
- Choice Open Access Managed Choice
- Elect Choice
- Open Choice and other commercial plans
- Empire BCBS:
- PPO, EPO and INDEMNITY
- Anthem Blue Cross Blue Shield PPO, PPOB
- Connecticut Anthem Only specific cards check with the office
- Federal Employee Program
- HMO, POS, Healthy New York (HNY) cards
- Unicare Affiliated PPO
- Wellpoint PPO, EPO, Indemnity
- Empire BCBS Pathway:
- Pathway Enhanced
- Pathway X
- Pathway X Enhanced
- EPO, PPO, INDEMNITY
- HMO, POS
- all “Open Access” plans
- Emblem Exchange: Emblem –Select Care
- Emblem Health
- ConnectiCare (HMO, POS, PPO)
- HIP Healthy NY
- HIP HMO, POS, Open Access I and II
- HIP PPO / EPO / Indemnity
- VYTRA ASO
Hospital for Special Surgery participates with many insurance plans.
If Dr. Boettner does not participate with your particular insurance plan, you still may have coverage subject to the availability of “out-of-network” benefits. Please do not hesitate to contact Leslie Ann Brown ( ) in our office if you have questions regarding your insurance coverage.
We do provide care for patients with GHI and other plans with out of network benefits, please contact Leslie for more information.
Effective January 1st, 2015 our new Medicare status will be “Non-Participating Provider.” Not a lot will actually change for you. We will still be happy to provide medical care to you, however, we will ask you to pay at the time of service, and you will get reimbursed from Medicare directly at 87% of our charges. This is how this process works:
- You will be charged a Medicare limited charge rate which you will need to pay at the time of service and we will provide you a receipt.
- We will then bill Medicare on your behalf and Medicare will send payment directly to you in the mail and then forward the information to your secondary insurance as well. Overall you will only be responsible for approximately 13% of the charge.
- Your hospital stay and necessary medical testing, such as hospital charges, laboratory tests and x-rays, will be billed directly to Medicare, exactly the same as in the past.
Essentially as an example if you are seen for new patient consultation you may be charged approximately $205.80 at the time of the encounter. Medicare and your secondary insurance will then reimburse you $178.96 and you will ultimately pay $26.84.
Another example: for a follow up visit with injection you may be billed approximately $168.85 at the time of the encounter. Medicare and your secondary insurance will then reimburse you $147.06, and you will be responsible for $21.79 out of pocket.
If you are having a hip replacement you may be billed $2,075.40 immediately after the surgery. Medicare and your secondary insurance will then reimburse you $1,804.69, and you would be responsible for $270.71. The hospital charges will be submitted to your insurance from the hospital directly and nothing will change regarding the hospital charges.